Abiraterone acetate (Zytiga®)
Abiraterone acetate (usually called abiraterone) is also known as Zytiga®. It is used to treat advanced prostate cancer.
Abiraterone acetate (abiraterone or Zytiga®) is a hormonal therapy drug used to treat advanced prostate cancer. It is given with steroid tablets. These help reduce some of the side effects of abiraterone.
Abiraterone is usually given with or after other types of hormonal therapy drugs, if these become less effective. Sometimes abiraterone is given as a first treatment along with other hormonal therapy drugs.
Your doctor will talk to you about this treatment and its possible side effects before you agree (consent) to have treatment.
Hormones are chemicals that our bodies make. They act as messengers and help control how cells and organs work. Hormonal therapies are drugs that change the way hormones are made or how they work in the body.
Prostate cancers need a hormone called testosterone to grow. Abiraterone reduces the amount of testosterone made by the body. This can help to control advanced prostate cancer.
Taking abiraterone tablets
Abiraterone comes as tablets you can take at home. You will also be given steroid tablets to take every day.
Always take the tablets exactly as explained. This is important to make sure they work as well as possible for you. Make sure you remember the following things:
- Do not take the abiraterone tablets with food. Take them at least 1 hour before or at least 2 hours after eating. Many people take abiraterone an hour before breakfast.
- Swallow the tablets whole with a glass of water.
- Do not chew or crush the tablets.
- Take them at the same time every day.
If you forget to take the abiraterone or steroid tablets, take the next dose as usual. Do not take a double dose. If you have missed more than one dose, tell your doctor or nurse straight away.
Other things to remember about your tablets:
- Keep them in the original package and at room temperature, away from heat and direct sunlight.
- Keep them safe and out of sight and reach of children.
- If you are sick just after taking the tablets, contact your healthcare team. Do not take another dose.
- Get a new prescription before you run out of tablets, and make sure you have enough for holidays.
- If your treatment is stopped, return any unused tablets to the pharmacist.
Your nurse or pharmacist may also give you other medicines to take home. Take all your medicines exactly as they have been explained to you. Do not stop taking any of your medicines unless your doctor tells you to.
We explain the most common side effects of this treatment here. We also include some less common side effects.
You may get some of the side effects we mention, but you are unlikely to get all of them. If you are also having treatment with other cancer drugs, you may have some side effects that we have not listed here.
You will see a doctor, nurse or pharmacist regularly while you are having this treatment. Always tell them about any side effects you have. They can give you drugs to help control most side effects. They can also offer advice to help you cope.
Most side effects can be managed. But sometimes side effects are harder to control. It is important not to stop taking hormonal therapy without telling your doctor. If side effects cannot be managed, your doctor may suggest you take a different type of hormonal therapy.
Serious and life-threatening side effects
Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.
Contact the hospital
Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.
We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) for more detailed information.
Build-up of fluid
You may put on weight or your ankles and legs may swell because of fluid building up. Tell your doctor or nurse if you notice this. If your ankles and legs swell, it can help to put your legs up on a foot stool or cushion.
Low blood potassium
Abiraterone can cause low levels of potassium in the blood. You will have regular blood tests to check your potassium levels.
If your levels are very low, you may need treatment and your doctor may tell you to stop taking abiraterone. Symptoms of low potassium levels include:
- twitching muscles
- feeling that your heart is beating harder or faster than usual.
If you notice these symptoms, tell a doctor straight away.
High blood pressure
Risk of infection
Abiraterone can make you more likely to get an infection. The most common type of infection when you are taking this drug is a urine infection. Some men develop serious infections and need treatment in hospital. It is important to contact your doctor if you have signs of infection such as:
- cloudy or smelly urine (pee)
- pain or discomfort when passing urine (peeing)
- feeling shivery
- sore throat or cough
Anaemia (low number of red blood cells)
This treatment can reduce the number of red blood cells in your blood. Red blood cells carry oxygen around the body. If the number of red blood cells is low, this is called anaemia. You may have symptoms such as:
- pale skin
- lack of energy
- feeling breathless
- feeling dizzy and light-headed.
Tell your doctor or nurse if you have these symptoms.
If you are very anaemic, you may need a drip to give you extra red blood cells. This is called a blood transfusion.
Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can give you more energy. If you feel sleepy, do not drive or operate machinery.
Hot flushes and sweats
Hot flushes are a common side effect of this treatment. During a flush, your neck and face may feel warm and look red. Flushes may last from a few seconds up to 10 minutes. You may have sweats and then feel cold and clammy. Some people feel anxious or irritable during a hot flush.
There are things you can do to try to reduce flushes:
- Wear clothes made from natural fabrics, such as cotton.
- Wear layers of clothes that you can remove if you feel hot.
- Use cotton bed sheets and have layers of bedding that you can remove if you feel hot.
- Keep room temperatures cool or use a fan.
- Have cold drinks rather than hot ones. Try to avoid drinks with caffeine in them.
You may have fewer hot flushes and sweats as your body adjusts to hormonal treatment. Or your doctor can prescribe drugs to help. Flushes and sweats usually stop a few months after treatment finishes, but some people continue to have them.
You can read more about coping with hot flushes.
