Zytiga: A Patient Guide to Prostate Cancer Treatment

Brand name: Zytiga
Generic name: abiraterone acetate
Drug class: CYP17 inhibitor

Overview

Zytiga (abiraterone acetate) is a hormone therapy medicine called an androgen production inhibitor. It lowers the amount of testosterone and other male hormones the body makes. It is used with prednisone to treat certain advanced prostate cancers that have spread.^1-3

Zytiga may be prescribed when the cancer continues to grow despite very low testosterone levels or when it still responds to testosterone-lowering treatment, but has a high risk of getting worse. Zytiga may be used before or after chemotherapy.^1-3

Your healthcare team will consider the type and stage of the cancer, previous treatment, test results, overall health, and other medicines before deciding whether Zytiga is an appropriate treatment for you.¹⁻³

Who Can Take Zytiga?

Zytiga may be prescribed for adult men with:

• Prostate cancer that has spread and keeps growing even though testosterone has been lowered to very low levels.
• Prostate cancer that has spread, still responds to testosterone-lowering treatment, and has a higher risk of getting worse.¹˒² 

How Does Zytiga Work?

Testosterone and other male hormones help prostate cancer cells grow. Zytiga blocks CYP17, a protein the body needs to make these hormones.^1-3 This blocking action lowers the amount of male hormones made by the testicles, adrenal glands, and prostate cancer cells.^1-3

From our partner

Join a Study, Help Future Patients. Researchers are studying a potential treatment for HER2+ metastatic breast cancer. Find out if you may qualify.

Zytiga is taken with prednisone to help keep the body’s natural steroid levels balanced. Without prednisone, Zytiga may cause the body to hold extra salt and water, raise blood pressure, or lower potassium levels.¹⁻³

How Is Zytiga Taken?

Take Zytiga once daily on an empty stomach. Do not eat for 2 hours before or 1 hour after taking it because food can increase the amount of medicine your body absorbs. Swallow the tablets whole with water. Do not crush or chew them.¹⁻³ 

What Does Research Show?

included 1,088 men with advanced prostate cancer. Men who started (Zytiga) abiraterone with prednisone lived about 34.7 months from the start of the study, compared with 30.3 months for men who started prednisone without  (Zytiga)abiraterone.⁴ 

Another study led by George and other researchers showed similar survival rates for a group of 50 Black men and 50 White men with advanced prostate cancer,who took abiraterone with prednisone: Black men lived a median of 35.9 months, while White men lived 35.7.⁵

While Black men showed similar survival rates as White men with this treatment, they had more side effects like, severe high blood pressure, low potassium, and high blood sugar, showing the need for close monitoring.⁵ 

A national study by Marar and other researchers reviewed records from 3,808 men whose prostate cancer had spread and kept growing even though their testosterone was very low.⁶ Among men who received Zytiga (abiraterone) as their first treatment, Black men lived about 23 months, compared with about 17 months for White men.⁶ After researchers considered other differences between the groups, Black men had a 24% lower chance of dying during the study.⁶  This study showed a link between Zytiga treatment and survival, but it did not prove that Zytiga (abiraterone) or race caused the difference. Further controlled research is needed to make those conclusions.⁶

Common Side Effects

Zytiga is taken with prednisone. Prednisone may affect blood sugar, appetite, mood, sleep, and the body’s ability to fight infections.^1-3 

From our partner

Have a child with sickle cell? Learn about a investigational pneumococcal vaccine trial recruiting in Georgia, Nebraska, New Jersey and Texas.

Possible side effects include:

• Tiredness or weakness
• Joint, muscle, or back pain
• Hot flashes
• Swelling in the legs, ankles, or feet
• High blood pressure
• Low potassium
• Diarrhea
• Cough or cold-like symptoms
• Headache
• Urinary tract infection
• Changes in liver test results
• Changes in blood sugar or cholesterol levels¹⁻³ 

Serious Side Effects

Seek immediate medical treatment for:

• Chest pain or breathing problems
• Fainting, weakness, or dizziness
• Fast or irregular heartbeat
• Severe headache, blurred vision
• High or lower than normal blood pressure 
• Muscle weakness, or cramping
• Swelling in the legs or sudden weight gain
• Yellowing of the skin or eyes, dark urine, severe nausea, or upper-abdominal pain
• Nausea or vomiting
• Sweating, shaking, confusion, or loss of consciousness
• Signs of infection, especially while taking prednisone

Special Precautions 

Taking medication

Do not stop prednisone suddenly unless your healthcare provider tells you how to do so safely. Stopping it too quickly may cause serious problems with the adrenal glands,which are located above the kidneys and they help control the body’s hormones and stress.^1-3

Liver problems

From our partner

Find a Doctor in Your Neighborhood! It's Easy! Just click here...

