Zytiga (Abiraterone) - Oral

What Is Zytiga?

Zytiga (abiraterone) is a prescription medication used to treat prostate cancer that has become metastatic (spread to other areas of the body). Specifically, it is used to treat metastatic castration-resistant prostate cancer (CRPC) and metastatic high-risk castration-sensitive prostate cancer (CSPC). It is used with prednisone (e.g., Rayos, Prednicot).

Zytiga is in the class of medications called cytochrome P450 (CYP) 17 inhibitors. Testosterone is used by prostate cancer cells as fuel for growth. This medication works by decreasing testosterone production in the testes, adrenal glands, and prostate cancer cells.

Zytiga is available as a tablet to be taken by mouth.

Drug Facts

Generic Name: Abiraterone

Brand Name(s): Zytiga

Drug Availability: Prescription

Administration Route: Oral 

Therapeutic Classification: CYP17 inhibitor

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Abiraterone acetate

Dosage Form(s): Tablet

What Is Zytiga Used For?

Zytiga is used to treat metastatic castration-resistant prostate cancer (CRPC) and metastatic high-risk castration-sensitive prostate cancer (CSPC) as part of a regimen to help reduce testosterone in the body. When prostate cancer grows, it uses testosterone as fuel to keep growing. Decreasing testosterone production can help slow prostate cancer growth.

Zytiga is given along with another testosterone-lowering medication called a gonadotropin-releasing hormone. It is also used in combination with prednisone, a steroid, daily. 

An illustration with drug information about zytiga (abiraterone)

Verywell / Dennis Madamba

How to Take Zytiga

Take Zytiga as prescribed, usually once a day and on an empty stomach (at least one hour before or two hours after eating). Taking this medication with food may affect its absorption in the body, potentially leading to side effects.

The tablets must be swallowed whole and not broken or crushed. You can take the tablets with water.

Storage 

Keep the tablets at room temperature and in the original packaging. It is important that the tablets are kept away from children and that pregnant people do not handle the medication. 

How Long Does Zytiga Take to Work?

After taking Zytiga, the medication can begin working soon after to help reduce testosterone production. However, it may take a few months of therapy before improvement in prostate cancer is seen. Your healthcare provider will monitor your response to the treatment and how well it is working.

What Are the Side Effects of Zytiga?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects 

There may be side effects when taking Zytiga. The most common side effects include:

  • Feeling tired
  • Hot flashes
  • High blood pressure
  • Joint pain
  • Fluid retention
  • Diarrhea
  • Nausea
  • Headache
  • Respiratory infection
  • Cough

The most common laboratory abnormalities include:

Severe Side Effects

Call your healthcare provider immediately if you have serious side effects. Call 911 if you feel your symptoms are life-threatening. Serious side effects and their symptoms can include the following:

  • Severely elevated blood pressure
  • Low potassium levels. Symptoms can include muscle spasms, fatigue, abnormal heart rhythm, and weakness.
  • Adrenal insufficiency: Symptoms can include fatigue, weakness, joint pain, and weight loss.
  • Liver toxicity: Signs or symptoms can include elevated liver tests, abdominal pain, and yellowing of the skin or eyes (jaundice).

Report Side Effects

Zytiga may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Zytiga Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For castration-resistant prostate cancer:
      • Adults—1000 milligrams (mg) (two 500 mg tablets or four 250 mg tablets) once a day, taken together with 5 mg oral prednisone 2 times a day.
      • Children—Use is not recommended.
    • For high-risk castration-sensitive prostate cancer:
      • Adults—1000 milligrams (mg) (two 500 mg tablets or four 250 mg tablets) once a day, taken together with 5 mg oral prednisone once a day.
      • Children—Use is not recommended.

Modifications 

For people with pre-existing liver disease, the starting dose of Zytiga will be decreased. A lower dose may also be needed if liver dysfunction develops while taking the medication.

Missed Dose 

If you miss a dose of Zytiga, take it as scheduled the next day. Missed doses should not be doubled.

Overdose: What Happens If I Take Too Much Zytiga?

Notify a healthcare provider immediately if you take more Zytiga than prescribed. Your healthcare provider may decide to monitor your reaction with lab values, such as liver tests, and by measuring your blood pressure and heart rhythm.

What Happens If I Overdose on Zytiga?

If you think you or someone else may have overdosed on Zytiga, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Zytiga, call 911 immediately.

