Zytiga Dosage, forms & strengths
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Zytiga (abiraterone acetate) is a type of androgen deprivation therapy that is manufactured by Janssen Biotech, Inc. It is FDA-approved along with prednisone to treat advanced prostate cancer that has spread to other parts of the body.
What is Zytiga’s mechanism of action?
Zytiga is a CYP17 inhibitor that works through the inhibition of testosterone production in the testicles and prostate tumor tissues. Testosterone is necessary for certain types of prostate cancer to grow. Zytiga can also cause a mineralocorticoid excess. High mineralocorticoid levels can cause you to have a salt and water imbalance. Prednisone is taken in combination with Zytiga to help reduce adverse effects related to increased mineralocorticoid levels.
Zytiga dosage forms and strengths
- 250mg uncoated tablet
- 500mg film-coated tablet
- Metastatic CRPC: Zytiga 1,000mg by mouth once a day with prednisone 5 mg by mouth twice a day.
- Metastatic castration-sensitive prostate cancer (CSPC): Zytiga 1,000mg by mouth once a day with prednisone 5 mg by mouth once a day.
Patients receiving Zytiga should also receive a gonadotropin-releasing hormone (GnRH) along with it if they haven’t had surgery to remove both testicles (bilateral orchiectomy).
Zytiga dosage restrictions
- No dosage adjustment is necessary for patients with renal impairment.
- The recommended dose of Zytiga is 250mg once a day in patients with baseline moderate hepatic impairment (Child-Pugh Class B).
- Zytiga should not be used in patients with baseline severe hepatic impairment (Child-Pugh Class C).
- Zytiga should not be taken along with strong CYP3A4 inducers such as carbamazepine and phenytoin. If they must be taken together, increase Zytiga to twice a day during the co-administration period. If the inducer is discontinued, reduce the Zytiga frequency back to once a day.
How to take Zytiga
- Read the Full Prescribing Information, Patient Information, and Medication Guide that comes with this medication.
- Take this medication exactly as your doctor prescribes it to you. Do not change your dose or stop taking this medication without discussing it with them first.
- This medication is taken once a day on an empty stomach. You should not eat 2 hours before or 1 hour after taking this medication.
- Swallow Zytiga tablets whole with water. Do not chew or crush Zytiga tablets.
- If you miss a dose of Zytiga, wait and take your usual dose the next day. If you miss more than 1 dose of this medication, call your doctor.
- While on Zytiga, your doctor will perform blood tests to check for adverse effects.
- Pregnant women or those who may become pregnant should not touch uncoated Zytiga tablets or other broken, damaged, or crushed tablets without wearing gloves. It may cause toxicity to the unborn child.
Zytiga dosage FAQs
What are some side effects of Zytiga?
Some common adverse reactions to Zytiga seen in clinical trials when compared to placebo include:
- Hypertension (high blood pressure)
- Hyperglycemia (high blood sugar)
- Arthralgia (joint pain)
- Upper respiratory infection
- Urinary tract infection (UTI)
- Increased cholesterol and triglycerides levels
- Fluid retention
- Muscle weakness
Zytiga can sometimes cause more serious side effects, including:
- Severe, hypersensitivity reactions (hives, swelling of the face or throat, and shortness of breath)
- Irregular heartbeats and torsades de pointes due to QT prolongation
- Adrenocortical insufficiency due to corticosteroid use
- Hypokalemia (low potassium levels)
- Increased alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels
- Liver problems including hepatotoxicity
- Increased incidence of bone fractures
Contact your doctor for medical advice about any side effects you experience while taking Zytiga. You can report your side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
What are some drug interactions with Zytiga?
The use of Zytiga with other medications can change how they work or increase the frequency and severity of side effects. Make sure your healthcare professional is aware of all the prescription drugs, over-the-counter medications, vitamins, and herbal supplements you are currently taking, including:
- CYP3A4 inducers such as rifampin and phenytoin
- Tucatinib (CYP2C8 enzyme substrate)
- Dextromethorphan (CYP2D6 substrate)
Are there any contraindications or precautions with Zytiga?
Zytiga is contraindicated in patients who have a known hypersensitivity to abiraterone acetate or any of the inactive ingredients in its formulation. The use of Zytiga along with prednisone/prednisolone should not be used with certain types of radiation. You should use Zytiga with caution if you have heart failure, cardiovascular disease, ventricular arrhythmias, diabetes, or adrenal gland problems.
Is it safe to use Zytiga while pregnant or breastfeeding?
Zytiga should not be used in female patients. Men who have female partners who can get pregnant should use effective birth control during Zytiga treatment and for 3 weeks after the last dose. There have not been any clinical studies that looked at whether Zytiga is found in breast milk or the effects it could have on the breastfed infant. You should discuss the risks and benefits of Zytiga with your healthcare provider if you have a female partner that may become pregnant while on this medication.
What is the main use of Zytiga?
Zytiga is used to increase the overall survival rate of men with:
- Metastatic castration-resistant prostate cancer (CRPC)
- Metastatic high-risk castration-sensitive prostate cancer (CSPC)
How do you know if Zytiga is working?
Your doctor may perform a blood test to check your prostate-specific antigen (PSA) every 2 or 3 months. While this alone doesn’t specifically show that the cancer has stopped growing, it does indicate that Zytiga is doing its job.
What happens if you take Zytiga with food?
Taking Zytiga with food can cause up to ten times more of it to be absorbed by your body and increase the risk of adverse effects.
Why do you have to take prednisone with Zytiga?
Zytiga inhibits your adrenal glands from making cortisol. Prednisone is used to increase cortisol levels back to normal to help reduce the risk of low potassium levels, edema, hypertension, or arrhythmias.
Will there be lab monitoring needed with Zytiga?
You should be monitored for high blood pressure, low potassium, and fluid retention at least once a month. You should also have liver function tests, including serum transaminases (ALT and AST) and total bilirubin before starting treatment, then every 2 weeks for the first 3 months of Zytiga treatment. After the first 3 months, you should be tested once a month thereafter.
What is the cost of Zytiga?
The average cost of #120, generic Zytiga 250mg tablets is over $4,700.
How often does Zytiga need to be taken?
Zytiga is taken one time a day on an empty stomach. You should not eat food at least 2 hours before and 1 hour after taking this medication.
How do you store Zytiga tablets?
You should store Zytiga tablets at room temperature between 68°F to 77°F (20°C to 25°C)
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