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This information is about a hormonal treatment| for advanced prostate cancer| called abiraterone acetate (often shortened to abiraterone). It is also known as Zytiga®.
Abiraterone is a hormonal therapy. It's used to treat men with advanced prostate cancer| that has progressed during or after treatment with a docetaxel chemotherapy| regimen or other hormonal treatment.
Although abiraterone is licensed and can be prescribed in the UK, it has not been approved for use by the National Institute for Health and Clinical Excellence (NICE)|. NICE currently gives advice on which new drugs or treatments should be available on the NHS. As a result, abiraterone may not be widely available on the NHS.
We have more information on what you can do if a treatment isn’t available|.
Hormonal therapies interfere with the production or action of particular hormones. Hormones are substances produced naturally in the body. They act as chemical messengers and help control the activity of cells and organs.
The male hormone, testosterone, can help prostate cancer cells grow, and hormonal treatments are often used to try to slow down this growth. To produce testosterone, the body needs an enzyme called 17α-hydroxylase (CYP17). CYP17 is found in the testicles, adrenal glands and prostate cancer cells. Most hormonal therapies either stop the production of testosterone in the testicles or block it from connecting with the cancer cells. Abiraterone works by blocking CYP17 so that testosterone can’t be produced.
Abiraterone is available as 250mg white tablets.
Abiraterone tablets are taken once a day on an empty stomach. You should take abiraterone at least two hours after eating, and you shouldn’t eat for at least one hour after taking the tablets.
Many people find it’s best to take abiraterone before breakfast and wait for an hour before eating. The tablets should be swallowed whole with a glass of water, and they must not be chewed or crushed. Try to take abiraterone at approximately the same time every day. You’ll usually take four tablets daily, but sometimes your doctor may alter the dose.
You will also be given steroid| tablets called prednisolone. These should be taken every morning after breakfast. These help reduce some of the side effects of abiraterone. It’s important that you do not stop taking these steroid tablets unless advised by your doctor.
Abiraterone is given to treat prostate cancer that has spread to other parts of the body (advanced prostate cancer). If you’re already taking a hormonal therapy such as goserelin (Zoladex®)| or leuprorelin (Prostap®)|, your doctor may ask you to continue with your existing treatment while taking abiraterone.
Your doctor will discuss the length of treatment they feel is appropriate for your situation with you.
Each person’s reaction to any medication is different. Some people have very few side effects while other may experience more. The side effects described here won’t affect everyone having this treatment.
Abiraterone treatment is usually well tolerated. We’ve outlined the most common side effects but haven’t included those that are rare and therefore unlikely to affect you. If you do notice any effects that aren’t listed in this information, please discuss them with your doctor, nurse, specialist or pharmacist.
Abiraterone may cause a rise in blood pressure. Your blood pressure will be checked regularly. It’s important that you take your prednisolone tablets to avoid this.
Abiraterone and/or the steroids may affect the salt and water balance in your body. You may notice that your ankles and/or fingers swell. Some people have a bloated feeling in the abdomen. Let your doctor know if this happens. The steroid tablets should help reduce this side effect.
Feeling tired| is a common side effect of many cancer treatments. If this happens to you, it’s important to try to pace yourself and get as much rest as you need. Try to balance this with doing some gentle exercise, such as short walks, which will help. If tiredness is making you feel sleepy, don’t drive or operate machinery.
There is a risk of bladder infections while taking abiraterone. Let your doctor know if you need to pass more urine than usual or if you have pain when passing urine. If you develop a temperature above 38°C (100.4°F) and feel unwell, contact your doctor immediately.
If this happens, it's usually temporary and can be reversed with medication. Your heart function will be checked before treatment starts. You’ll also have regular blood tests to check a chemical in the blood called potassium. Changes in your potassium levels can affect the normal rhythm of the heart.
Treatment with abiraterone may cause changes in the way that your liver works. You're very unlikely to notice any problems, but your doctor will take regular blood samples to check that your liver is working properly. When you first start taking abiraterone, you may need to have blood tests as frequently as every two weeks.
Always let your doctor or nurse know about any side effects you have. There are usually ways in which they can be controlled or improved.
Some medicines, including those you can buy in a shop or chemist, can be harmful to take when you’re having abiraterone. Tell your doctor about any medicines you’re taking, including over-the-counter drugs, complementary therapies| and herbal drugs|.
It's not advisable to father a child while taking abiraterone, as it may harm the developing baby. It’s important to use effective contraception while taking this drug. You can discuss this with your doctor or nurse.
It’s not known whether this drug is present in semen. To protect your partner, it’s safest to use a barrier form of contraception while taking abiraterone.
If you’re admitted to hospital for a reason not related to your cancer, it’s important to tell the doctors and nurses looking after you that you’re having treatment for prostate cancer. You should also tell them the name of the drugs you’re taking. It’s important for the doctors to know you’re taking prednisolone. You should tell them the name of your cancer specialist so that they can ask for advice.
It’s a good idea to know who you should contact if you have any problems or troublesome side effects when you’re at home. During office hours, you can contact the clinic or ward where you had your treatment. Your nurse or doctor will tell you who to contact during the evening or at weekends.
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.