Precautions

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It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests will be needed to check for any unwanted effects that may be caused by this medicine.

Women and children should not use this medicine. Pregnant women or women who may become pregnant should not handle or touch the tablets without protection (eg, gloves). This medicine may also cause birth defects if the father is using it when his sexual partner becomes pregnant. You must use a condom and another effective method of birth control during treatment with this medicine and for 3 weeks after the last dose. If a pregnancy occurs while you are using this medicine, tell your doctor right away.

You will also need to have your blood pressure measured before starting this medicine and while you are using it. If you notice any changes to your recommended blood pressure, call your doctor right away. If you have questions about this, talk to your doctor.

Do not interrupt or stop using this medicine together with prednisone without first asking your doctor. This may increase your risk of having adrenal gland problems. Talk to your doctor if you have darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Abiraterone and prednisone/prednisolone may increase your risk for bone fractures and death when used together with radium 223 dichloride (radiation treatment). Tell your doctor if you are having any other treatment for your prostate cancer.

This medicine may cause hypoglycemia (low blood sugar), especially if you have diabetes and take certain medicines for diabetes. Check with your doctor right away if you have anxiety, blurred vision, chills, cold sweats, coma, confusion, cool, pale skin, depression, dizziness, fast heartbeat, headache, increased hunger, nausea, nervousness, nightmares, seizures, shakiness, slurred speech, or unusual tiredness or weakness.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Zytiga?

Pregnant people should not take or handle Zytiga, as it can cause significant fetal harm.

Also, you should not take Zytiga if you have severe liver disease.

What Other Medications Interact With Zytiga?

Some medications should be avoided if possible while taking Zytiga. Before using this medication, tell your healthcare provider all the medications, over-the-counter (OTC) products, and herbal supplements that you are taking. If any of these cannot be stopped, a dose reduction of Zytiga may be necessary.

These medications include, but may not be limited to:

Other drug interactions may occur with Zytiga. Tell your healthcare provider about all medications, vitamins, and herbal supplements you take.

What Medications Are Similar?

Many medications are available to treat prostate cancer. However, not all of them work the same way as Zytiga. Unlike Zytiga, which suppresses testosterone, some instead block the ability of testosterone to attach to the cancer cell.

Ketoconazole is one medication that works similarly to Zytiga. It should not be used in combination with Zytiga. 

Other medications used to treat prostate cancer include:

Frequently Asked Questions

  • What is Zytiga used for?

    Zytiga is used in combination with prednisone to treat metastatic prostate cancer. In metastatic disease, the cancer has spread from one part to other parts of the body.

  • What are the side effects of Zytiga?

    Side effects of Zytiga can include, but are not limited to:

    • Fatigue
    • Hot flashes
    • Joint pain
    • Headache
    • Weakness
  • How do I stop taking Zytiga?

    Zytiga should not be stopped unless instructed by the oncologist.

  • Can I take Zytiga with food?

    No, do not take Zytiga with food. Instead, take your dose on an empty stomach. Do not eat two hours before and one hour after taking it. Taking it with food can increase how much of the drug is absorbed in the body, which might cause side effects.

How Can I Stay Healthy While Taking Zytiga?

Although being diagnosed with prostate cancer can be overwhelming, remember that many effective treatments are available. Prostate cancer generally comes with a good prognosis for the average person, especially compared with other cancers. Still, undergoing cancer treatment can be a physical and emotional adjustment for many people.

Communicate with your oncologist and follow all instructions for taking your medication. Ask for a written-out treatment plan or other suggestions if you have trouble remembering what to do. It's important to take your medication exactly as prescribed to get the best results.

If you're worried about the financial toll of treatment, there are options for cost assistance for those with cancer. Your healthcare team may also be able to direct you to financial assistance programs.

Discuss any questions or concerns about side effects or how to take your medication with the oncology care team.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. Zytiga label.

  2. Amaniera G, Ballatore V, Ruatta F, et al. Low doses of ketoconazole and prednisone in patients with castration resistant prostate cancer (Crpc): a retrospective study on 73 patientsJCO. 2013;31(15_suppl):e16099-e16099. doi:10.1200/jco.2013.31.15_suppl.e16099

  3. Johns Hopkins Medicine. Prostate cancer prognosis.

By Julie Scott, MSN, ANP-BC, AOCNP
Julie is an Adult Nurse Practitioner with oncology certification and a healthcare freelance writer with an interest in educating patients and the healthcare community.