Medical Oncologist
Abiraterone (Zytiga)
Abiraterone Side Effects: — What to Expect and When to Call
Abiraterone causes a predictable set of side effects. Most are manageable. A few need same-day contact. Knowing which is which is the most useful thing you can do in the first weeks of treatment.
Medically reviewed by Dr. Bharati Devi Gorantla, Medical Oncologist, MBBS · MD · DM (Adyar, Chennai) · ECMO · MRCP SCE (UK) · Last reviewed August 2026
- Liver and potassium changes — Blood tests catch these early, often before you feel anything.
- Blood pressure rises early — Usually in the first weeks — checked at every appointment and sometimes at home.
- Food timing matters more than most drugs — Eating with abiraterone can dramatically change how much you absorb.
- The steroid is part of the treatment — Never stop prednisone or prednisolone without telling your team.
17+
Cancer Specialists
on Panel
on Panel
96.9%
Breast Cancer
Survival Rate*
Survival Rate*
15,000+
Patients
Treated
Treated
4.8★
Google Rating
(800+ reviews)
(800+ reviews)
Abiraterone commonly causes fatigue, high blood pressure, fluid retention, and hot flushes. Liver enzyme changes and low potassium are also common and are monitored with regular blood tests. Most side effects begin in the first weeks to months. Call your team the same day for yellow skin, dark urine, chest pain, or severe swelling.
Which side effects need a call today, and which can wait?
| Side effect | How common | When it typically starts | What to do |
|---|---|---|---|
| Fatigue | Very common | First weeks | Mention at next visit if mild; call today if sudden, severe, or limiting basic activities |
| High blood pressure | Common | First weeks | Checked at each visit; call the same day for headache, blurred vision, or a reading that alarms you |
| Swollen ankles or legs | Common | Weeks to months | Tell your team at next visit; call today if rapid, one-sided, or with breathlessness |
| Liver enzyme rise | Common | Most often in first 12 weeks | Caught by blood tests; call today for yellow skin, dark urine, or right-side abdominal pain |
| Low potassium | Common | First months | Caught by blood tests; call today for muscle cramps, weakness, or irregular heartbeat |
| Hot flushes | Very common | First weeks | Manageable for most; mention at next appointment if troublesome |
| Diarrhoea | Common | Any time | Call today if it lasts more than 24 hours, worsens, or includes blood |
| Urinary tract infection | Common | Any time | Call today for burning on urination, fever, or cloudy urine |
| Typically starts | Most blood-related effects | First weeks to months | Monitoring blood tests are most frequent in the first 12 weeks of treatment |
Meet the Specialists
17+ senior cancer specialists. One panel for your case.
Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Interventional Radiologist
Dr. Mohammed Imran
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
Want a specific doctor for your case? Mention them when booking.
Book Free ConsultationBook an appointment with our specialist
Share your name and number — we'll call you back within 30 minutes to schedule your consultation.
Not sure whether this counts as an emergency?
Call the helpline. It is always better to check than to wait.
Why do regular blood tests matter so much on abiraterone?
Liver enzyme changes and low potassium are two of the most common effects on abiraterone. Neither usually causes noticeable symptoms until levels are quite abnormal. Blood tests catch them before that point.
In the first few months your team will typically check liver function, potassium, and blood pressure more frequently than later on. Keep those appointments, even when you feel well.
Feeling fine is reassuring, but it is not a reliable guide to what is happening with liver enzymes or electrolytes. The monitoring schedule exists precisely because the most important changes on this drug often arrive silently.
What should I do every day while taking abiraterone?
- Take abiraterone on a completely empty stomach — at least one hour before eating, or two hours after your last meal.
- Take your prednisone or prednisolone dose at the time your team specified. Do not skip it.
- If your team has asked you to monitor your blood pressure at home, note the reading each day.
- Keep all blood test appointments, even if you feel perfectly well.
- Tell every doctor and pharmacist you see that you are taking abiraterone, including for unrelated conditions.
- Do not start any new medicine, supplement, or herbal preparation without checking with your oncology team first.
What causes each side effect and when should I worry?
Why does abiraterone raise blood pressure, and what can I do about it?
