Abiraterone acetate (Zytiga®)

Abiraterone acetate is usually called abiraterone. It is a hormonal therapy drug. Abiraterone is 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 therapy and the type of cancer you have. 

Your cancer team will talk to you about this treatment and its possible side effects before you agree (consent) to have 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.

You have abiraterone as tablets you can take at home. You will also be given steroid tablets to take every day. This is usually a steroid called prednisolone.

During your treatment, you will meet someone from your cancer team, such as a:

• cancer doctor
• specialist nurse
• specialist pharmacist. 

This is who we mean when we mention doctor, nurse or pharmacist in this information.

Your cancer team will discuss your treatment plan with you.

Always take the tablets exactly as they tell you to. This is important to make sure they work as well as possible for you. Make sure you:

• do not take abiraterone tablets with food.
• do not eat anything for 2 hours before taking the tablets and for 1 hour after
• swallow them whole with a glass of water
• do not chew, break or crush them
• take them at the same time every day.

If you forget to take the abiraterone or steroid tablet, take your usual dose the following day. Do not take a double dose. If you have missed more than 1 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 moisture, heat and direct sunlight.
• Keep them safe, where children cannot see or reach them.
• If you are sick (vomit) just after taking them, do not take an extra dose. Take your next dose at the usual time.
• Get a new prescription before you run out, and make sure you have plenty for holidays.
• Do not throw away unused tablets. Return them to a pharmacy.

Your cancer team may also give you other medicines to take home. Take all your medicines exactly as they tell you to.

The amount of prednisolone you take may need to change if you have a medical emergency. Your doctor will tell you if you need to change the amount. Do not stop taking any of your medicines unless your doctor tells you to.

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.

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 a serious and potentially life-threatening complication of an infection (sepsis) and need urgent treatment in hospital. If you have any of the following symptoms, contact the hospital straight away on the 24-hour number:

• urine (pee) that is cloudy or strong smelling, or that contains blood 
• passing urine more often than usual
• pain or discomfort when you pass urine
• a temperature above 37.5°C
• a temperature below 36°C
• you feel unwell, even with a normal temperature
• feeling shivery and shaking
• sore throat or cough
• diarrhoea
• breathlessness

It is important to follow any specific advice your cancer treatment team gives you.

This treatment may cause diarrhoea. Diarrhoea means passing more stools (poo) than is normal for you, or having watery or loose stools. You may also have stomach cramps. If you have a stoma, it may be more active than usual. 

If you are passing loose stools 3 or more times a day and this is not normal for you, contact the hospital as soon as possible on the 24-hour number. Follow the advice they give you about:

• taking anti-diarrhoea medicines 
• drinking enough fluids to keep you hydrated and to replace lost salts and minerals
• any changes to your diet that might help. 

They might also ask you for a specimen of your stool to check for infection.

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.

Contact the hospital straight away on the 24-hour number if you have any of these symptoms during treatment:

• breathlessness
• dizziness
• changes to your heart beat
• swollen feet and ankles

Other conditions can cause these symptoms, but it is important to get them checked by a doctor.

Always call 999 if you have:

• chest pain, pressure, heaviness, tightness or squeezing across the chest 
• difficulty breathing.

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.

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.

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.

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.

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.

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

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.

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: 

• medicines you have been prescribed
• medicines you buy in a shop, pharmacy or online
• vitamins or supplements 
• herbal drugs and complementary or homeopathic therapies
• recreational drugs – for example, cannabis.

This treatment may contain lactose. If you have a lactose allergy or intolerance, ask your doctor, nurse or pharmacist for more information.

Your doctor, nurse or pharmacist 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 treatment and for a while after it finishes.

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.

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.