abiraterone acetate at a glance
Medicine class
Androgen-biosynthesis inhibitor; endocrine anticancer treatment.
Main role
Treatment of specified metastatic hormone-sensitive or castration-resistant prostate cancers.
Food
Take on an empty stomach because food can markedly and unpredictably increase absorption.
Regular checks
Monitoring includes liver function, potassium, blood pressure and fluid retention.
What is abiraterone acetate used for?
Licensed uses represented by the selected product are:
Newly diagnosed, high-risk metastatic hormone-sensitive prostate cancer in adult men, as part of specialist combination treatment.
Metastatic castration-resistant prostate cancer when symptoms are absent or mild after androgen-deprivation therapy and chemotherapy is not yet clinically indicated.
Metastatic castration-resistant prostate cancer that has progressed during or after docetaxel-based chemotherapy.
Off-label context: NHS England commissions abiraterone acetate with prednisolone for eligible adults with high-risk hormone-sensitive non-metastatic prostate cancer.
How does abiraterone acetate work?
The acetate form is converted in the body to abiraterone. This blocks CYP17, an enzyme needed to make androgens in the testes, adrenal glands and prostate tumour tissue. Lower androgen levels reduce hormonal stimulation of prostate cancer. CYP17 blockade can also increase mineralocorticoids, contributing to high blood pressure, low potassium and fluid retention.
abiraterone acetate preparations and strengths
Tablet
Route: Oral
Strengths: 250 mg, 500 mg, 1000 mg
How to take abiraterone acetate
Follow the oncology team’s instructions and take the accompanying corticosteroid exactly as prescribed.
Take the tablets on an empty stomach: wait at least two hours after food, then avoid food for at least one hour afterwards.
Swallow tablets whole with water.
Do not stop the accompanying prednisone or prednisolone suddenly without specialist advice.
Check before changing brand or formulation because instructions and excipients should be confirmed for the supplied product.
abiraterone acetate side effects
Common or expected effects
- Low potassium
- High blood pressure
- Ankle or leg swelling from fluid retention
- Diarrhoea or indigestion
- Urinary tract infection
- Raised liver enzymes
- Tiredness, joint or muscle pain, hot flushes or dizziness
Get urgent medical advice
- Severe low potassium, which may cause weakness, cramps, palpitations or fainting
- Heart problems, including chest pain, breathlessness, abnormal rhythm or worsening swelling
- Serious liver injury, suggested by jaundice, dark urine or marked illness
- Sepsis or another serious infection
- Adrenal insufficiency, particularly if corticosteroid treatment is interrupted
- Severe muscle injury with significant pain, weakness or dark urine
- Serious allergic reaction
abiraterone acetate in pregnancy
Abiraterone acetate is not intended for women and is contraindicated in women who are or may be pregnant. A man having sex with a pregnant woman should use a condom; with a partner who could become pregnant, a condom plus another effective contraceptive method is required. Pregnant women should not handle the tablets without protection such as gloves.
abiraterone acetate while breastfeeding
Abiraterone acetate is not intended for use in women, including during breastfeeding. Specialist advice is required if exposure or handling occurs.
abiraterone acetate interactions
Give the oncology team and pharmacist a complete list of prescribed, over-the-counter and herbal products.
Radium-223
Use with abiraterone acetate plus prednisone or prednisolone is contraindicated because fractures increased and mortality showed an adverse trend.
Strong CYP3A4 inducers, including carbamazepine, phenytoin, rifampicin, phenobarbital and St John’s wort
These may reduce abiraterone exposure and should generally be avoided unless no suitable alternative exists.
Common questions about abiraterone acetate
Answers are fully visible for fast scanning and source review.
Why is a steroid taken with abiraterone acetate?
Prednisone or prednisolone reduces the effects of excess mineralocorticoids caused by CYP17 inhibition, including high blood pressure, low potassium and fluid retention. It should not be stopped suddenly without specialist advice.
Can abiraterone acetate be taken with food?
No. Food can substantially and unpredictably increase absorption, so the fasting instructions are important.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.