Prednisone Reduces the Incidence and Severity of Mineralocorticoid-Related Adverse Reactions Associated With ZYTIGA®
ZYTIGA® may cause hypertension, hypokalemia, and fluid retention as a consequence of increased mineralocorticoid levels resulting from CYP17 inhibition. Inhibition of CYP17 by abiraterone can also result in increased mineralocorticoid production by the adrenals. Coadministration of prednisone suppresses adrenocorticotropic hormone (ACTH) drive, reducing the incidence and severity of mineralocorticoid-related adverse reactions.
CORTISOL PRODUCTION IS DRIVEN BY ACTH
Adrenocortical Insufficiency (AI)—AI was reported in patients receiving ZYTIGA® in combination with prednisone, after an interruption of daily steroids and/or with concurrent infection or stress. Use caution and monitor for symptoms and signs of AI if prednisone is stopped or withdrawn, if prednisone dose is reduced, or if the patient experiences unusual stress. Symptoms and signs of AI may be masked by adverse reactions associated with mineralocorticoid excess seen in patients treated with ZYTIGA®. Perform appropriate tests, if indicated, to confirm AI. Increased dosages of corticosteroids may be used before, during, and after stressful situations.