An androgen-synthesis inhibitor for prostate cancer
Abiraterone
A tablet hormone therapy for prostate cancer that stops testosterone being made, taken with a steroid.
What is Abiraterone?
Abiraterone is a hormone-therapy tablet for prostate cancer. Rather than blocking testosterone at the cancer cell, it stops the body from making testosterone in the first place. Because of how it works, it is always taken together with a steroid such as prednisolone. It is started by a cancer specialist and taken at home, importantly on an empty stomach. It can raise blood pressure, lower potassium and cause fluid retention, and it can affect the liver, so you will have regular blood tests and blood pressure checks. It does not carry the infection risk of chemotherapy.
Education and reference only. This is a plain-language guide to Abiraterone — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Abiraterone is a hormone therapy used to treat prostate cancer. It comes as a tablet taken by mouth and is taken at home as part of treatment planned by a cancer specialist. It is always given together with a steroid (such as prednisolone), which is an essential part of the treatment, not an optional extra. It is used in prostate cancer that has spread or needs more than standard hormone treatment alone, and is started and supervised by a specialist.
How it works
Prostate cancer is driven by male hormones (androgens) such as testosterone. Abiraterone blocks an enzyme the body uses to make these hormones, not just in the testicles but throughout the body, including within the tumour itself. By cutting off the supply of testosterone, it starves the cancer of what it needs to grow. Blocking this enzyme also affects the balance of other hormones made by the adrenal glands, which can raise blood pressure, lower potassium and cause fluid retention — and this is exactly why a steroid is taken alongside, to keep that balance steady.
Company & origin
Originated / developed by: Specialist cancer medicine.
A hormone-therapy tablet used in the UK for prostate cancer, taken with a steroid, started by a cancer specialist and taken at home.
Practical use
How to take Abiraterone
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it once a day on an empty stomach: do not eat for a couple of hours before and for a while after, and swallow the tablets whole with water.
- Always take it with the steroid (such as prednisolone) you are prescribed, and do not stop the steroid unless your specialist tells you to.
- Take both regularly even when you feel well, and carry a steroid card so others know you are taking a steroid.
- Attend your blood pressure checks and blood tests, which monitor your potassium, liver and how the cancer is responding.
- Report swollen ankles, severe tiredness, muscle weakness, an irregular heartbeat or yellowing of the skin or eyes.
Weighing it up
Advantages & disadvantages of Abiraterone
Advantages
- An effective hormone tablet for prostate cancer, taken at home.
- Cuts off testosterone production throughout the body, including within the tumour.
- Does not lower the infection-fighting white cells the way chemotherapy does.
Disadvantages
- Must be taken on an empty stomach and always with a steroid, which needs care and routine.
- Can raise blood pressure, lower potassium and cause fluid retention.
- Can affect the liver, so it needs regular blood tests and monitoring.
Practical use
Good to know
Two practical points matter most with abiraterone. First, it must be taken on an empty stomach: do not eat for a couple of hours before and for a while after taking it, because food greatly increases how much is absorbed and could lead to too much in the body. Second, it must always be taken with the steroid (such as prednisolone) you are prescribed — do not stop the steroid, as it balances the hormone effects and stopping it can be dangerous. Because of how abiraterone works, it can raise blood pressure, lower potassium (which can cause muscle weakness or an irregular heartbeat) and cause fluid retention with swollen ankles, so these are monitored with regular blood pressure and blood tests. It can also affect the liver, so report yellowing of the skin or eyes, dark urine or severe tiredness. It does not lower the infection-fighting white cells the way chemotherapy does. It is for prostate cancer in men and is not for use in women or children.
Who should not take it / use with caution
- It is for prostate cancer in men and must not be used in women or children.
- It is used with particular care in significant liver problems, uncontrolled high blood pressure or heart problems, with monitoring.
- People who have had a serious allergic reaction to abiraterone should not take it.
Monitoring
- Regular blood pressure checks and blood tests for potassium and liver function, especially early on.
- Regular PSA blood tests and reviews to see how the cancer is being controlled.
- Reviewing the steroid dose and watching for fluid retention and signs of liver problems.
Side effects
- High blood pressure, low potassium (causing muscle weakness or an irregular heartbeat) and fluid retention with swollen ankles.
- Tiredness, hot flushes and changes in liver blood tests.
- Rarely, signs of a liver problem such as yellowing of the skin or eyes that need checking.
Key interactions
- It changes how the liver handles some medicines, so other medicines may need adjusting; tell your team everything you take.
- Medicines that lower potassium or affect the heart rhythm add to the risk and need reviewing.
- Check before starting any new medicine, including over-the-counter and herbal products, under specialist guidance.
Available as: Tablets taken by mouth on an empty stomach, with a steroid.
Answers
Abiraterone: frequently asked questions
Why must I take abiraterone on an empty stomach?
Food greatly increases how much abiraterone is absorbed, which could lead to too much in the body, so it must be taken without food for a couple of hours before and a while after.
Why do I also take a steroid with it?
Abiraterone changes the balance of hormones from the adrenal glands, and the steroid keeps that balance steady; it is an essential part of the treatment, so do not stop it unless your specialist advises.
Why do I need regular blood tests?
They check your potassium, blood pressure and liver, which abiraterone can affect, alongside PSA tests to see how the cancer is responding.
Does it lower my immune system like chemotherapy?
No. It is a hormone therapy that stops testosterone being made and does not lower the infection-fighting white cells the way chemotherapy does.
What should I report between appointments?
Tell your team about swollen ankles, severe tiredness, muscle weakness, an irregular heartbeat, or yellowing of the skin or eyes, as these can point to effects that need checking.
Authoritative sources
- BNF
- NICE CKS
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