Abiraterone acetate (Zytiga®)

Abiraterone acetate (usually called abiraterone) is also known as Zytiga®. It is used to treat advanced prostate cancer.

What is abiraterone acetate (Zytiga®)?

Abiraterone (Zytiga®) is a hormonal therapy drug used to treat advanced prostate cancer. It is given with steroid tablets which can help reduce some side effects.

Abiraterone is usually given with (or after) 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. 

More information about this treatment

This information is correct at time of publishing. But sometimes the types of cancer this treatment is used for, or treatment side effects, may change between revision dates.

You can talk to your cancer team if you want more detailed information about this treatment. Or visit the electronic Medicines Compendium (eMC) website, which has patient information leaflets (PIL) for individual drugs.

How abiraterone works

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 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 drugs to take every day. Your nurse or doctor will talk to you about your treatment plan.

Always take the tablets exactly as explained. This is important to make sure they work as well as possible for you. Important things to remember:

  • Do not take abiraterone tablets with food. Take them at least 1 hour before food, or at least 2 hours after eating. Many people take them an hour before breakfast.
  • Swallow them 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 tablet, 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 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. 

About side effects

We explain the most common side effects of this treatment here. We also include some that are less common.

You may get some of the side effects we mention, but you are unlikely to get all of them. And you may have some side effects, including rarer ones, that we have not listed here. 

Other cancer treatments may cause different side effects. If you are also having other cancer treatment, you may have other side effects.

When you have this treatment, you will have regular appointments with a doctor, nurse or pharmacist. Always tell them about any side effects you have. They can give you: 

  • drugs to help control most side effects 
  • advice about managing side effects. 

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 a different type of hormonal therapy.

Serious and life-threatening side effects

Some cancer treatments can cause serious side effects. Sometimes, these may be life-threatening. Your doctor, nurse or pharmacist can explain the risk of these side effects to you.

Contact the hospital

Your doctor, nurse or pharmacist will give you 24-hour contact numbers for the hospital. If you feel unwell or need advice, you can call at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.

Common side effects

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 include: 

  • weakness 
  • twitching muscles 
  • feeling that you heart is beating harder or faster than usual. 

If you notice these symptoms, contact the hospital straight away on the 24-hour number.

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 people can develop serious infections and need treatment in hospital. It is important to contact your doctor straight away if you have signs of infection such as:

  • cloudy or smelly urine (pee)
  • pain or discomfort when passing urine (peeing)
  • feeling shivery
  • fever
  • sore throat or cough
  • diarrhoea.

High blood pressure

Tell your doctor or nurse if you have ever had any problems with your blood pressure. You will have regular blood pressure checks when taking this drug. Let your doctor or nurse know if you have any headaches.

Diarrheoa

While taking abiraterone, you may have diarrhoea which is not caused by an infection. Your doctor may prescribe anti-diarrhoea tablets if needed. If you have diarrhoea, drink plenty of fluids. Aim for at least 2 litres (about 3½ pints) a day.

Feeling tired (fatigue)

Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest between activities.

Being physically active can help to manage tiredness and give you more energy. It also:

  • helps you sleep better
  • reduces stress
  • improves your bone health.

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. If you have white skin, your skin may look red. If you have black or brown skin, your skin colour may deepen. Flushes can last up to 5 minutes. You might also have sweats or feel anxious or irritable during a flush. 

Here are some things you can do to reduce the effects of hot flushes:

  • Wear natural fabrics, such as cotton.
  • Wear layers so you can remove clothes as needed. 
  • Use cotton sheets and layers of bedding you can remove. 
  • Try cooling pads or pillows to keep you cool.
  • Keep rooms cool or use a fan.
  • Have cold drinks and avoid caffeine and alcohol. 

You might have fewer hot flushes as your body adjusts to this treatment. You could try therapies to help you cope with hot flushes, such as:

  • talking therapies like cognitive behaviour therapy (CBT)
  • controlled breathing exercises
  • yoga
  • acupuncture. 

If they do not improve, talk to your doctor. Certain drugs can help to improve hot flushes. 

Flushes usually stop a few months after treatment ends. But some people continue to have them.

Sexual effects

It is common to lose your sex drive and have erection difficulties with hormonal therapy. Hormonal therapy may also make your penis shorter and your testicles smaller. 

Your doctor can prescribe drugs and treatments to help with erection difficulties. These will not increase your sex drive. But they might work, even with a low sex drive. 

Things can improve a few months after you stop taking the drug. But it depends on how long you take hormonal therapy, and what other treatments you have had. Some people continue to have problems after treatment ends.

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. If your liver is affected, your doctor may need to reduce your dose or stop treatment for a while.

