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Orgovyx and Diltiazem

Posted by ggimlick @ggimlick, 3 days ago

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?

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northoftheborder | @northoftheborder | 3 days ago

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.

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1 reply
ggimlick | @ggimlick | 3 days ago
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.

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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.

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northoftheborder | @northoftheborder | 2 days ago

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.

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ggimlick | @ggimlick | 2 days ago
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

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