Zytiga has anybody tryed it

ralph.townsend1
ralph.townsend1 Member Posts: 359 Member
I'm a Vietnam Vet 1970 with Prostate remove in 2008, Gleason 9 (4+5). After Proton radiation in 08/2009 and by 04/2010 when to MD Anderson for for CT/bone scan and found PC in Lymph node's. Started lupron and Psa when back down to 0.5, but then started climbing again psa 1.5. By 04/2011 at started Bicalutamide and the PSA went back down PSA 0.7, but by 07/2011 back up PSA 1.0. They remove me from the drug 10/2011 PSA 1.2 and kept me on lupron. They waited until 12/2011 to see what the PSA would do and now it was PSA 1.9 Waiting on next drug, took until 01/15/2012 because insurance conpany. PSA 2.6 in 02/01/2012. Started Zytiga 1000 mg with prednisone 5mg. My side effect are OK, but time will tell!!

It is metastatic prostate cancer, I also have two stent in my heart, DiabetesII, and Peripheral Neuropathy thru-out body.

My Brother and sister's are older than me and all in good health! I'm better looking :-)

Where did I go wrong?
«1

Comments

  • Kongo
    Kongo Member Posts: 1,166 Member
    Welcome
    Ralph,

    Welcome to the forum and sorry about your numbers. As you are probably aware, Vietnam era veterans with boots on the ground in country or "brown water" sailors, or sailors who served on certain ships that regularly called on Vietnames ports have a proven link to Agent Orange. These men also tend to have more aggressive cancer as you do. The Agent Orange exposure has also been linked to increased cases of diabetes for Vietnam veterans compared to the general population.

    Hopefully, the VA is paying for your treatment and has awarded you an increased disability number.

    K
  • ralph.townsend1
    ralph.townsend1 Member Posts: 359 Member
    Kongo said:

    Welcome
    Ralph,

    Welcome to the forum and sorry about your numbers. As you are probably aware, Vietnam era veterans with boots on the ground in country or "brown water" sailors, or sailors who served on certain ships that regularly called on Vietnames ports have a proven link to Agent Orange. These men also tend to have more aggressive cancer as you do. The Agent Orange exposure has also been linked to increased cases of diabetes for Vietnam veterans compared to the general population.

    Hopefully, the VA is paying for your treatment and has awarded you an increased disability number.

    K

    Lupron and Zytiga
    The Doctors from MD Anderson have me on the lupron 4 month dose with Zytiga. I think MD Anderson are the best the nation and my Doctor is one the best! They told me last month or should I said to them. How much time do have and said 2 1/2 to 5 years. He said how fast it move into the bone's and if they can slow it down. That do think of MDV3000? VA is Compenstated me 100% totally and Permanently To think I will maybe only make to my 65th birthday. Got shot at and miss and **** at and hit. I know that there is 58 some thousands people that would like to in my shoe, that did not come home and I honor them as the true hero's! Sorry side track, do you know about this Zytiga?
  • Kongo
    Kongo Member Posts: 1,166 Member

    Lupron and Zytiga
    The Doctors from MD Anderson have me on the lupron 4 month dose with Zytiga. I think MD Anderson are the best the nation and my Doctor is one the best! They told me last month or should I said to them. How much time do have and said 2 1/2 to 5 years. He said how fast it move into the bone's and if they can slow it down. That do think of MDV3000? VA is Compenstated me 100% totally and Permanently To think I will maybe only make to my 65th birthday. Got shot at and miss and **** at and hit. I know that there is 58 some thousands people that would like to in my shoe, that did not come home and I honor them as the true hero's! Sorry side track, do you know about this Zytiga?

    MD Anderson
    Ralph,

    I have heard nothing but fantastic reports about MD Anderson and regularly correspond with a radiologist there. Of course you realize that your physican's mortality estimate is only that. Many men have lived much longer periods with advanced cancer. I don't know specifics about Zytigia other than I know that it works inside individual prostate cancer cells to inhibit the production of testosterone in advanced cancer. Zytigia is different from Lupron in that it addresses the cancer cells individually and not the testes. The side effects from Zytigia should be less than from Lupron.

    Eventually prostate cancer becomes resistant to Lupron. As it advances the cancer actually becomes more primitive and eventually begins producing its own testosterone which it needs to survive. That's the point where Zytigia and similar drugs come into play. I think I recall reading that men taking Zytigia survived 33% longer than those men taking a placebo.

    Eventually, all of these drugs become ineffective but hopefully they delay our mortality until something else gets us.

    I'd encourage you to look at diet and nutrition as another tool in fighting prostate cancer, especially your intake of dairy and meat products.

    During that war I spent my time off the coast on an aircraft carrier in Yankee Station...never made it ashore. In retrospect I'm thankful for that and I agree with you about who the true heros there were.

