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Patient information - Prostate cancer metastatic hormone-resistant - Abiraterone and prednisolone

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This information sheet outlines your treatment. It should be reviewed together with your doctor, nurse or pharmacist to address any questions or concerns.

The treatment schedule below explains when you will receive the medicines and how they are given.  Your doctor, nurse or pharmacist will be able to explain how your treatment works in more detail.

It is important to understand that abiraterone is not a traditional chemotherapy drug and has a different way of working. It works by targeting the cancer cells to stop them growing and spreading. The treatment schedule below explains how the drug for this treatment is given.

Abiraterone and prednisolone
This treatment is continuous. Your doctor will advise you how long to take the treatment for.
Day Treatment How it is given
Continuous Abiraterone (a-bir-A-ter-one) Take orally (dose 1000 mg, see table below) ONCE a day on an empty stomach, one hour before food or 2 hours after food. Swallow whole with a glass of water, do not break, crush or chew.
Prednisolone (pred-NIS-oh-lone) Take orally with or after food (see table below).

Abiraterone tablets are available in two tablet strengths, 250 mg and 500 mg. It is important that you take the correct tablets and understand how to take them. Ask your doctor, nurse or pharmacist to complete the table below with the correct number of tablets for you.

Abiraterone Number of tablets When to take
250 mg tablets    
500 mg tablets    
Prednisolone Number of tablets When to take
5 mg tablets    
Missed doses:
  • Abiraterone or prednisolone : if you forget to take a tablet or vomit a tablet, take your normal dose the next time it is due. Do not take an extra dose.

Anticancer drugs (drugs used to treat cancer) can sometimes cause serious problems. It is important to get medical help immediately if you suddenly become unwell.

Emergency contact details

Ask your doctor or nurse from your treating team when you should get help and who to contact if you have a problem
Daytime: 
Night/weekend: 
Other instructions: 

 

Changes to your dose or treatment delays

Sometimes a treatment may be started at a lower dose or the dose needs to be changed during treatment. There may also be times when your treatment is delayed. This can happen if your doctor thinks you are likely to have severe side effects, if you get severe side effects, if your blood counts are affected and causing delays in treatment, or if you are finding it hard to cope with the treatment. This is called a dose reduction, dose change or treatment delay. Your doctor will explain if you need any changes or delays to your treatment and the reason why.

Blood tests and monitoring 

You may need to have blood tests while you are receiving this treatment. Your doctor or nurse will tell you when to have these blood tests.

Androgen deprivation therapy (ADT)

For more information see the eviQ patient information sheet on Androgen deprivation therapy (ADT) for prostate cancer. 

Short-term effects of steroids

Steroids are a group of medications which you may be required to take as part of your cancer treatment, examples include dexamethasone, prednisolone, methylprednisolone. You may need to monitor your blood sugar levels closely while you are taking steroids. If you have diabetes, your diabetic medication may need to be adjusted because of the effects of steroids. Speak to your diabetes advisor.

Cancer treatments can cause damage to normal cells in your body, which can cause side effects. Everyone gets different side effects, and some people will have more problems than others.

The table below shows some of the side effects you may get with this treatment. You are unlikely to get all of those listed and you may also get some side effects that have not been listed.

Tell your doctor or nurse about any side effects that worry you. Follow the instructions below and those given to you by your doctor or nurse.

This treatment has minimal side effects. In the clinical trial when abiraterone was compared with a dummy tablet (placebo) very few side effects were caused by abiraterone. Most of the symptoms that patients had were due to their prostate cancer. Below is a table of possible side effects you may get with this treatment. Remember most of these side effects are temporary and can be managed. Some people have more side effects than others, everyone is different. If you are worried about any of your symptoms, contact your doctor or nurse

Symptoms Abiraterone - Moderate or severe (%) Placebo - Moderate or severe (%)
Heart problems  3-6 2-3
Low blood potassium levels*  2-3 1-2
High liver blood tests 3-8 <1-3
Fluid retention and swelling 1-2 1
Urinary tract infection 2 <1
High blood pressure (hypertension) 1-5 <1-3
Bleeding and bruising (thrombocytopenia) 1 <1

* Low blood potassium levels may be found from your routine blood tests and treated by your doctor. If it is severe you may get muscle cramps or twitches, constipation, confusion or an irregular heartbeat. Tell your doctor or nurse as soon as possible if you get any of these signs or symptoms.

