Patient Teaching for Abiraterone and Prednisone
Patients starting abiraterone must take it on an empty stomach (at least 1 hour before or 2 hours after food) with prednisone 5 mg once daily, and they need to understand critical monitoring requirements and warning signs that require immediate medical attention. 1
Medication Administration
Abiraterone Dosing
- Take 1,000 mg (four 250 mg tablets) once daily on an empty stomach
- Must be at least 1 hour before eating or 2 hours after eating 1
- Swallow tablets whole with water—do not crush or chew 1
- Taking with food dramatically increases drug absorption and can cause serious adverse reactions 2, 1
Prednisone Dosing
- Take 5 mg once daily as prescribed 2, 3
- Never stop prednisone without consulting your healthcare provider 1
- Prednisone is essential to prevent serious side effects from abiraterone 1, 4
Missed Doses
- If you miss a dose, take your normal dose the next day—do not double up 1
- If you miss more than one dose, contact your healthcare provider immediately 1
Critical Monitoring and Warning Signs
Blood Pressure and Fluid Retention
Monitor for hypertension, swelling, and fluid retention—these occur in approximately 10% of patients and require immediate attention 3:
- Check blood pressure regularly at home if possible
- Report new or worsening swelling in legs, ankles, or feet
- Report sudden weight gain (>5 pounds in a week)
- Report shortness of breath or difficulty breathing
Potassium Levels (Hypokalemia)
Low potassium is a serious risk that can cause dangerous heart rhythm problems 1:
- You will need monthly blood tests to check potassium levels
- Report muscle weakness, cramps, or irregular heartbeat immediately
- Report severe fatigue or confusion 5, 6
Liver Function
Severe liver toxicity can occur—approximately 7% of patients experience grade 3-5 liver problems 3:
- You will need regular blood tests to monitor liver function
- Immediately report: yellowing of skin or eyes, dark urine, severe nausea/vomiting, or right upper abdominal pain 1
Blood Sugar (For Diabetic Patients)
If you have diabetes, severe low blood sugar (hypoglycemia) can occur, especially if taking pioglitazone or repaglinide 1:
- Monitor blood glucose more frequently during treatment
- Report symptoms of low blood sugar: shakiness, sweating, confusion, rapid heartbeat 1
Adrenal Insufficiency
Report symptoms of adrenal crisis: severe fatigue, weakness, dizziness, loss of appetite, nausea, or vomiting 1. This can occur if prednisone is stopped abruptly or during times of stress.
Required Monitoring Schedule
You will need blood tests at least monthly to check 3, 1:
- Potassium levels
- Liver function (ALT, AST, bilirubin)
- Blood pressure monitoring
- Kidney function
Important Contraindications and Precautions
Pregnancy and Fertility
This medication can cause severe harm to unborn babies and loss of pregnancy 1:
- If you have a female partner who can become pregnant, use effective contraception during treatment and for 3 weeks after stopping abiraterone 1
- Pregnant women should not handle broken, crushed, or damaged tablets even with gloves 1
- This medication may impair male fertility 1
Drug Interactions
- Continue your GnRH therapy (hormone therapy injections) throughout treatment—do not stop 1
- Do not take with radium Ra 223 dichloride—this combination increases death rates and fracture risk 1
- Inform all healthcare providers about this medication before starting any new treatments
Common Pitfalls to Avoid
Taking with food: This is the most common error and increases drug exposure unpredictably, potentially causing serious side effects 2, 1
Stopping prednisone: Never discontinue prednisone on your own—it prevents dangerous mineralocorticoid excess and adrenal crisis 1, 4
Missing monitoring appointments: Regular blood tests are not optional—they detect life-threatening complications early 3, 1
Ignoring warning signs: Patients over 70 years have higher rates of severe side effects (47% vs 33%) and treatment-related deaths, making symptom reporting critical 3
Storage and Handling
- Store at room temperature (68°F to 77°F) 1
- Keep out of reach of children 1
- Women who are or may be pregnant should not handle tablets if broken, crushed, or damaged without gloves 1
When to Contact Your Healthcare Provider Immediately
- New or worsening high blood pressure
- Swelling or sudden weight gain
- Muscle weakness or irregular heartbeat
- Yellowing of skin or eyes
- Severe abdominal pain
- Signs of low blood sugar (if diabetic)
- Severe fatigue or dizziness
- Any symptoms of infection (fever, chills)