Abiraterone acetate (often shortened to abiraterone) is a hormone therapy drug used to treat advanced prostate cancer.
HOW DOES ABIRATERONE ACETATE WORK?
Hormones are substances produced naturally in the body. These act as chemical messengers and help control the activity of cells and organs. Hormone therapies interfere with the way hormones are made or formed in the body.
Most prostate cancers need the hormone testosterone to grow. Almost all of the testosterone in men is made by the testicles. A small amount is made by the adrenal glands, which are located above the kidneys.
Abiraterone lowers the amount of testosterone produced by the body. This lowers testosterone levels and may shrink the prostate cancer or stop its growth.
WHEN IS ABIRATERONE GIVEN?
Abiraterone is used to treat prostate cancer in men whose cancer has spread to other parts of the body (advanced cancer). It can be given alone or alongside other types of treatment. If you are taking some other hormone therapy drug such as goserelin (Zoladex®) or leuprorelin (Prostap®), your doctor may ask you to continue taking it while you are taking abiraterone.
Your doctor or nurse will explain how long you should take abiraterone.
TAKING YOUR ABIRATERONE TABLETS
You will take abiraterone in pill form once daily. Take it at the same time each day. Always take the pills exactly as your nurse or pharmacist has told you. This is important to ensure that it is working as well as possible.
You should take abiraterone on an empty stomach. Take is at least two hours after eating, and do not eat for at least an hour after taking the pills. Many people find that it is best to take abiraterone one hour before breakfast. Swallow the tablets whole with a glass of water – do not crush or chew them.
You will also be given steroids called prednisolone to take every day. These help reduce some of the side effects of abiraterone.
It is important that you not stop taking any of your pills if not told to do so by your doctor. Here are some important things to remember:
- Do not double the dose if you forget to take one of your pills. Just take your normal dose the next day.
- Keep the pills in their original packaging at room temperature. They should be stored away from heat and direct sunlight.
- Keep them safe and out of the reach of children.
- Get a new prescription before the one you have runs out, and keep track of holidays, when pharmacies may be closed.
- Return the remaining pills to the hospital if the treatment is discontinued.
POSSIBLE SIDE EFFECTS OF ABIRATERONE
You may experience some of the side effects mentioned here, though it is rare for a patient to have all of them. If you are taking other drugs, you may have certain side effects that are not listed here.
Always inform your doctor or nurse of the side effects you experience. They can prescribe drugs to help control them and can also give you advice on managing side effects. Do not stop taking abiraterone without talking to your doctor first.
You may feel tired or lacking in energy while taking abiraterone. Try to pace yourself if you feel tired. Try to strike a balance between getting enough rest and staying physically active. Evidence indicates that regular exercise may reduce tiredness in men who are having hormone therapy. Ask your doctor or nurse about what you can do.
If you feel drowsy, don't drive or operate heavy machinery.
ANEMIA (LOW RED BLOOD CELLS)
Abiraterone may lower your number of red blood cells. Red blood cells transport oxygen throughout the body. If you have a low number of red blood cells, you may be tired and short of breath. Tell your doctor or nurse if you feel like this.
HIGH BLOOD PRESSURE
Abiraterone may cause increased blood pressure. You will have regular blood pressure checks when taking this drug.
You may notice your legs and ankles become swollen because of the build-up of fluid. Let your doctor or nurse know if this happens. If your ankles and legs swell up, it may help to put your feet up on a stool or cushion. Steroids in pill form will help prevent this.
Most men can lose their sex drive and have erection difficulties during the hormone therapy. Things often return to normal after they stop taking the medication, though some keep having difficulties after the treatment is over. Your doctor can prescribe treatments to help with erection problems, though these do not influence sex drive.
If you need support in coping with sexual difficulties, your nurse or doctor can give you information and refer you to specialized support services.
MUSCLE OR BONE PAIN
If you have pain or stiffness in your muscles or bones, your doctor can prescribe painkillers to give you relief.
URINARY TRACT INFECTIONS
Talk to your doctor if you develop symptoms of a urinary tract infection. The symptoms include cloudy or foul-smelling urine or pain or discomfort when urinating.
Occasional, abiraterone can cause diarrhea. Drink plenty of fluids if this is the case—at least two liters a day. Your doctor can prescribe pills for diarrhea if necessary.
Occasionally, people develop mild skin rashes. This often gets better without treatment. Tell your doctor if you develop a rash.
CHANGES TO YOUR HEARTBEAT
Abiraterone may cause changes in your heartbeat. If this happens, it is usually temporary and can be treated with medication. You will have tests done to check on your heart before and during the treatment. You will also have periodic blood tests done to check a chemical in the blood called potassium.
Changes in the levels of potassium can affect the normal rhythm of the heart. Muscle weakness or spasms may also be signs that the level of potassium in your blood is low. You should contact your doctor or nurse if you have any of these symptoms.
POSSIBLE SIDE EFFECTS OF LONG-TERM USE OF ABIRATERONE
EFFECTS ON THE LIVER
Abiraterone can sometimes affect the liver. Your doctor will give you periodic blood tests to check on your liver. The effect is usually mild and does not prevent you from continuing to take abiraterone.
LEVELS OF BLOOD SUGAR
Steroids can increase your blood sugar levels. Your nurse will request that you have regular blood tests. The symptoms of raised blood sugar include a feeling of thirstiness, a need to urinate more frequently, and tiredness. 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 for your insulin dose to be changed.
BONE THINNING (OSTEOPOROSIS)
Over time, taking abiraterone increases the risk of bone thinning (osteoporosis). In some men, this may increase the risk of bone fractures. If necessary, your doctor can give you advice on controlling and treating this. Exercise such as walking and resistance exercises such as lifting weights can help keep your bones strong. Eating a healthy diet and not smoking will also help protect your bones. Tell your doctor if you have any discomfort in the bones or joints.
MORE INFORMATION ABOUT ABIRATERONE
Abiraterone can interact with other drugs. This includes medications that can be purchased in a store or pharmacy. Tell your doctor if you are taking any medicines, including over-the-counter drugs, complementary therapies, vitamins, and herbal remedies.
Your doctor will advise you not to conceive during the treatment. This is because the drugs can harm developing babies. It is important to use effective methods of contraception during chemotherapy and for a few months after the treatment ends. You can talk to your doctor or nurse about this.
If you have to go to the hospital for whatever reason other than cancer, tell the doctors and nurses that you are taking abiraterone. Explain to them that you are undergoing hormone therapy that no one should stop or restart if it is not done under the advice of a specialist doctor.