Indigestion

You may have indigestion while taking abiraterone. Your doctor can give you medication to help if needed.

Skin changes

This treatment can affect your skin. It may cause a rash, which may be itchy. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using soap-free cleansers and unperfumed moisturising cream every day. 

Always tell your doctor or nurse about any skin changes. They can give you advice and may prescribe creams or medicines to help. Changes to your skin usually improve when treatment ends.

Raised blood sugar levels

This treatment can raise your blood sugar levels and increase the risk of diabetes. 

Signs of raised blood sugar include:

  • feeling thirsty
  • needing to pass urine (pee) more often than usual
  • feeling more tired than usual. 

Tell your doctor or nurse if you have these symptoms. They can do tests to check your blood sugar level and give you advice.

If you already have diabetes, your blood sugars may be higher than usual. You may need to check them more often, or make changes to your diabetic treatment. Your diabetic doctor or nurse will talk to you about how to manage this.

Effects on the heart

This treatment might increase certain risk factors for heart problems. Tell your doctor if you have:

  • had any problems with your heart
  • high blood pressure
  • high levels of cholesterol – a fatty substance in your blood. 

They can monitor or treat these if needed. Talk to your doctor if you are worried about this. 

Things you can do to take care of your heart include:

  • not smoking
  • maintaining a healthy weight 
  • being physically active.

Raised cholesterol level

This treatment can raise the level of cholesterol. This is a fatty substance in the blood. You may have a blood test to check the level of cholesterol. Your doctor may refer you to a dietitian for advice on diet, or prescribe medicines to control your cholesterol levels.

Bone thinning (osteoporosis)

Taking this treatment for several months or more can increase the risk of bone thinning. This is called osteoporosis. It can make you more likely to get a broken bone (fracture). 

You may have bone density scans to check your bone health before and during treatment. These scans can diagnose osteoporosis or osteopenia (low bone density) so that it can be monitored. If your scan shows osteoporosis, your doctor usually prescribes:

  • drugs to protect your bones called bisphosphonates
  • calcium and vitamin D supplements. 

Regular exercise where you support your body weight, like walking, running and dancing, can help look after your bones. This is called weight-bearing exercise. Other types of strength exercises are also helpful. If you have any bone thinning or the cancer is affecting your bones, get advice from your cancer team first. 

Eating a healthy diet and not smoking also helps take care of your bones.

Muscle or joint pain

You may get pain in your muscles or joints. If this happens, tell your doctor or nurse. They can give you advice and painkillers or other drugs to help. Being physically active and keeping to a healthy weight may help with the pain. It can keep your joints flexible and reduce stress on them. If the pain does not get better, tell your doctor or nurse. They may talk to you about changing to a different hormonal drug.

Blood in the urine

This treatment can cause blood in the urine (pee). Tell your doctor or nurse if you notice this.

Less common side effects

Effects on the lungs

This treatment can cause changes to the lungs, but this is rare. Tell your doctor if you develop:

  • a cough
  • wheezing
  • a fever (high temperature)
  • breathlessness.

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.

  • feel tired and exhausted
  • crave salty food
  • feel dizzy and light-headed when standing up.

Other information

Blood clot risk

Cancer and some cancer treatments can increase the risk of a blood clot. Contact the hospital straight away on the 24-hour number if you have any of these symptoms during or after treatment:

  • throbbing pain or swelling in a leg or arm
  • reddening of the skin in the area – if you have black or brown skin, this can be harder to notice, but the skin might become darker
  • suddenly feeling breathless or coughing.

Always call 999 if you have:

  • chest pain
  • difficulty breathing.

A blood clot is serious, but it can be treated with drugs called anticoagulants. These thin the blood. Your doctor, nurse or pharmacist can give you more information about preventing and treating blood clots.

Other medicines

Some medicines can affect how this treatment works or be harmful while you are having it. Always tell your cancer doctor, nurse or pharmacist about any drugs you are taking or planning to take, such as: 

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.

Low salt diet

Abiraterone contains 27mg of sodium in 2 tablets. Tell your doctor if you are on a low salt (low sodium) diet.

Fertility

Some cancer drugs can affect whether you can get pregnant or make someone pregnant. If you are worried about this, it is important to talk with your doctor before you start treatment.

Contraception

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 healthcare professional that you are having cancer treatment. Give them the contact details for your cancer doctor or cancer team so they can ask for advice.

If you have appointments with a dentist, always tell them you are having cancer treatment. Talk to your cancer team before you have any dental treatment.

About our information

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert health professionals and people living with cancer.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

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We want everyone affected by cancer to feel our information is written for them.

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We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

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Date reviewed

Reviewed: 01 February 2022
|
Next review: 01 August 2024
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

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