Opinion
Video
Formulations, Food, and Frequency: Optimizing Absorption and Tolerability in Daily Practice
Author(s):
Paul E. Dato, MD, discusses how formulation and dosing differences between abiraterone options affect absorption and tolerability, with the micronized version potentially providing better compliance due to no fasting requirement, though insurance coverage remains a significant hurdle for its use.
Clinical Brief: Pharmacokinetic and Safety Considerations With Abiraterone Formulations
Main Discussion Topics
- Absorption Differences: Fasting requirements significantly impact drug absorption and plasma levels
- Safety Profile: Similar across formulations, but risk of adverse effects increases with variable plasma levels
- Potential Adverse Events: Hypertension, sodium retention, edema, hypokalemia, and hepatic toxicity
- Clinical Decision-Making: Balancing efficacy, tolerability, compliance, and access considerations
Key Points for Physicians
- Micronized formulation provides more consistent pharmacokinetic profile without fasting requirement
- Standard and generic formulations require strict patient education regarding timing and fasting
- All formulations are administered once daily
- Regular monitoring for compliance and adverse effects is essential regardless of formulation
Notable Insights
Treatment selection should be tailored based on food-dependent absorption, tolerability, and compliance factors, with careful patient education and follow-up being critical components of care.
Clinical Significance
The selection of abiraterone formulation impacts not only drug efficacy but also patient adherence and safety profile, requiring physicians to balance pharmacokinetic considerations with practical aspects of patient care.
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