While taking abiraterone, you may have diarrhoea which is not caused by an infection. Your doctor can prescribe anti-diarrhoea tablets if needed. Drink plenty of fluids if you have diarrhoea – at least 2 litres (about 3½ pints) a day.
You may feel sick or have indigestion while taking this drug. This is usually mild. Your doctor can give you tablets to help if needed.
Effects on the liver
This treatment may affect how your liver works. This is usually mild. You will have blood tests to check how well your liver is working.
This treatment may affect your skin. It may cause a rash, which might be itchy. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day.
Always tell your doctor or nurse about any changes to your skin. They can give you advice and may prescribe creams or medicines to help. Skin changes usually improve when treatment finishes.
Most men lose their sex drive and have erection problems during hormonal therapy. Things often return to normal after you stop taking the drug. But some men continue to have problems after treatment is over. Your doctor can prescribe treatments to help with erection problems. But these treatments will not increase your sex drive.
Raised blood sugar levels
This treatment can raise your blood sugar levels. If you have a raised blood sugar level, you may:
- feel thirsty
- need to pass urine (pee) more often
- feel tired.
Tell your doctor or nurse if you have these symptoms.
If you have diabetes, your blood sugar levels may be higher than usual. Your doctor will talk to you about how to manage this. You may need to change your insulin or tablet dose.
Effects on the heart
This treatment can affect the way your heart works. Your doctor may do tests to see how well your heart is working. You may have these tests before, during, and sometimes after treatment.
Contact a doctor straight away if you:
- have pain or tightness in your chest
- feel breathless or dizzy
- feel your heart is beating too fast or too slowly.
Other conditions can cause these symptoms. But it is important to get them checked by a doctor.
Raised cholesterol level
This treatment can raise the level of cholesterol (a fatty substance) in the blood. You may have a blood test to check the level of cholesterol. Your doctor may give you medicines to control your cholesterol levels.
Bone thinning (osteoporosis)
If you take this treatment for several months or more, you may get bone thinning. This is called osteoporosis. This can increase your risk of a broken bone (fracture). You may have bone density scans to check your bone health before and during treatment.
Doing regular exercise, such as walking, can improve your bone health. Eating a healthy diet can help too. Your doctor may prescribe drugs called bisphosphonates to help protect your bones. They may also advise you to take calcium and vitamin D supplements.
Muscle or joint pain
You may get pain in your muscles or joints. If this happens, tell your doctor so they can give you painkillers. Being physically active may help with the pain and keep your joints flexible. Keeping to a healthy weight may help too. Tell your doctor or nurse if the pain does not get better.
Blood in the urine
This treatment can cause blood in the urine (pee). Tell your doctor or nurse if you notice this.
Effects on the lungs
This treatment can cause changes to the lungs, but this is rare. Tell your doctor if you develop:
- a cough
- a fever (high temperature)
You should also tell them if any existing breathing problems get worse. You may have tests to check your lungs.
Adrenal gland problems
This treatment can cause problems with the adrenal glands, but this is not common. The adrenal glands sit at the top of the kidneys and produce hormones. If they do not produce enough of certain hormones, it can affect the levels of salt in your body.
Tell your doctor if you:
- feel tired and exhausted
- crave salty food
- feel dizzy and light-headed when standing up.
Some medicines can affect how this treatment works or be harmful when you are having it. Always tell your cancer doctor about any drugs you are taking or planning to take, such as:
- medicines you have been prescribed
- medicines you buy in a shop or chemist
- vitamins, herbal drugs and complementary therapies.
Tell other doctors, pharmacists or dentists who prescribe or give you medicines that you are having this cancer treatment.
You can visit the electronic Medicines Compendium (eMC) for more detailed information about your treatment.
Blood clot risk
Cancer and some cancer treatments can increase the risk of a blood clot. Symptoms of a blood clot include:
- throbbing pain, redness or swelling in a leg or arm
- suddenly feeling breathless or coughing
- sharp chest pain, which may be worse when you cough or take a deep breath.
If you have any of these symptoms, contact the hospital straight away on the 24-hour contact number you have been given. If you cannot get through to your doctor, call the NHS urgent advice number on 111.
A blood clot is serious, but it can be treated with drugs that thin the blood (anticoagulants). Your doctor or nurse can give you more information.You can help reduce the risk of developing a blood clot by:
- staying active during treatment
- drinking plenty of fluids, especially water.
You may be given anticoagulants to help prevent a clot.
Problems with lactose
These tablets contain a type of sugar called lactose. If you have been told by a doctor that you cannot digest some sugars or are lactose intolerant, talk to your doctor before taking this drug.
Abiraterone contains 27mg of sodium in two tablets. Tell your doctor if you are on a low-salt (low-sodium) diet.
Some drugs can affect whether you can make someone pregnant.
There may be ways to preserve your fertility. If you are worried about this, it is important to talk with your doctor before you start treatment.
Your doctor will advise you not to make someone pregnant while having this treatment. The drug may harm the developing baby. It is important to use a condom plus another effective form of contraception during your treatment. It is also important to use a condom if you have sex with someone who is pregnant.
Your doctor or nurse can give you more information about this.
Medical and dental treatment
If you need medical treatment for any reason other than cancer, always tell the doctors and nurses you are having cancer treatment. Give them the contact details for your cancer doctor so they can ask for advice.
If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having cancer treatment.