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- Title
Potential negative pharmacodynamic interaction of spironolactone and abiraterone in two prostate cancer patients.
- Authors
Vicente-Valor, Juan; Escudero-Vilaplana, Vicente; Collado-Borrell, Roberto; López-López, Cristina; Villanueva-Bueno, Cristina; Revuelta-Herrero, José Luis; Ruiz-Briones, Paula; Somoza-Fernández, Beatriz; Herranz, Ana; Sanjurjo, María
- Abstract
Introduction: Spironolactone when combined with abiraterone in metastatic castration-resistant prostate cancer (mCRPC) may theoretically exert androgenic properties, thereby compromising the therapeutic effectiveness of abiraterone. Case report: Two patients with a medical history of cardiovascular disease and mCRPC combined spironolactone within the course of abiraterone regimen. The abiraterone-spironolactone interaction was identified using the Lexicomp® interaction tool (classified as risk C). Management & outcome: Spironolactone treatment was maintained as it was considered beneficial due to the cardiac condition. The prostate-specific antigen (PSA) levels started to rise when these two drugs were used together. Eventually, tumour progression was observed. Discussion: There is increasing evidence that spironolactone behaves as a selective androgen receptor modulator. Strategies to overcome abiraterone-spironolactone interaction could involve the use of eplerenone, although this drug is also controversial. The best strategy should imply a multidisciplinary evaluation by cardiologists and oncologists.
- Subjects
SPIRONOLACTONE; CANCER invasiveness; CARDIOLOGISTS; METASTASIS; ABIRATERONE acetate; CARDIOVASCULAR diseases; CASTRATION-resistant prostate cancer; DRUG interactions; HEALTH care teams; DRUG side effects; PROSTATE-specific antigen; ONCOLOGISTS; PHARMACODYNAMICS; DISEASE risk factors
- Publication
Journal of Oncology Pharmacy Practice, 2022, Vol 28, Issue 5, p1259
- ISSN
1078-1552
- Publication type
Article
- DOI
10.1177/10781552221074621