JimJimJimJim Posted February 21, 2012 Share Posted February 21, 2012 Ketoconazole vs Zytiga before taxotere Dr Snuffy Myers thoughts in a video posted on 3 August 2011 Ketoconazole has a clearly established role before taxotere - it has been studied ad nausium in this setting. Small's publications, for instance, good evidence for this. No anti-tumor superiority for Zytiga. Convinced Ketoconazole a far safer drug than Zytiga. Zytiga's main problem is that its clearance by the liver saturates within the clinical useable range. This means that a minor change in the amount of drug absorbed results in a big jump in blood level. This is a problem because as Zytiga blood levels get higher, you get liver and heart damage. How big a problem is this? When you take Zytiga with/without a meal, blood levels can go up 20 fold. And what is 'food'? Ketoconazole does not have this problem. Both have problems with drug interactions with several common medications, including some statins (like Lipitor) and cough medicines. But Zytiga will jump much higher than Ketoconazole. So, don't use Zytiga before taxotere until clinical trials have shown its safety in this setting. On present indications (August 2011) Ketoconazole is a much safer drug than Zytiga. This is a rapidly changing field, so this video may be outdated. But check out the video yourself at: Click for video Link to comment Share on other sites More sharing options...
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