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

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.

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.

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.

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

@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?

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!

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