Can I take Zytiga (abiraterone) with a glass of water?

Taking Zytiga with Water: Administration Requirements

Zytiga (abiraterone acetate) must be taken on an empty stomach with water, at least one hour before or at least two hours after a meal. 1

Proper Administration of Zytiga

Zytiga has specific administration requirements that must be followed to ensure proper absorption and effectiveness:

• Timing with meals:

  • Take on an empty stomach
  • At least one hour before a meal OR
  • At least two hours after a meal 1

• Administration method:

  • Swallow tablets whole with water
  • Do not crush or chew tablets 1

Rationale for Administration Requirements

The strict administration requirements are based on Zytiga's pharmacokinetic properties:

• Food effect: Systemic exposure of abiraterone is significantly increased when taken with food:

  • With low-fat meals: 5-fold higher exposure
  • With high-fat meals: 10-fold higher exposure 1, 2

• Clinical implications of food effect:

  • Taking Zytiga with food leads to unpredictable and highly variable drug exposures
  • This variability can affect both efficacy and safety 1

Consequences of Improper Administration

Taking Zytiga with food can result in:

1. Increased drug exposure: Up to 10-fold higher levels with high-fat meals 2
2. Increased variability: Less predictable drug levels between doses
3. Potential for increased side effects: Higher drug levels may increase risk of adverse reactions including:
   • Hypertension (22% of patients)
   • Hypokalemia (17% of patients)
   • Fluid retention
   • Liver function abnormalities 3

Common Pitfalls to Avoid

• Do not take with any food, even small amounts
• Do not crush or chew tablets
• Do not modify the dosing regimen without medical supervision
• Do not switch between different formulations of abiraterone without medical guidance, as they have different bioavailability profiles 3

Special Considerations

• For patients who have difficulty swallowing tablets, note that alternative formulations may be available, but standard Zytiga tablets should not be crushed 1
• Women who are pregnant or may become pregnant should not handle broken or crushed Zytiga tablets without protection (e.g., gloves) 1
• The original formulation of Zytiga (1000 mg) must be taken on an empty stomach, while newer fine-particle formulations may have different administration requirements 3

Following these administration guidelines is essential to ensure proper treatment efficacy and minimize the risk of adverse effects in the management of metastatic prostate cancer.