Blood clot risk

  • Cancer and anticancer drugs can increase the risk of a blood clot (thrombosis).
  • Tell your doctor if you have a family history of blood clots.
  • A blood clot can cause pain, redness, swelling in your arms or legs, shortness of breath or chest pain.
  • If you have any of these symptoms go to your nearest hospital Emergency Department.

Medications and vaccinations 

  • Before you start treatment, tell your doctor and pharmacist about any medications you are taking, including over-the-counter products, vitamins or herbal supplements.
  • Don’t stop or start any medications during treatment without talking to your doctor and pharmacist first.
  • Do not have any vaccinations without discussing with the doctor who is managing your cancer treatment.
  • People you live with should be fully vaccinated, according to the current vaccination schedule. Extra care needs to be taken with hand washing and careful disposal of soiled nappies for infants who have recently received the rotavirus vaccine.

Other medical and dental treatment

  • If you go to hospital or any other medical appointment (including dental appointments), always tell the person treating you that you are receiving anticancer drugs.
  • Before you have any dental treatment, talk to your doctor. 

Diet

  • While you are receiving this treatment it is important that you try to maintain a healthy diet.
  • Grapefruit and grapefruit juice can interact with your medication and should be avoided while you are on this treatment. 
  • Speak to your doctor or nurse about whether drinking alcohol is safe with your treatment.
  • If you have any concerns about recent weight loss or weight gain or questions about your diet, ask to speak to a dietitian.
  • Avoid drinking or cooking with untreated water (e.g. water from rainwater tanks, bores or rivers) due to risk of contamination. If you intend to drink or cook with rainwater, you should bring it to a boil and allow the water to cool down before drinking or cooking with it. For more information see the NSW Health - Rainwater tanks opens in a new tab or window webpage.

Fertility

  • Some cancer treatments can reduce your fertility. This can make it difficult or impossible to father a child.
  • Talk to your doctor or nurse before you start any treatment. Depending on your situation there may be fertility sparing options available to you and/or your partner, discuss these with your doctor or nurse. 

Fathering a child

  • Some cancer treatments can be dangerous to unborn babies. Talk to your doctor or nurse if you think there is any chance that your partner could be pregnant.
  • Do not try to father a child during this treatment. Contraception should be used during treatment and after stopping treatment. Ask your doctor or nurse about what type of contraception you should use.
  • If you are planning fatherhood after completing this treatment, talk to your doctor. Some doctors advise waiting between 6 months and 2 years after treatment.

Sex life and sexuality 

  • The desire to have sex may decrease as a result of this treatment or its side effects. 
  • Your emotions and the way you feel about yourself may also be affected by this treatment. 
  • It may help to discuss your concerns with your partner and doctor or nurse.

Quitting smoking

  • It is never too late to quit smoking. Quitting smoking is one of the best things you can do to help your treatment work better.
  • There are many effective tools to improve your chances of quitting.
  • Talk to your treating team for more information and referral to a smoking cessation support service.

Staying active

  • Research shows that exercise, no matter how small, has many benefits for people during and after cancer treatment.
  • Talk to your doctor before starting an exercise program. Your doctor can advise whether you need a modified exercise program.

For more information about cancer treatment, side effects and side effect management see our Patient and carers section. 

Telephone support

  • Call Cancer Council on 13 11 20 for cancer information and support

Prostate cancer information

General cancer information and support

Quit smoking information and support

Quitting smoking is helpful even after you have been diagnosed with cancer. The following resources provide useful information and support to help you quit smoking. Talk to your treating team about any other questions you may have.

This document is a guide only and cannot cover every possible situation. Your treating team will consider your individual situation when making decisions about your care. Contact your doctor, nurse, pharmacist, or radiation therapist if you have any questions or concerns about your treatment, or you are having problems coping with side effects. While eviQ aims to provide reliable information, eviQ and the Cancer Institute NSW do not endorse or accept responsibility for the accuracy, currency, reliability or correctness of the content of linked external information sources. Use of this document is subject to eviQ’s disclaimer available at www.eviQ.org.au

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The currency of this information is guaranteed only up until the date of printing, for any updates please check:

https://www.eviq.org.au/pi/1417

08 Jun 2025