Abiraterone (ZYTIGA)

Prostate cancer, non-metastatic

Prostate cancer, metastatic castration-sensitive

Prostate cancer, metastatic castration-resistant

Prostate cancer, non-metastatic

• Dose – Oral: 1000 mg once daily continuously until disease progression or unacceptable toxicity
• Given in combination with prednisone and androgen deprivation therapy (ADT)

Prostate cancer, metastatic castration-sensitive

• Dose – Oral: 1000 mg once daily continuously until disease progression or unacceptable toxicity
• Given in combination with prednisone and androgen deprivation therapy (ADT) +/- docetaxel

Prostate cancer, metastatic castration-resistant

• Dose – Oral: 1000 mg once daily continuously until disease progression or unacceptable toxicity
• Given either in combination with prednisone or with olaparib + prednisone

Available as uncoated 250 mg tablets and film-coated 500 mg tablets. Tablets contain lactose. Tablets should NOT be crushed or broken. Store at room temperature.

Antiandrogen

Take on an empty stomach, no food for at least 2 hours before and at least 1 hour after the dose

If a dose is missed, patients should be instructed not to take the missed dose but to resume with the next scheduled dose.

Common: Peripheral edema, Hypertension.

Less Common: Hypokalemia, Fluid retention, Hepatotoxicity.

The adverse effects listed above are not exhaustive. Please refer to the relevant product monograph for full details.

Baseline before treatment: CBC & differential, platelets, bilirubin, ALT, alkaline phosphatase, creatinine, glucose, sodium, potassium, testosterone.

During treatment: CBC & differential, platelets, ALT, alkaline phosphatase, bilirubin, creatinine, glucose, sodium, potassium, blood pressure, testosterone, PSA.

• ‍For cycles 1 to 3: Monitor blood pressure, serum potassium, ALT, alkaline phosphatase, bilirubin every 2 weeks.

If clinically indicated: MUGA scan or echocardiogram.

• This drug can impact or be impacted by metabolic enzymes for absorption and excretion. Many drugs can also affect or be affected by these enzymes, so please consult with pharmacy to assess for interactions.
• Avoid grapefruit, grapefruit juice, Seville oranges, or Seville orange juice.
• Current drug interaction databases should be consulted for more information.

• Avoid in pregnancy and lactation.
• Increased mineralocorticoids effects from this drug may result in hypertension, hypokalemia, and fluid retention. Concomitant administration with corticosteroids reduces the incidence and severity of these adverse events.
• Avoid choosing spironolactone as a potassium-sparing diuretic because it may stimulate the androgen receptor and cause disease progression.

BC Cancer. BC Cancer Drug Manual. Abiraterone. Vancouver, British Columbia: BC Cancer Agency. Available at: http://www.bccancer.bc.ca/drug-database-site/Drug%20Index/Abiraterone_monograph.pdf. Updated August 1, 2017. Accessed January 22, 2024.

Lexicomp. Abiraterone Monograph. In: Lexi-Drugs. Hudson, Ohio: Lexi-Comp, Inc. Available at: https://online-lexi-com.qe2a-proxy.mun.ca/lco/action/doc/retrieve/docid/patch_f/2929479?cesid=8F1VZnjkqos&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Dabiaterone%26t%3Dname%26acs%3Dfalse%26acq%3Dabiaterone. Updated January 29, 2024. Accessed January 30, 2024.

Cancer Care Ontario. Abiraterone Monograph. Drug Formulary. Toronto, Ontario: Cancer Care Ontario. Available at: https://www.cancercareontario.ca/en/drugformulary/drugs/monograph/44251. Updated June 2021. Accessed January 22, 2024.Janssen Inc. ZYTIGA® Product Monograph. Toronto, Ontario. Updated March 9, 2018.