Abiraterone blocks a hormone pathway that also controls how the body handles salt and water. Without the steroid taken alongside it, this imbalance would be more pronounced. A degree of blood pressure rise is still common even with the steroid. Your blood pressure will be checked at each visit, and your team may prescribe or adjust a blood pressure medicine. If you have a home monitor, note the readings and bring them to your appointment. Call the same day if you develop a headache, blurred vision, or a reading that concerns you — do not wait for your next scheduled visit.
What does low potassium feel like, and should I be worried?
Many people with mildly low potassium on abiraterone notice nothing at all — it is picked up on a routine blood test. When potassium drops further, you may notice muscle cramps, unusual tiredness, or constipation. A more significant drop can cause muscle weakness or a feeling that your heartbeat is irregular. Your blood tests track this throughout treatment. Do not wait for your next appointment if cramps or weakness appear between tests — call your team the same day so they can check your levels sooner.
How serious are liver enzyme changes and how would I know?
Abiraterone can cause the liver to produce higher levels of certain enzymes, particularly in the first months of treatment. This does not cause symptoms in most people and is detected by blood tests, which is why the tests are done frequently early on. In a small proportion of patients the rise is significant enough to require pausing or adjusting treatment. Symptoms of a more serious liver reaction include yellowing of the skin or whites of the eyes, dark brown urine, and pain in the upper right side of the abdomen. Call the same day if you notice any of those — do not wait.
Does it matter whether I have eaten before taking abiraterone?
Yes — this is one of the most important practical rules for this medicine. Taking abiraterone with food, or shortly before or after eating, can dramatically increase how much of the drug is absorbed into the blood. This does not produce a stronger anti-cancer effect. It makes side effects more likely without adding benefit. Take abiraterone on a completely empty stomach: at least one hour before eating, or at least two hours after your last meal. Most people find a fixed time before bed — when the stomach is reliably empty — the easiest routine to maintain. A missed dose on an empty stomach is better than a taken dose with food.
Can I take other medicines or supplements while on abiraterone?
Abiraterone interacts with a significant number of other medicines — including some commonly used for blood pressure, heart conditions, epilepsy, and pain. Supplements and herbal preparations also carry interaction risks. Tell your oncology team about everything you are taking, including over-the-counter medicines, vitamins, and anything prescribed by another doctor for a different condition. Never stop, start, or change a dose of another medicine without checking first. Some interactions affect how well abiraterone works. Others increase the risk of side effects. This applies even to medicines that seem entirely unrelated to cancer.
Explore 50 more Prostate Cancer Targeted Medicines topics
Drug Deep Dive: Abiraterone (Zytiga)
- Abiraterone (Zytiga, Abirapro, Abretone): The Complete Patient Guide
- Abiraterone Interactions: Steroids, BP Medicines and Herbal Products
- Abiraterone Myths: Steroids, Weight Gain and 'It Stops Working Fast'
- Abiraterone Price in India: Brand, Generic and Monthly Cost
- Abiraterone Side Effects: The Complete List and Timeline
- Abiraterone Success Rate and Survival: An Honest Look at the Numbers
- Abiraterone With ADT, Docetaxel and Radiation: Your Full Regimen Explained
- Abiraterone in Elderly Patients and Those With Other Illnesses
- Abiraterone in Hormone-Sensitive vs Castration-Resistant Prostate Cancer
- Abiraterone vs Enzalutamide: How to Choose in Prostate Cancer
- Diet and Nutrition While on Abiraterone
- Fatigue, Hot Flushes and Joint Pain on Abiraterone
- Fertility, Pregnancy and Contraception on Abiraterone
- How Does Abiraterone Work? The CYP17 Inhibitor Explained
- How Long Does Abiraterone Take to Work?
- How Long Will You Stay on Abiraterone?
- Liver Enzyme Rises on Abiraterone: Why the First Three Months Matter Most
- Swelling, Low Potassium and High Blood Pressure on Abiraterone
- Tests and Monitoring While You Are on Abiraterone
- When Abiraterone Stops Working: Resistance and What Comes Next
- Who Is Eligible for Abiraterone? Advanced and Metastatic Prostate Cancer
- Why Abiraterone Is Always Given With Prednisolone
- Why Abiraterone Must Be Taken on an Empty Stomach
- Will Insurance or a Government Scheme Pay for Abiraterone?
