Abiraterone Disease Interactions

Postmarketing studies have associated the use of abiraterone with severe hepatic toxicity, including fulminant hepatitis, acute liver failure and deaths. Serum transaminases and bilirubin levels should be measured before starting treatment and every 2 weeks for the first three months of treatment and then monthly thereafter. Any liver test elevations should prompt more frequently monitoring. Treatment should be discontinued permanently in patients with concurrent elevations of ALT greater than 3 x ULN and total bilirubin greater than 2 x ULN. In patients with baseline moderate hepatic impairment (Child-Pugh Class B), the recommended dose should be reduced to 250 mg once daily. Abiraterone should not be used in patients with severe hepatic impairment (Child-Pugh Class C).

Abiraterone may cause hypertension, hypokalemia and fluid retention as a consequence of increased mineralocorticoid levels resulting from CYP17 inhibition. Use caution when treating patients whose underlying medical conditions might be compromised by increases in blood pressure, hypokalemia or fluid retention such as patients with heart failure, recent myocardial infarction, ventricular arrhythmias. Use with caution in patients with cardiovascular disease and monitor regularly.