    Best,

    K
  • ralph.townsend1
    ralph.townsend1 Member Posts: 359 Member
    Kongo said:

    MD Anderson
    Ralph,

    I have heard nothing but fantastic reports about MD Anderson and regularly correspond with a radiologist there. Of course you realize that your physican's mortality estimate is only that. Many men have lived much longer periods with advanced cancer. I don't know specifics about Zytigia other than I know that it works inside individual prostate cancer cells to inhibit the production of testosterone in advanced cancer. Zytigia is different from Lupron in that it addresses the cancer cells individually and not the testes. The side effects from Zytigia should be less than from Lupron.

    Eventually prostate cancer becomes resistant to Lupron. As it advances the cancer actually becomes more primitive and eventually begins producing its own testosterone which it needs to survive. That's the point where Zytigia and similar drugs come into play. I think I recall reading that men taking Zytigia survived 33% longer than those men taking a placebo.

    Eventually, all of these drugs become ineffective but hopefully they delay our mortality until something else gets us.

    I'd encourage you to look at diet and nutrition as another tool in fighting prostate cancer, especially your intake of dairy and meat products.

    During that war I spent my time off the coast on an aircraft carrier in Yankee Station...never made it ashore. In retrospect I'm thankful for that and I agree with you about who the true heros there were.

    Best,

    K

    Service/ diet
    First, thank you for your service! If I had a dime everytime a doctor, I want you to go on this diet or you should eat this food. I call it the YO-YO effect. My Heart Doctor wants me on a Protien diet, My primary wants me try this, and my nutritist at MD Anderson keep it under 2000 cal's. But they all know if I eat 1000 cal's aday and on hormone drug it like eating 3000 cal's aday. Primary Doc said walking is my best defense :-) I Thing he right! + Diet and less dairy and meat. I'm like a rabbit eating green's
  • VascodaGama
    VascodaGama Member Posts: 3,511 Member

    Service/ diet
    First, thank you for your service! If I had a dime everytime a doctor, I want you to go on this diet or you should eat this food. I call it the YO-YO effect. My Heart Doctor wants me on a Protien diet, My primary wants me try this, and my nutritist at MD Anderson keep it under 2000 cal's. But they all know if I eat 1000 cal's aday and on hormone drug it like eating 3000 cal's aday. Primary Doc said walking is my best defense :-) I Thing he right! + Diet and less dairy and meat. I'm like a rabbit eating green's

    Where did I go wrong?
    Ralph,

    I read with interest your comments in the various threads in this forum and do understand your “high and low spirits” in your suggestions.
    Treatments for PCa are not perfect and there is lots of guessing when a doctor recommends us something. Your experience in your survival is proving of that and all one can hope is that things work positively in our favour.

    What one have chosen as a therapy is, without any doubt, the best, and we all tend to be biased to recommend the same to others.
    Like you I have endured two failed treatments and now I am on my way to a continuing fight which I will never win. However, I know that I can be the “commandant” and so I can try to move things around when they become “too hot”. I only need to be ready and ahead of the things before they happen. I do it by educating myself in all matters that concern our sickness and try to be healthy to better sustain the side effects of the treatments. In fact the cancer has never bothered me.

    Your treatment with Zytiga seems to be the best you can get for your present status. Your doctor’s suggestion with regards to the newer drug “on the block”, the MDV3100, is also something that have shown success on the trials (now advanced for FDA’s approval). These are drugs I hope one day to get to give me a grip on the cancer.
    Kongo has explained well their action as intratumoral effect in the cancer cells. Lupron is lowering your body’s testosterone and hypogonadism may be causing you the typical “mood change” and “hot flashes”. You can check for this condition with a testosterone test. I would recommend you to get your lipids checked because the condition can cause problems with diabetes and Zytiga may cause liver damage.

    I am still on the beginning (14 months) of the hormonal treatment with Eligard (leuprolide acetate). This drug has caused a decrease in the PSA (from 1.0 to 0.02) and several side effects which I have countered with a change on my diet and life style. I try to be fit and healthy so that my body will accept better any "difficult-to-control" drug in the future (such as Prednisone).

    I would recommend you to get checked for any bone metastases with the newer Na 18F PET bone scan. This can provide more accurate readings which could lead to focal radiation on any spot. MRI with C11 contrast (radioactive agent) and 3Tesla field can check for any metastases in local tissue providing you with added possibilities to “kill” cancer localized. Here is a link;
    http://www.molecularimaging.com.sg/c11_acetate.asp

    You can inquire on the above with your doctor. Another drug that may be of help in your future treatment is Alpharadin from Bayer that is awaiting approval by FDA. This drug attacks PCa in bone successfully. Here is an article on the wonder drug;
    http://www.medicalnewstoday.com/articles/234945.php

    I believe that all of us in this boat got the same question without a proper answer;
    Where did I go wrong?

    The best to you.