- Work, Travel and Daily Life on Abiraterone
Drug Deep Dive: Enzalutamide (Xtandi)
- Diet and Nutrition While on Enzalutamide
- Dizziness, Falls and Seizure Risk on Enzalutamide
- Does Enzalutamide Need a Steroid? Why It Differs From Abiraterone
- Enzalutamide (Xtandi, Bdenza, Enzamide): The Complete Patient Guide
- Enzalutamide Interactions: Blood Thinners, Statins and Seizure-Threshold Drugs
- Enzalutamide Myths: 'It's Chemotherapy', Fatigue and Loss of Masculinity
- Enzalutamide Price in India: Brand, Generic and Monthly Cost
- Enzalutamide Side Effects: The Complete List and Timeline
- Enzalutamide Success Rate and Survival: An Honest Look at the Numbers
- Enzalutamide With ADT and Other Prostate Cancer Treatments
- Enzalutamide in Elderly Patients and Those With Other Illnesses
- Enzalutamide in Non-Metastatic vs Metastatic Prostate Cancer
- Enzalutamide vs Abiraterone vs Apalutamide: Choosing an AR Inhibitor
- Fertility, Pregnancy and Contraception on Enzalutamide
- How Does Enzalutamide Work? The Androgen Receptor Signalling Inhibitor Explained
- How Long Does Enzalutamide Take to Work?
- How Long Will You Stay on Enzalutamide?
- Memory, Concentration and Blood Pressure Changes on Enzalutamide
- Severe Fatigue on Enzalutamide: The Commonest Reason Men Stop
- Taking Enzalutamide: Food, Timing and What to Do If You Miss a Dose
- Tests and Monitoring While You Are on Enzalutamide
- When Enzalutamide Stops Working: Resistance and What Comes Next
- Who Is Eligible for Enzalutamide? Advanced and Metastatic Prostate Cancer
- Will Insurance or a Government Scheme Pay for Enzalutamide?
- Work, Travel and Daily Life on Enzalutamide
Next step
Still not sure what applies to you?
Send your reports across and a senior medical oncologist will go through what they mean, what is known, and what the options actually are.
Common questions
Frequently asked questions
Do abiraterone side effects get better over time?
For many people, fatigue and hot flushes ease after the first few months as the body adjusts. High blood pressure and fluid retention tend to persist and need ongoing management, sometimes including medication. Liver enzyme changes, if they occur, are most common early and are usually caught by blood tests before you feel anything. The picture differs by side effect, so ask your oncologist at each appointment whether what you are experiencing is expected to improve, stabilise, or needs active treatment.
Why do I have to take a steroid alongside abiraterone?
Abiraterone blocks hormone production in both the adrenal glands and the tumour. When the adrenal pathway is blocked, the body can overproduce certain hormones that raise blood pressure and lower potassium. The steroid — prednisone or prednisolone — counteracts that effect and prevents a condition called adrenocortical insufficiency. Never stop the steroid without telling your team, even if you feel well. Stopping it suddenly can cause a serious hormonal reaction.
What should I do if I miss a dose of abiraterone?
If you remember the same day, take it on an empty stomach as soon as you can. If it is nearly time for your next dose, skip the missed one and continue as normal. Do not take two doses together. Missing one dose occasionally is unlikely to affect how well treatment is working. Taking the medicine with food is a more significant problem than skipping a dose — so if your stomach is not empty when you remember, the safer choice is to wait until it is.
Can abiraterone affect the heart?
It can. High blood pressure and fluid retention — both of which abiraterone can cause — put extra load on the heart over time. There are also reports of cardiac arrhythmias in people on this medicine. Tell your team about any heart history before you start. If you develop chest pain, palpitations, or breathlessness during treatment, call or go to the emergency department the same day rather than waiting for your next appointment.
How will my team know if abiraterone is working?
PSA is the main marker used — a sustained fall in PSA is the most common early sign of response. Imaging such as a CT scan, bone scan, or PET-CT is usually repeated after a period of treatment to assess how much has changed. Do not be alarmed if PSA rises slightly in the first few weeks; this occasionally happens before it falls. Your team will interpret the trend across multiple readings rather than act on a single result.