Men with liver problems may need a lower starting dose and closer monitoring. Zytiga is generally not recommended for men with advanced liver problems.¹˒²

Fertility

Zytiga may affect a man’s ability to have children. Men who may want children in the future should ask their healthcare provider about  fertility options before starting treatment.¹ 

What Should You Discuss With Your Doctor?

Zytiga can cause serious high blood pressure, fluid buildup, low potassium, liver injury, heart problems, and adrenal gland problems. Regular blood tests and health checks can help find these problems early.^1-3

Ask how often your blood pressure, potassium, liver function, and blood sugar will be checked. People with diabetes may need more frequent blood-sugar monitoring because both Zytiga and prednisone can affect sugar levels.^1-3

Ask your healthcare provider whether any medicines need to be changed, which symptoms need urgent medical attention, and how your health history, insurance coverage, transportation needs, and ability to attend follow-up visits may affect your care. 

Before taking Zytiga, tell your doctor if you have:

From our partner

Do you still have gout symptoms even though you're taking medication? You’re not alone. The Kadence study is a clinical research study for adults with uncontrolled gout. Learn More

• High blood pressure
• Heart disease, heart failure, or an irregular heartbeat
• Low potassium
• Liver problems
• Diabetes
• Adrenal or pituitary gland problems
• A history of fluid buildup or swelling
• An active infection
• Plans to have children

Bring a complete list of prescription medicines, over-the-counter products, vitamins, and supplements. Zytiga can affect how some medicines work, and other medicines can change the amount of Zytiga in the body. This may be important for medicines used for high blood sugar, heart problems, irregular heart rhythms, seizures, mental health conditions, pain, and other long-term health problems. Avoid St. John’s wort unless your healthcare provider approves it.¹⁻³ 

Why This Matters for Black Men

Zytiga can raise blood pressure and blood sugar, lower potassium, and cause fluid buildup.^5,6 These conditions, along with limited access to specialty care, can make Zytiga side effects harder to manage.^5,6 This is especially important for Black men, who are more likely to have high blood pressure, diabetes, and heart problems.^5,6

A study of 100 men receiving Zytiga with prednisone found similar prostate cancer outcomes in Black and White men. However, Black men had more severe high blood pressure, low potassium, and high blood sugar than White men.⁵ 

Because high blood pressure is more common in Black men, careful attention to heart function and close monitoring of blood pressure, potassium, and blood sugar are very important during treatment.⁵ 

All men should discuss their health history, current medicines, access to blood testing, insurance coverage, transportation, and ability to attend follow-up visits throughout their prostate cancer treatment. Your plan of care should include cancer medicine, along with personal health and social factors that may affect your overall condition and treatment results.  

Key Points

• Zytiga is used with prednisone for certain types of prostate cancer that have spread.
• Take Zytiga once daily on an empty stomach.
• Blood pressure, potassium, liver function, fluid buildup, heart health, and blood sugar require monitoring.
• Men with female partners who could become pregnant should use effective birth control during treatment and for three weeks after the last dose.
• Zytiga may affect male fertility.
• Do not stop or change the amount of Zytiga, prednisone, or testosterone-lowering medicine without speaking with your healthcare provider.

References

1. Janssen Biotech, Inc. Zytiga (abiraterone acetate) prescribing information. Revised November 2024. Accessed July 20, 2026.
2. Drugs.com. Zytiga: uses, dosage, side effects, warnings, and interactions. Updated April 30, 2024. Accessed July 20, 2026.
3. US Food and Drug Administration. Prostate cancer symptoms, tests, and treatments. Accessed July 20, 2026.
4. Ryan CJ, Smith MR, de Bono JS, et al. Abiraterone in metastatic prostate cancer without previous chemotherapy. N Engl J Med. 2015;368(2):138-148. doi:10.1056/NEJMoa1209096
5. George DJ, Heath EI, Sartor AO, et al. A prospective trial of abiraterone acetate plus prednisone in Black and White men with metastatic castrate-resistant prostate cancer. Cancer. 2021;127(16):2954-2965. PubMed
6. Marar M, Long Q, Mamtani R, Narayan V, Vapiwala N, Parikh RB. Outcomes among African American and non-Hispanic White men with metastatic castration-resistant prostate cancer with first-line abiraterone. JAMA Netw Open. 2022;5(1):e2142093. doi:10.1001/jamanetworkopen.2021.42093