Abiraterone acetate (Zytiga®)

OncoLink Team
The Abramson Cancer Center of the University of Pennsylvania
Last Modified: July 9, 2014

Pronounced: A-bir-A-ter-one AS-e-tate
Classification: Anti-androgen

About Abiraterone acetate

Most prostate cancers need supplies of the male hormone testosterone to grow. Testosterone is an androgen (hormone) produced by the testes and adrenal glands. Abiraterone acetate works by blocking an enzyme necessary for the production of testosterone. Without testosterone, the cancer cells may either grow more slowly, or stop growing altogether.

How to Take Abiraterone acetate

Abiraterone acetate is given as a tablet that should be taken once a day, on an empty stomach, 1 hour before or 2 hours after eating. Take the tablet(s) whole with water; do not chew break or crush them.

The blood levels of this medication can be affected by certain foods and medications, so they should be avoided. These include (but are not limited to): rifampin, phenytoin, St. John's wort and dexamethasone. Be sure to tell your healthcare provider about all medications and supplements you take.

Possible Side Effects of Abiraterone acetate

There are a number of things you can do to manage the side effects of abiraterone acetate. Talk to your doctor or nurse about these recommendations. They can help you decide what will work best for you. These are some of the most common side effects:

Hot Flashes

Most men find that hot flashes decrease after a period of time on the medication. There are a few things you can do to help with hot flashes. Several medications have been studied, including some low doses of antidepressants (such as venlafaxine and Paxil), and certain hormone therapies (medroxyprogesterone acetate and cyproterone acetate). Non-medical recommendations include: keeping well-hydrated with eight glasses of water daily, wearing cotton or lightweight, breathable fabrics, dressing in layers, exercising on a regular basis (generally walking exercise is best), practicing relaxation exercises, and avoiding triggers such as warm rooms, spicy foods, caffeinated beverages, nicotiene and alcohol.

Sexual and Reproductive Changes

This drug can affect your reproductive system, resulting in sperm production becoming irregular or stopping permanently. In addition, you may experience erectile dysfunction or a decreased desire for sex during treatment. Talk to your urologist about options for treating erectile dysfunction.

Exposure of an unborn child to this medication could cause birth defects, so you should not father a child while on this medication. Effective birth control is necessary during treatment, even if you believe you are not making sperm. Pregnant or breastfeeding women should not touch this medication without wearing gloves. Men who are sexually active with a pregnant woman must use a condom during treatment and for 1 week after stopping treatment with this medication.

Nausea and/or Vomiting

Talk to your doctor or nurse so they can prescribe medications to help you manage this side effect. In addition, dietary changes may help. Avoid things that may worsen the symptoms, such as heavy or greasy/fatty, spicy or acidic foods (lemons, tomatoes, oranges). Try antacids, (e.g. milk of magnesia, calcium tablets such as Tums), saltines, or ginger ale to lessen symptoms. Read the Nausea and Vomiting Tip Sheet for more suggestions.

Weakening of the bones (osteoporosis)

Men who take hormone therapy for extended periods of time are at risk for bone thinning (osteoporosis). You may be advised to take calcium and vitamin D supplements to help prevent bone loss. You may have a bone density scan (DEXA scan) to assess your bone health. If your physician determines that you are at high risk of developing osteoporosis, they may recommend additional treatment with a type of medication called a bisphosphonate to help strengthen the bones. Learn more about bone health after cancer therapy.

High Blood Pressure and Swelling

Abiraterone acetate can cause elevated blood pressure (hypertension) and fluid retention. Your oncology team will monitor you for these side effects. If you experience headaches, dizziness, fast heartbeat, rapid weight gain or swelling in your legs or feet, notify your oncology team.


Your oncology team can recommend medications to relieve diarrhea. Also, try eating low-fiber, bland foods, such as white rice and boiled or baked chicken. Avoid raw fruits, vegetables, whole grain breads, cereals and seeds. Soluble fiber is found in some foods and absorbs fluid, which can help relieve diarrhea. Foods high in soluble fiber include: applesauce, bananas (ripe), canned fruit, orange sections, boiled potatoes, white rice, products made with white flour, oatmeal, cream of rice, cream of wheat, and farina. Drink 8-10 glasses on non-alcoholic, un-caffeinated fluid a day to prevent dehydration. Read Low Fiber Diet for Diarrhea for more tips.

Low Red Blood Cell Count (Anemia)

Your red blood cells are responsible for carrying oxygen to the tissues in your body. When the red cell count is low, you may feel tired or weak. You should let your doctor or nurse know if you experience any shortness of breath, difficulty breathing or pain in your chest. If the count gets too low, you may receive a blood transfusion. Read the anemia tip sheet for more information.


While on cancer treatment you may need to adjust your schedule to manage fatigue. Plan times to rest during the day and conserve energy for more important activities. Exercise can help combat fatigue; a simple daily walk can help. Talk to your healthcare team and see OncoLink's Fatigue Tip Sheet for helpful tips on dealing with this side effect.

Liver Toxicity

Abiraterone acetate can cause liver toxicity, which your doctor may monitor for using blood tests called liver function tests. Notify your healthcare provider if you notice yellowing of the skin or eyes, your urine appears dark or brown or pain in your abdomen, as these can be signs of liver toxicity.

Other Side Effects

This medication can cause muscle and joint pain or aches. Talk to your healthcare provider about medications to help with this pain.

Some men report mood swings and depression while on hormone therapy. It can be helpful to talk about concerns and feelings with a partner or close friend. If you find that feelings of sadness are interfering with life, talk with your team about finding a counselor experienced in working with cancer patients.


Click on any of these terms for more related articles


Breaking news: Supreme Court votes to uphold Affordable Care Act Subsidies
by Christina Bach, MSW, LCSW, OSW-C
June 26, 2015