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Xtandi and Lupron: Possible drug interaction with spironolactone?
I have been recently diagnosed with prostate cancer with Mets (lymph nodes) and am being treated with Lupron Depot and Xtandi. Due to a rise in BP, my cardiologist prescribed spironolactone 25 mg two times a day. I know there has been shown to be an interaction between abiraterone and spironolactone that caused a rise in PSA and tumor progression, but I haven't seen anything like that regarding Lupron/Xtandi and spironolactone. Does anyone have any information that might help me decide whether or not to take the spironolactone? Thanks!
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Hi @ronnieh, this is a new one for me. But I have some members who might be able to offer ideas or experiences about prostate treatments and possible interactions with heart meds, like @markheuer @dirtdancer @dakotarunner @hbp who have or are taking enzalutamide (Xtandi). And @ruste is taking Plavix along with Xtandi for heart issues and may have thoughts to share.
Heart issues can be a concern with some treatment options. You may ask about a cardio-oncology specialist or department.
Mayo Clinic offers a program to address heart problems associated with cancer treatment called cardio-oncology or for people who have a pre-existing heart condition when diagnosed with cancer. The Cardio-Oncology Clinic (https://www.mayoclinic.org/departments-centers/cardio-oncology-clinic/overview/ovc-20442193) evaluates people prior to cancer treatment and patients who have experienced side effects due their treatment, and can help evaluate treatment when you have both cancer and heart conditions.
Another option is to discuss with on oncology pharmacist.
Do you have access to a similar cardio-oncology program or a knowledgeable pharmacist?
The main side effect from Xtandi for me is chills and I have not read of any side effects for the heart; however Xtandi is a powerful drug and the interaction with other drugs is something I don’t know about
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1 ReactionI have had heart issues for many years prior to any of my prostate adventures. First stent was placed 22 years ago, and two more stents were placed 2 years ago and started Plavix to protect the stents. Started Lupron plus Xtandi a year ago when my PC metastasized. Although all my doctors have copies of all my meds, neither my cardiologist nor my PC oncologist identified any drug interactions. The potential interaction between Plavix and Xtandi was brought to my attention by my pharmacist when I went to refill my Xtandi. Since then I have been on a half dose of Xtandi and so far it is still working. I don't know anything about Xtandi having an interaction with spironolactone.
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1 ReactionBefore I was treated for prostate cancer, my cancer doctors required that I be cleared by my cardiologist and family doctor. I believe that the pet scan and chest scan and bone scan and full body scans were done before they required the clearance from the cardiologist. After all of this I was placed on ADT and Ereada for 13 months with a RP midway through the treatment. At this time I am being monitored and blood tested every 3 months and my PSA was last .01
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1 ReactionYes, I have asked this same question to my urologist, oncologist, and
pharmacist. No definitive answer, but since spironolactone has caused a
rise in psa and progression of cancer in a couple of PC patients that were
taking abiraterone there is some concern. Spironolactone is considered a
aldosterone modulator rather than an aldosterone agonist, and in some cases
can actually cause testosterone to rise in a low T environment, which can
affect PSA levels.