Abiraterone acetate (abiraterone or Zytiga®) is a hormonal therapy drug used to treat advanced prostate cancer. It is given with steroid tablets and sometimes with other types of hormonal therapy drugs. It is best to read this information with our general information about hormonal therapies and the type of cancer you have. 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. Hormones 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 the hormone 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 called prednisolone to take every day. Steroid tablets help reduce some of the side effects of abiraterone.
Always take the tablets exactly as explained. This is important to make sure they work as well as possible for you. Make sure you:
- Do not take the abiraterone tablets with food. Take them at least two hours after eating then do not eat for another hour. Many people take abiraterone an hour before breakfast.
- Swallow the abiraterone tablets whole with a glass of water.
- Do not chew or crush the abiraterone tablets.
- Take them at the same time every day.
If you forget to take the abiraterone or the steroid tablets, you should take the next tablets 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.
- Get a new prescription before you run out of tablets, and make sure you have plenty 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. Always tell your doctor, nurse or pharmacist about any side effects you have.
Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects. After your treatment is over, most side effects start to improve.
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’s important to contact your doctor if you have signs of infection such as:
- cloudy or smelly urine
- pain or discomfort when passing urine (peeing)
- feeling shivery
- sore throat or cough
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
Treatment may affect how your liver works. This is usually mild. You will have regular blood tests to check how well your liver is working. Tell your doctor if you have a history of liver disease.
This treatment may affect your skin. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day. The treatment may cause a rash, which may be itchy.
Always tell your doctor or nurse about any skin changes. They can give you advice and may give you creams or medicines to help. Any changes to your skin are usually temporary and improve when treatment finishes.
Most men lose their sex drive and have erection difficulties during hormonal therapy.
Your doctor can prescribe treatments to help with erection difficulties. But these treatments will not increase 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 pee (pass urine) 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 adjust your insulin or tablet dose.
Effects on the heart
Chemotherapy can affect the way the heart works. You may have tests to see how well your heart is working. These may be done before, during and sometimes after treatment. If the treatment is causing heart problems, your doctor can change the type of chemotherapy you are having.
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.
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.
Some medicines can affect the hormonal treatment or be harmful when you are having it. This includes medicines you can buy in a shop or chemist. Tell your cancer doctor about any drugs you are taking, including vitamins, herbal drugs and complementary therapies.
These tablets contain a type of sugar called lactose. If you have been told by a doctor that you cannot digest lactose (lactose intolerant) or other sugars, talk to your doctor before taking this drug.
Low salt diet
Abiraterone contains 27mg of sodium in 2 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 effective contraception during your treatment and for a few months afterwards. 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 that 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.