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Abiraterone 💊 is an oral antiandrogen approved for metastatic hormone sensitive and castrate resistant prostate cancer

Why does abieraterone have to be coadministered with prednisone? 🤔 What if a patient wishes to avoid steroid therapy? 🤯

#oncopharm #pharmpearl
Abiraterone is a CYP17 inhibitor that suppresses downstream non-gonadal androgen synthesis
As a consequence➡️ reflex↗️↗️ ACTH production leads to excess in mineralocorticoids

Early trials WITHOUT pred▶️pts developed severe hypertension, hypokalemia and edema 2/2 ↗️ aldosterone Image
To suppress the reflex activation of the HPA axis & diminish symptoms of mineralocorticoid excess▶️coadministration with prednisone is required

If a pt is reluctant to taking long term pred▶️try Epleronone ✅ Mineralocorticoid receptor antagonist- blocks🛑 aldosterone!
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