Has anyone lowered their Abiraterone Dosage? To what effect?

Thanks, rrosberg1. I haven't experienced the headaches (yet!), but I do deal with the "hot flushes" (the more common term in Europe, I've heard, and at least in my case it seems more accurately descriptive: mine last for more than a flash!). Unlike your experience, though, mine seem to have lessened in frequency after some time on the meds -- can't know if that's just an unrelated coincidence, my body has adjusted to whatever causes them, or I've just become more accustomed to them and so notice them less.
Again, thanks for sharing, and I wish you continued NDs on your PSAs!

Well… I started on four pills a day in the morning before food. Nauseous, throwing up, feeling bad, sick,… It was no way to live and so after about three weeks I cut it back to three. Still not good but much better. So I saw a different doctor and he said there is excellent results in a study taking one pill with food. So that’s what I started doing and my primary doctor became angry. However, he was also my provider of that $18,000 a month medication. So obviously I needed less of it Makes me wonder a year and a half later he switched me to Erleada. Throughout this whole process, my PSA has gone up and down and up and down with a high of 7.5 and a low of .1.

dirtdancer: I was taking two abiraterone pills a day (2 x 500mg = 1,000mg, for almost two months), which I understood to be the standard dosage (in addition to 3-month Lupron injections). Were you taking 2,000mg per day (4 x 500mg)?
Also, did either doctor check your testosterone levels (which I understand is the purpose in taking abiraterone: to *assist* in lowering testosterone, intending to "starve" cancer cells and thereby lowering the PSA), and if so and the results were available to you, what were the testosterone levels on the 4 pills, then the 3 pills, and now the Erleada (and at what dosage?)?
Hopefully, the Erleada has been more uniformly and reliably efficacious, and *much less* of a problem for you!

The answer from my P.A. regarding reduced Abiraterone dosage.....

I am attaching the below information regarding your question:
"Data from a small, phase 2 study suggest that abiraterone (Zytiga) 250 mg once daily administered with or within 30 minutes of a low-fat breakfast is noninferior to the standard dose (1,000 mg) administered on an empty stomach; prostate-specific antigen and progression-free survival results were similar between the 2 arms, although higher troughs were reported with the standard dose (Ref). Low-dose abiraterone may decrease patient financial burden and improve adherence for those in resource-poor settings; further study is necessary to determine long-term efficacy of this dosing approach. "

Given the small sample size and unknowns about long term efficacy, we do not routinely advise patients to proceed with this approach.

Follow up. Started with 4-250mg of Abbie (Abiraterone). Went to 2 a day to get rid of headaches after about 6 months. Three months later PSA is ND (non detectible). Now going to one a day and see if PSA stays ND. Always taken on empty stomach 2-3 hours after dinner.

I have had your thought before. My theory would say you need higher dosage to knock down the high levels of psa/testosterone than would be required to maintain a low level. The object would be to limit adverse side effects and prolong efficacy of the drug before failure. Might be wishful thinking on my part but glad you brought it up for discussion. My observation is that there several bright minds in this group.

Yes my husband was lowered to three pills and taking at night but is still do fatigued

My story is very similar to yours and my doctor was the provider of that medication only he charged $20,000 Per month. My PSA went to 74 before he would take me off of Erleada and last time I was in the office he would not see me – he sent me to his associate. I think they know, but their greed gets the best of them.
I also could not tolerate four pills a day and saw another Doctor Who recommended the one pill with food and so that’s what I did. But eventually, aButeron. Affected my ureas so badly that I had to get off at and had extreme pain and problems. I doubled the dose of prednisone on my own to try and overcome that closure of the urethra, but nothing worked except getting off of it. Now I am looking at nuclear medication.
I do feel my doctors dependency on that $20,000 a month was a contributing factor to my PSA now being 74. Just my opinion.

My husband was reduced to 750 didn’t make a difference still so tired and no appetite

I reduced from 1,000mg to 750mg halfway through my 24 month treatment and it did not result in any appreciable improvements of the side effects from the treatment.