# GU PROS Castration resistant Metastatic - abiraterone and dexamethasone - HL7® FHIR® Te Aho o Te Kahu, Cancer Control Agency Implementation Guide v0.1.0

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **GU PROS Castration resistant Metastatic - abiraterone and dexamethasone**

## PlanDefinition: GU PROS Castration resistant Metastatic - abiraterone and dexamethasone 

| | |
| :--- | :--- |
| *Official URL*:https://fhir.nzf.org.nz/fhir/PlanDefinition/52451000210102 | *Version*:0.1.0 |
| Active as of 2026-05-21 | *Computable Name*:GU PROS Castration resistant Metastatic - abiraterone and dexamethasone |
| *Other Identifiers:*http://snomed.info/sct#SNOMED CT International Edition#52451000210102 | |
| **Usage:**Clinical Focus: Disease of the genitourinary system, Clinical Focus: Carcinoma of prostate, Clinical Focus: Hormone refractory prostate cancer (disorder) | |
| **Copyright/Legal**: All rights reserved. | |

 
A drug treatment regimen for Urogenital Prostate Castration resistant Metastatic - abiraterone and dexamethasone 

# GU PROS Castration resistant Metastatic - abiraterone and dexamethasone

## Treatment Overview

This regimen is for corticosteroid switch after progression on abiraterone plus prEDNISone.

##  Cycle 1 (and all further cycles) - 28 days 

**Cycle length:**

28

## Cycle details

##  Cycle 1 (and all further cycles) - 28 days 

| | | | | |
| :--- | :--- | :--- | :--- | :--- |
| abiraterone* | 1000 mg flat Once daily | oral administration | 1 to 28 |  |
| dexamethasone* | 500 microgram flat Once daily | oral administration | 1 to 28 |  |

## Full details

##  Cycle 1 (and all further cycles) - 28 days 

### Day: 1

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 2

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 3

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 4

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 5

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 6

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 7

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 8

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 9

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 10

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 11

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 12

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 13

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 14

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 15

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 16

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 17

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 18

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 19

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 20

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 21

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 22

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 23

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 24

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 25

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 26

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 27

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

### Day: 28

* Medication: abiraterone*
  * Dose: 1000 mg flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take each dose on an empty stomach - one hour before OR two hours after food. Monitor blood pressure at least once a month during treatment; for patients with hypertension monitor blood pressure every 2 weeks for the first 3 months of treatment.
* Medication: dexamethasone*
  * Dose: 500 microgram flat Once daily
  * Route: oral administration
  * Max duration: 
  * Details: **Instructions:**Take with food. Do not stop taking this medicine without consulting your doctor.

## Supportive Care Factors

No supportive care factors specified

## References

 1. Fenioux C, Louvet C, Charton E, et al. Switch from abiraterone plus prednisone to abiraterone plus dexamethasone at asymptomatic PSA progression in patients with metastatic castration-resistant prostate cancer. BJU Int. 2019;123(2):300-306. doi:10.1111/bju.14511, PMID: 30099821 

 2. Romero-Laorden N, Lozano R, Jayaram A, et al. Phase II pilot study of the prednisone to dexamethasone switch in metastatic castration-resistant prostate cancer (mCRPC) patients with limited progression on abiraterone plus prednisone (SWITCH study). Br J Cancer. 2018;119(9):1052-1059. doi:10.1038/s41416-018-0123-9, PMID: 30131546 

 3. Roviello G, Sobhani N, Corona SP, D'Angelo A. Corticosteroid switch after progression on abiraterone acetate plus prednisone. Int J Clin Oncol. 2020 Feb;25(2):240-246. doi: 10.1007/s10147-019-01577-w. Epub 2019 Nov 8., PMID: 31705219 

 4. Attard G, Merseburger AS, Arlt W, Sternberg CN, Feyerabend S, Berruti A, Joniau S, Géczi L, Lefresne F, Lahaye M, Shelby FN, Pissart G, Chua S, Jones RJ, Tombal B. Assessment of the Safety of Glucocorticoid Regimens in Combination With Abiraterone Acetate: A Randomized, Open-Label Phase 2 Study. JAMA Oncol. 2019 Jun 27;5(8):1159–67. doi: 10.1001/jamaoncol.2019.1011. Epub ahead of print. Erratum in: JAMA Oncol. 2019 Aug 1;5(8):1232., PMID: 31246234 

*** The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.**



## Resource Content

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        }],
        "url" : "http://hl7.org.nz/fhir/StructureDefinition/sact-timing-of-days"
      },
      {
        "extension" : [{
          "url" : "day",
          "valueInteger" : 27
        },
        {
          "url" : "instructions",
          "valueString" : "Take with food. Do not stop taking this medicine without consulting your doctor."
        }],
        "url" : "http://hl7.org.nz/fhir/StructureDefinition/sact-timing-of-days"
      },
      {
        "extension" : [{
          "url" : "day",
          "valueInteger" : 28
        },
        {
          "url" : "instructions",
          "valueString" : "Take with food. Do not stop taking this medicine without consulting your doctor."
        }],
        "url" : "http://hl7.org.nz/fhir/StructureDefinition/sact-timing-of-days"
      }],
      "definitionCanonical" : "#b05f461c-ce1d-4976-862d-b96f3ee44341"
    }]
  }]
}

```
