It's been a while since you posted this, but I thought I'd add my two cents. I'm a member of two social media sites related to prostate cancer, specifically metastatic cases so we're all battling lesions outside the prostate. Anyway, I've been on Orgovyx since February, finished my RT in September. Have had only one real medical companion since starting this journey in Nov 2023: my RT Oncologist. Because of its rural nature, the hospital does not have a permanent MO. So, I've seen 4 different MOs since March. It was my RT Oncolgist who recommended Orgovyx for me, not an MO. (She said the Lupron injections can be a little rough and it takes longer to recover one's T on it.) After finishing RT, the MO I did see wanted me to start abiraterone immediately: 1000mg, plus 5 mg Prednisone. I've read of serious side effects from this ARPI and in all cases the MO reduced the prescription from 1000mg to 500mg to stem the SEs. So, brilliant me, I decided I'd start myself on 500 mg of the abiraterone. The primary effect that I've noticed is increased brain fog and blood pressure. I'd finally gotten my high BP under control, due the Orgovyx, but it has crept up to the 150s, systolic, (still way down from the 200's in my early Orgovyx days). But it's tolerable and I've not needed the prescribed nausea medications. Two months since RT, my PSA has fallen to "undetectable" for the last two tests (< 0.02). I'm being tested monthly. Recently, after further thought, I am now bifurcating the prednisone into 2.5 mg. I am an engineer, after all. If I'm halving the abi, why not the prednisone? For a couple of days, I notice increased joint pain, but then it ceased. At this point, I'm tolerating both the Orgovyx and Zytiga well, as far as I know. The hospital has promised to tell me if my blood tests get out of whack, although they didn't say who's looking at them. My question regarding the reduced dosage of abiraterone is how do we know if it's not enough? As long as PSA levels remain low for the next two years, it would appear that the Stampede Trial's recommended regimen of ADT+ARPI is working. My original logic for reducing dosage is that the same quantity of abiraterone is prescribed whether one weighs 300lbs or 160lbs. I'm consulting with the "new" MO in Feb 2025. (Must be the rain in the PNW that chases them away.) I fully expect to have my wrists slapped, but until I can see a study of patients who are in the lighter weight category, taking a reduced dosage and faring poorly in their cancer battle, I will continue on my 500 mg of A+ 2.5 mg of P regimen. I'll report how my encounter with the new MO goes and how I fare over the next two years in my battle with PCa.