USES

Abiraterone is primarily prescribed for metastatic castration-resistant prostate cancer (mCRPC) and metastatic high-risk castration-sensitive prostate cancer (CSPC) in adult men. It works by inhibiting CYP17, an enzyme required for androgen synthesis, which reduces testosterone levels and slows cancer growth. Women and children should not use this medication

Dosage and Administration Standard adult dose:

1,000 mg once daily, typically taken as four 250 mg tablets or two 500 mg tablets, depending on the formulation.

Complementary steroid:

Usually taken with prednisone 5 mg twice daily or comparable prednisolone dosing to prevent adrenal insufficiency.

Intake instructions:

Take on an empty stomach—at least two hours after eating and wait an hour before eating again. Swallow tablets whole; do not crush, chew, or break them.

Missed dose:

Skip a missed dose and resume the next day; do not double dose.

Special Populations and Dose Adjustments Liver impairment:

• Mild (Child-Pugh A): No adjustment needed.
• Moderate (Child-Pugh B): Reduce dose to 125 mg daily (monitor liver function closely).
• Severe (Child-Pugh C): Not recommended.
• Renal impairment: No adjustment required
• Elderly: Can be used with caution; elderly patients may be more sensitive to effects.
• Monitoring During Treatment Liver function tests (ALT, AST, bilirubin) every 2 weeks for the first 3 months, then monthly.
• Blood pressure and potassium levels at least monthly, due to risk of hypertension and hypokalemia.
• Cardiac function in patients with history of heart disease. Signs of adrenal insufficiency if steroid therapy is interrupted or stress occurs

Side Effects

Common –

Fatigue, weakness, fluid retention (edema) hypertension, hypokalemia (low potassium), joint pain, headaches Nausea, diarrhea, hot flashes.

Less Common-

Serious liver toxicity (elevated liver enzymes, jaundice), adrenal insufficiency, heart rhythm abnormalities, arrhythmias, bone fractures when combined with radium-223 dichloride outside clinical trials, Rare Acute liver failure, severe allergic reactions (difficulty breathing, facial swelling), muscle pain or weakness, rhabdomyolysis

Precautions and Contraindications Pregnancy:

• Contraindicated for women and should be handled with care around pregnant partners
• Cardiovascular disease: Use caution in patients with heart failure, recent heart attack, arrhythmias, or uncontrolled hypertension.
• Liver disease: Avoid in severe impairment; monitor liver enzymes weekly if moderate.
• Drug interactions: Avoid strong CYP3A4 inducers (rifampin, phenytoin, carbamazepine) or adjust dosing.
• Monitor for interactions with CYP2D6 substrates (e.g., metoprolol, codeine) and drugs affecting potassium.
• Storage Store at room temperature, away from moisture and heat.
• Keep the medication out of reach of children.
• Do not use after expiry, and consult a pharmacist for proper disposal methods.