Abiraterone (Zytiga, Abirapro, Abretone): — What You Need to Know

Most men take abiraterone for as long as it continues to control the disease — which can be many months or years. There is no fixed course length the way chemotherapy has cycles. Your oncologist will monitor your PSA and periodically request scans to assess response. If the cancer shows signs of progressing despite the drug, next steps will be discussed at that point. Do not stop taking it without speaking to your team first.

Food significantly increases how much abiraterone is absorbed into your bloodstream, which raises the risk of side effects. The prescribing guidance specifies a clear timing window around meals; your pharmacist should explain this when you collect the prescription. Follow the same timing every day — consistency matters as much as the timing itself. If you are ever unsure whether you have waited long enough, ask your pharmacist rather than guessing.

Abiraterone blocks the enzyme your body uses to make testosterone, but the same enzyme helps produce other hormones called mineralocorticoids. When these fall too low, the result is fluid retention, raised blood pressure and low potassium. The low-dose steroid (prednisone or prednisolone) corrects this imbalance. It is not a cancer treatment — it is preventing a predictable consequence of how abiraterone works. If you stop the steroid without telling your team, these effects can develop quickly.

Abiraterone lowers testosterone, which is the primary cause of reduced libido and erectile difficulties in men on prostate cancer hormone treatment. Most men receiving abiraterone are already on hormone injections that have the same effect, so abiraterone often adds to rather than newly introduces these changes. If sexual side effects are significantly affecting your quality of life, tell your treating team — it is a legitimate clinical concern and there are options worth discussing, including referral to a specialist if appropriate.

Tell your oncologist and pharmacist about every preparation you are taking, including ayurvedic medicines, supplements and herbal remedies. Some traditional preparations affect the liver enzymes that process abiraterone, which can alter how much of the drug is active in your body. This is not a reason to stop a practice that is meaningful to you, but it is important information for your team to have so they can advise on timing or flag known interactions. Disclosing it helps your team look after you more safely.

A rising PSA does not automatically mean abiraterone has stopped working. Your team will look at the pattern over several tests, alongside imaging and how you are feeling, before drawing conclusions. PSA can rise briefly at the start of treatment before falling, and a modest rise sometimes stabilises. A consistently rising trend alongside scan changes or new symptoms usually prompts a conversation about next steps — and there are further treatment options your oncologist will discuss at that point. Do not stop your tablet based on a single result.