Food and drug interactions are often unpredictable. That is why people taking warfarin are counseled to avoid leafy vegetables that could reverse the effects of this anticoagulant. People with high cholesterol taking a statin-type cholesterol-lowering drug may be advised to avoid grapefruit. Not all statins are affected by grapefruit, but the fruit or its juice can raise blood levels of atorvastatin, lovastatin and simvastatin. Are there interactions that could affect Zytiga?
Taking Zytiga with Cereal or Toast:
A new study suggests that this expensive prostate cancer drug is more effective if taken with a low-fat meal. Abiraterone (Zytiga) can cost as much as $9,000 a month.
Patients may have to take this drug for a year or more. One benefit of Zytiga is that metastatic prostate cancer continues to respond to this drug several months longer than the alternative, enzalutamide (Xtandi) (Pilon et al, Journal of Managed Care and Specialty Pharmacy, Feb. 2017). Copays can be as much as $3,000 a month, so costs mount up.
The study included 72 men with recurrent prostate cancer. They were randomly assigned to one of two groups. Half the men took Zytiga on an empty stomach at a standard dose. The other half took one-fourth the dose with a low-fat breakfast.
Despite the dramatic difference in dose, the medicine worked equally well in both groups. Those taking the drug with food had fewer digestive tract side effects.
Don’t Take Zytiga with a High-Fat Meal:
Taking abiraterone with a high-fat meal could result in much higher blood levels, leading to side effects such as hot flashes, fatigue, cough, high blood pressure or swelling in the legs or joints. The interaction with high-fat foods is much less predictable. Consequently, men on this regimen should stay away from bacon and fried eggs for breakfast.
ASCO’s 2017 Genitourinary Cancers Symposium in Orlando, FL