1. < Prostate Cancer

Orgovyx and Diltiazem: Should I be concerned about drug interactions?

Posted by ggimlick @ggimlick, Jun 25 9:16am

I’m about to start a 6-8 week course of Orgovyx in preparation to have HIFU once the prostate shrinks enough. I have a pacemaker and take Diltiazem XR for afib control. The drug interaction chart lists this combination as having major implications. All the doctors have signed off on concurrent use with warnings about what to look out for as possible side effects that would be serious. All a bit scary to this 70 yr old.

Has anyone done this combination of drugs?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

northoftheborder | @northoftheborder | Jun 25 4:28pm

I was taking Diltiazem as a second hypertension drug (not for afib), but stopped it when I had to begin ADT and ARSI.

The list of potential interactions for our prostate-cancer medications is huge, so this is a hard situation to avoid. I am still on some other meds that can potentially have serious interactions with Orgovyx and Apalutamide, but so far everything's been fine (after a few weeks of close monitoring).

It's a tough decision, and I wish you well.

REPLY
1 reply
ggimlick | @ggimlick | Jun 25 5:58pm
In reply to @northoftheborder "I was taking Diltiazem as a second hypertension drug (not for afib), but stopped it when..." + (show)
@northoftheborder

I was taking Diltiazem as a second hypertension drug (not for afib), but stopped it when I had to begin ADT and ARSI.

The list of potential interactions for our prostate-cancer medications is huge, so this is a hard situation to avoid. I am still on some other meds that can potentially have serious interactions with Orgovyx and Apalutamide, but so far everything's been fine (after a few weeks of close monitoring).

It's a tough decision, and I wish you well.

Jump to this post

Thanks for you info. The cardiologist has signed off on concurrent use and will do an EKG after one week. I start Orogvyx tomorrow. Diltiazem is considered a moderate or weak P-gp inhibitor depending on the source so they feel it’s a safe bet, but will monitor for side effects. Strong inhibitors can increase the levels of Orgovyx by 6 times.

I guess we'll "fly it and watch it" as they told us in Army aviation.

REPLY
northoftheborder | @northoftheborder | Jun 26 4:26pm

Many smart watchs have an ECG feature. It's not as good as a full ECG, but it might give you some peace of mind between visits to the doctor's office.

REPLY
1 reply
ggimlick | @ggimlick | Jun 26 4:58pm
In reply to @northoftheborder "Many smart watchs have an ECG feature. It's not as good as a full ECG, but..." + (show)
@northoftheborder

Many smart watchs have an ECG feature. It's not as good as a full ECG, but it might give you some peace of mind between visits to the doctor's office.

Jump to this post

I have an Apple watch that checks for normal sinus rhythm and monitors pulse, but that’s as good as it gets. I have a Kardia 6L device that does a 6 lead ECG and much more accurate, but that won’t detect elongated QT intervals.

They’ve told me to watch for dizziness, heart racing, arrhythmias, etc and let them know immediately. I have a pacemaker so I suppose they’re hoping that will help.

I started Orgovyx today and have to say it’s the first time I’ve had a combination of drugs that scare me. Hoping for the best though

REPLY
Moderator
Colleen Young, Connect Director | @colleenyoung | Jul 3 5:00pm

@ggimlick, checking in. It sounds like you've got good care and communication between your cardiologist and oncologist. I wanted to write to let you and others know about a specialty called cardio-oncology.

Cardio-oncology offers expertise in addressing heart problems, potential or current issues during cancer treatments. At Mayo Clinic for example, 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.

How are you doing on Orgovyx?

REPLY
1 reply
ggimlick | @ggimlick | Jul 3 9:12pm
In reply to @colleenyoung "@ggimlick, checking in. It sounds like you've got good care and communication between your cardiologist and..." + (show)
@colleenyoung

@ggimlick, checking in. It sounds like you've got good care and communication between your cardiologist and oncologist. I wanted to write to let you and others know about a specialty called cardio-oncology.

Cardio-oncology offers expertise in addressing heart problems, potential or current issues during cancer treatments. At Mayo Clinic for example, 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.

How are you doing on Orgovyx?

Jump to this post

One week in and so far it seems to be fine. No discernible interactions between the Diltiazem and Orgovyx. The only thing I’ve noticed so far is some mild hot flashes that don’t last long.

I had an EKG today so will get those results in a day or two. I assume the focus is on whether there is any elongation of the QT interval.

Thanks you for the info on Cardio-oncology!

REPLY
ggimlick | @ggimlick | Jul 10 4:52pm

EKG results showed no elongation of the QT intervals from the combination of Orgovyx and Diltiazem. No arrhythmias or side effects other than hot flashes yet.

I’ve been on Orogvyx for two weeks now. Will have an ultrasound to measure prostate size in three weeks to see if it’s shrunk enough for HIFU

REPLY
Please sign in or register to post a reply.