Skip to Content
Diagnosed with Prostate Cancer? Learn about your treatment options >>

Drug interactions between Xofigo and Zytiga

Results for the following 2 drugs:
Xofigo (radium 223 dichloride)
Zytiga (abiraterone)

Interactions between your drugs


abiraterone radium Ra 223 dichloride

Applies to: Zytiga (abiraterone) and Xofigo (radium 223 dichloride)

Consumer information for this interaction is not currently available.

CONTRAINDICATED: The concomitant use of radium Ra 223 dichloride with abiraterone and prednisone/prednisolone may increase the risk of death and fractures in patients with metastatic castration-resistant prostate cancer (CRPC). Preliminary results of a phase III clinical trial involving this combination has reported an increased risk of mortality (34.7% vs 28.2%) and fractures (26% vs 8.1%) in patients receiving radium Ra 223 dichloride plus abiraterone and prednisone/prednisolone compared to patients treated with placebo and abiraterone and prednisone/prednisolone (n=405). It is unknown if enzalutamide (a second generation androgen receptor antagonist) can be effectively and safely used with radium Ra 223 dichloride.

MANAGEMENT: Until more information is available, use of radium Ra 223 dichloride with abiraterone and prednisone/prednisolone should be considered contraindicated. European and US authorities are prohibiting the start of new treatments with this combination and suspending use in patients currently receiving these drugs in combination in favor of other therapeutic alternatives. In addition, continued monitoring for fractures should be considered for patients previously treated with the combination. Preliminary evidence suggests that use of bone health agents such as bisphosphonates or denosumab may diminish the risk of fractures.


  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Bayer HealthCare Pharmaceuticals, Inc "Important Drug Warning: Xofigo. Available from: URL:" ([2017, Nov 30]):
  3. European Medicines Agency "Prostate cancer medicine Xofigo must not be used with Zytiga and prednisone/prednisolone. Available from: URL:" ([2018, Mar 19]):

Drug and food interactions


abiraterone food

Applies to: Zytiga (abiraterone)

Taking abiraterone with food increases the amount of medicine that gets absorbed by the body. This may increase the risk of side effects such as high blood pressure, water retention, and a condition called hypokalemia (low blood potassium), which in severe cases can lead to muscle weakness, paralysis, breathing and swallowing difficulties (due to muscle paralysis), and irregular heart rhythm. You should take abiraterone once a day on an empty stomach. No food should be eaten for at least two hours before and one hour after taking abiraterone. Let your doctor know if you experience nausea, vomiting, constipation, abdominal cramping, confusion, dizziness, lightheadedness, fainting, muscle weakness, muscle cramps, numbness or tingling, rapid heart beat, chest pain, and/or swelling in the legs or feet, as these may be symptoms of hypokalemia or excessive effects of abiraterone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Therapeutic duplication warnings

No therapeutic duplications were found for your selected drugs.

Drug Interaction Classification

The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.