Zytiga is an oral inhibitor of androgen biosynthesis that acts by inhibiting the CYP17 enzyme complex required for the formation of androgens in all three sources.

Zytiga contains abiraterone acetate as an active agent. ZYTIGA blocks the production of testosterone in the body, which can slow down the development of prostate cancer. The drug, abiraterone cost marketed as ZYTIGA^® now retails for more than $9,000 per month. Even patients with blue-ribbon health insurance can have co-pays ranging from $1,000 to $3,000 per month Zytiga cost.

Abiraterone acetate in vivo is converted to abiraterone, which is an inhibitor of androgen biosynthesis. In particular, abiraterone selectively inhibits the activity of the 17α-hydroxylase / C17,20-lyase (CYP17) enzyme. This enzyme is expressed and is required for the biosynthesis of androgens in the testes, adrenal glands and prostate tumor cells. CYP17 catalyzes the conversion of pregnenolone and progesterone by 17α-hydroxylation and cleavage of the C17,20 bond to testosterone precursors: dehydroepiandrosterone and androstenedione, respectively. Inhibition of CYP17 activity is also accompanied by an increase in the synthesis of mineralocorticoids in the adrenal glands.

Androgen-sensitive prostate cancer responds to androgen-lowering treatments. Antiandrogen therapy, such as the use of luliberin agonists or orchiectomy, attenuates androgen synthesis in the testes, but does not affect androgen synthesis in the adrenal glands and tumors. The use of Zytiga in conjunction with luliberin agonists (or orchidectomy) reduces the serum testosterone concentration to a level below the detection threshold.

The drug Zytiga reduces the concentration of testosterone and other androgens in the serum below those values ​​that can be obtained with the use of luliberin agonists or after orchidectomy. This is due to the selective inhibition of the enzyme CYP17, which is required for androgen biosynthesis. PSA concentration serves as a biomarker in patients with prostate cancer.

Indications:

Preparation Zitiga used to treat prostate cancer, gave metastasized to other areas of the body.

How to use:

You can take Zytiga only as directed by your doctor. If you are not entirely sure, please consult your doctor or pharmacist for advice.

The usual dose is 1000 mg (four tablets) once a day.

The drug is taken orally. Do not take Zitiga with food. You should eat at least two hours before taking Zytig or at least one hour after taking the pills. buy abiraterone acetate online in Indian Pharmacy

The tablets should be swallowed whole with water. You cannot break pills. Zytiga is taken with the drug Prednison or Prednisolon.

Do not take Prednison or Prednisolon unless directed by your doctor. The amount of Prednison or Prednisolon you are taking should be changed as needed if medically necessary. Your healthcare provider will tell you whether to change the amount of Prednison or Prednisolon you take. Do not stop taking Prednison or Prednisolon without the strong advice of your doctor.

The doctor may also prescribe other medications while using Zytig and Prednison or Prednisolon.

Side effects:

Zitiga has side effects that do not always occur in patients: muscle weakness, muscle twitching, or violent heartbeat (tachycardia). These side effects could be an indicator that the potassium concentration in your blood is too low.

Additional side effects:

Very common (in more than 1 in 10 people): Swelling of the legs or feet, low blood potassium, high blood pressure, urinary tract infection.

Often (1 out of 10 patients): high blood lipids, elevated liver counts, chest pain, irregular heartbeat, heart failure, accelerated heart rate.

Sometimes (may affect up to 1 in 100 people): Adrenal gland problems (accompanied by problems with salt and water balance).

Bone atrophy may occur in men who have been treated for prostate cancer. Zytiga, together with Prednison or Prednisolon, can increase bone atrophy.

Abiraterone Brands in India:

1. Abirapro

2. Xbira

Contraindications :

Reception of Zytig is contraindicated for: hypersensitivity (allergy) to abiraterone acetate or other Zytiga components, with existing or potential pregnancy, severe liver dysfunction, children under 18 years of age.

