Has anyone lowered their Abiraterone Dosage? To what effect?

Posted by joecontheroad @joecontheroad, Nov 9, 2023

Has anyone had personal experience (or know of others' experiences or know of related studies) taking half the usual dosage of abiraterone (i.e., taking 500mg daily instead of the usual 1000mg daily)?


If so, what was the effect on testosterone levels, and any other information you feel is relevant (except a recommendation not to do so, unless accompanied by pertinent experiences and/or studies, please)?
Thanks.

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@maurq61

I reduced my abiraterone from 1000mg to 750mg due to side effects impacting my heart.
My PSA went from 18 in July 2022 to 0.07 in March 2023. I did get my hematology oncologist permission.
I received 25 rounds of proton therapy radiation in July -August 2023. My PSA dropped to 0.04. As of October 2023, my PSA is 0.05. I was also on Lupron for a year. Hope this info helps. Good luck

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So, maurq61, how long have you been on the reduced abiraterone, and as I asked in my op, what effects have you noticed -- that you would attribute to the reduction in the abiraterone? (All such effects from reducing the abiraterone, and if you feel comfortable with sharing, the the change that the reduction has had on the side effects that had been affecting your heart.)

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Anyone experiencing black “moods”? My husband is in a dark place with me (his wife of 44 years) and can’t seem to come back to a normal relationship.
Am I headed for a divorce? He had surgery in April and is taking Abiraterone with Prednisone.

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@joecontheroad

So, maurq61, how long have you been on the reduced abiraterone, and as I asked in my op, what effects have you noticed -- that you would attribute to the reduction in the abiraterone? (All such effects from reducing the abiraterone, and if you feel comfortable with sharing, the the change that the reduction has had on the side effects that had been affecting your heart.)

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I don’t mind sharing. I was experiencing chest tightness and pain consistently for a couple of weeks. I had a stress test, EKG and lipids test.
My labs were normal for the most part. Cholesterol were slightly above normal.

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@maurq61

I don’t mind sharing. I was experiencing chest tightness and pain consistently for a couple of weeks. I had a stress test, EKG and lipids test.
My labs were normal for the most part. Cholesterol were slightly above normal.

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Heart issue’s dissipated after reduction in dosage. I reduced dosage two months after I started my abiraterone. So I would say 10 months or so.

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@al2

Congratulations on your PSA dropping, my PSA was a 13
two months ago, now it's 0.03. My Doctor put me on Abiraterone at 1000mg, with 5mg of Prednisone. I haven't gotten the proton radiation treatments yet but I'm hopeful that I don't have to get any proton treatments, but if I have to I will. I'm in the process of getting PSA testing every 3 months, and getting a Lupron injection every 6 months. Thank you for your update, it give all of us fighting the battle hope to continue on. Thank you again for your good readings and sharing your experience.

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Thank you. I wish you well on your journey.

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Thanks, maurq61. It seems that with all the testing not showing heart issues, you've concluded the reduction in the abiraterone probably provided the relief, and without any detrimental effect on your PSA. (The onetime blip from 0.04 to 0.05 is meaningless, as you know, and I wish you those continued low numbers... forever!)

I haven't experienced those heart problems on the abiraterone or the Lupron (yet!), but if I do I'll immediately bring up your experience with my provider. Thanks again.

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@lmacfive

Anyone experiencing black “moods”? My husband is in a dark place with me (his wife of 44 years) and can’t seem to come back to a normal relationship.
Am I headed for a divorce? He had surgery in April and is taking Abiraterone with Prednisone.

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We’ve experienced this for about 6 months after the diagnosis and starting Lupron & Xtandi. We’ve been married 53 years and the light went out of his eyes for life. He didn’t show any affection, refused to talk about anything, even researching other options.
I started researching and followed this group for suggestions, especially for help with side effects which were horrible. I finally said I’m not going to go on living like your dying. We need to get on with our life as best as we can. We traveled the country and have bought a house in a place that we both love. No more wasted days😊

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@joecontheroad, to help focus this discussion on the potential effects of lowering the dosage of Abiraterone, I modified the title of the discussion as per your suggestion. 🙂

Has anyone lowered their Abiraterone Dosage? To what effect?

@maurq61, thanks for your helpful and useful feedback given your experience of reducing from 1000mg to 750mg.

@griff1492, Did you learn anything by asking your PA at Mayo?
I found these studies:
- Low-Dose Abiraterone in Metastatic Prostate Cancer: Is It Practice Changing? Facts and Facets https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7113122/
- Is Low-Dose Abiraterone for Prostate Cancer An Attractive Strategy for Limited Resource Settings? https://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-0042-1742400.pdf
.
I suspect it was this quote from the conclusion of the study that had everyone giggling:
"The available evidence from pharmacokinetic studies and a phase 2 clinical study shows encouraging trends of using low dose abiraterone with non-inferior biochemical response in short term, making it an attractive option especially for patients and national health schemes due to better economic viability. However, this proposition possibly does not seem lucrative for the drug manufacturing and marketing firms evidenced by lack of any ongoing or planned phase 3 studies exploring this possibility further."

@joecontheroad, like @al2, I'd be interested to know more about your interest in lowering the dose. Are you, like @maurq61, experiencing side effects that make it dangerous or difficult to take the full dose?

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After being on Abbie(1000mg) with Prednisone(5mg) and Eliguard shots for 6 months, I was having bad headaches. Cut the Abbie in half for the last two months and headaches went away. PSA is still ND, but hot flashes and sweats seem a little worse..

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