With care: lactase deficiency, lactose intolerance, glucose-galactose malabsorption; patients with prostate cancer with severe renal impairment (there are no clinical data on the use of Zytiga in such patients); treatment of patients whose condition may worsen with an increase in blood pressure or the development of hypokalemia (including patients with heart failure, recent myocardial infarction or ventricular arrhythmia, left ventricular ejection fraction less than 50%, heart failure III-IV functional class according to NYHA classification ).

Pregnancy :

The drug Zitiga not designed for the reception of women.

- This drug may harm the fetus if taken by women during pregnancy and should not be taken by women while breastfeeding.

- Women during actual or possible pregnancy should wear gloves if necessary to touch Zytig tablets or handle them in any way.

- When having sexual intercourse with a woman who might become pregnant, use a condom and other effective contraception.

When having sex with a pregnant woman, use a condom to protect the fetus.

Interaction with other drugs:

Potential effect of other drugs on the effects of abiraterone. In a study of the pharmacokinetic interaction of a strong inducer of the isoenzyme CYP3A4 in healthy volunteers - rifampicin 600 mg per day for 6 days and then a single dose of abiraterone acetate 1000 mg, the average plasma AUC∞ of abiraterone decreased by 55%.

Avoid the combined use of Zytiga and strong inducers of the CYP3A4 isoenzyme (for example, phenytoin, carbamazepine, rifampicin, rifabutin, rifapentine, phenobarbital). The appointment of this group of drugs is possible only after a thorough assessment of clinical efficacy.

Potential effect of Zytiga on the action of other drugs. Abiraterone inhibits the hepatic isozymes involved in the metabolism of drugs - CYP2D6 and CYP2C8.

In a clinical study, when determining the efficacy of abiraterone acetate (plus prednisone) per dose of the substrate dextromethorphan CYP2D6, the systemic exposure to dextromethorphan increased by about 200%. The AUC24 for dextrorphan, the active metabolite of dectromethorphan, increased by approximately 33%.

It is recommended to prescribe Zytiga with caution to patients receiving drugs that are metabolized by the CYP2D6 isoenzyme, especially for drugs with a narrow therapeutic index. In such cases, the possibility of reducing the dose of drugs with a narrow therapeutic index, metabolized by the isoenzyme CYP2D6, should be considered, including drugs such as metoprolol, propranolol, desipramine, venlafaxine, haloperidol, risperidone, propafenone, flecainide, codeine, oxycodone and tramadol.

In the same study, when determining the efficacy of abiraterone acetate (plus prednisone) per dose of theophylline substrate CYP1A2, no systemic exposure to theophylline substrate was observed.

In a CYP2C8 drug-drug interaction study in healthy subjects, the AUC of pioglitazone was increased by 46% and the AUCs of M-III and M-IV, each of the active metabolites of pioglitazone, decreased by 10% when pioglitazone was administered together with a single 1000 mg dose of abiraterone acetate. Although these results indicate that no clinically significant increases in exposure are expected if Zytiga is used in combination with other drugs that are predominantly eliminated by CYP2C8, patients should be monitored for signs of toxicity associated with a narrow therapeutic index CYP2C8 substrate when used concomitantly with with Zitiga.

Overdose :

There have been no cases of overdose with Zytig during clinical trials.

Treatment: there is no specific antidote. In case of an overdose, Zytiga should be discontinued and general supportive measures should be taken, including arrhythmia control. Liver function should also be monitored.

Storage conditions:

Zytiga medicine should be stored out of the reach of children. Do not use Zitiga after the shelf life indicated on the carton or on the bottle label. The storage period extends to the last day of the month. Do not store at temperatures above 30 ° C. Do not dispose of the medicinal product in waste water or waste chutes. Release form: Zytiga tablets are white-cream in color, oval in shape, with an imprint "AA250" on one side.

The tablets are in a plastic bottle with a plastic cap. Each bottle contains 120 tablets. Each carton contains one bottle.

Composition :

The active ingredient of Zytiga is abiraterone acetate. Each tablet contains 250 mg of abiraterone acetate.

Other ingredients: lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, povidone, sodium dodecyl sulfate, magnesium stearate and highly dispersed silicon dioxide.