    VGama
  • ralph.townsend1
    ralph.townsend1 Member Posts: 359 Member

    Where did I go wrong?
    Ralph,

    I read with interest your comments in the various threads in this forum and do understand your “high and low spirits” in your suggestions.
    Treatments for PCa are not perfect and there is lots of guessing when a doctor recommends us something. Your experience in your survival is proving of that and all one can hope is that things work positively in our favour.

    What one have chosen as a therapy is, without any doubt, the best, and we all tend to be biased to recommend the same to others.
    Like you I have endured two failed treatments and now I am on my way to a continuing fight which I will never win. However, I know that I can be the “commandant” and so I can try to move things around when they become “too hot”. I only need to be ready and ahead of the things before they happen. I do it by educating myself in all matters that concern our sickness and try to be healthy to better sustain the side effects of the treatments. In fact the cancer has never bothered me.

    Your treatment with Zytiga seems to be the best you can get for your present status. Your doctor’s suggestion with regards to the newer drug “on the block”, the MDV3100, is also something that have shown success on the trials (now advanced for FDA’s approval). These are drugs I hope one day to get to give me a grip on the cancer.
    Kongo has explained well their action as intratumoral effect in the cancer cells. Lupron is lowering your body’s testosterone and hypogonadism may be causing you the typical “mood change” and “hot flashes”. You can check for this condition with a testosterone test. I would recommend you to get your lipids checked because the condition can cause problems with diabetes and Zytiga may cause liver damage.

    I am still on the beginning (14 months) of the hormonal treatment with Eligard (leuprolide acetate). This drug has caused a decrease in the PSA (from 1.0 to 0.02) and several side effects which I have countered with a change on my diet and life style. I try to be fit and healthy so that my body will accept better any "difficult-to-control" drug in the future (such as Prednisone).

    I would recommend you to get checked for any bone metastases with the newer Na 18F PET bone scan. This can provide more accurate readings which could lead to focal radiation on any spot. MRI with C11 contrast (radioactive agent) and 3Tesla field can check for any metastases in local tissue providing you with added possibilities to “kill” cancer localized. Here is a link;
    http://www.molecularimaging.com.sg/c11_acetate.asp

    You can inquire on the above with your doctor. Another drug that may be of help in your future treatment is Alpharadin from Bayer that is awaiting approval by FDA. This drug attacks PCa in bone successfully. Here is an article on the wonder drug;
    http://www.medicalnewstoday.com/articles/234945.php

    I believe that all of us in this boat got the same question without a proper answer;
    Where did I go wrong?

    The best to you.

    VGama

    Highs and lows
    Vascodagama
    Yes, you hit it on the head. My condition's is one day in the gutter and the next day on top of the world. If I was just fighting cancer, I would be a happy camper, but the other condition's cause more problem with the drug's I take for the cancer. Along with the Peripheral neuropathy and bowel dysfunction and diabetes II and it goes on, But the good thing is that I'm taking walk's again" everyday :)))! My mind sometime fade in-out with the lyrica. Oh yes with the Zytiga you have to take the Prednisone

    The best for you TOO

    Ralph
  • ssyyp6
    ssyyp6 Member Posts: 4
    MD Anderson
    hi, my friend is going through very tough time right now due to his high PSA, it seems the chemo treatment doesn't work on him, because his PSA is still going up, and doctor said he might be out of option, i am so worry about him, trying to find the best and specialist doctor for him to try again, you are talking about MD Anderson, how to find him, is he very good? thank you for you great help!
  • Kongo
    Kongo Member Posts: 1,166 Member
    ssyyp6 said:

    MD Anderson
    hi, my friend is going through very tough time right now due to his high PSA, it seems the chemo treatment doesn't work on him, because his PSA is still going up, and doctor said he might be out of option, i am so worry about him, trying to find the best and specialist doctor for him to try again, you are talking about MD Anderson, how to find him, is he very good? thank you for you great help!

    Sorry about your friend
    ssyyp,

    So sorry about your friend. Although the details you shared are pretty sketchy, high and rising PSA after chemotherapy is not a good sign as I'm sure you and your friend realize. Typically, chemotherapy is the last option for advanced prostate cancer.

    I hope he seeks other opinions but MD Anderson has a great reputation as a world class cancer center and I am sure his medical team is doing everything possible. Sometimes, despite the best efforts of science and the medical community, these aggressive cancers win out in the long term.

    Can you share more details about your friend and his medical history in reaching this stage?

    Hoping for the best.

    K
  • ralph.townsend1
    ralph.townsend1 Member Posts: 359 Member
    ssyyp6 said:

    MD Anderson
    hi, my friend is going through very tough time right now due to his high PSA, it seems the chemo treatment doesn't work on him, because his PSA is still going up, and doctor said he might be out of option, i am so worry about him, trying to find the best and specialist doctor for him to try again, you are talking about MD Anderson, how to find him, is he very good? thank you for you great help!

    One month on Zytiga
    One thing I for sure like about MD Anderson is the way they attack this Prostate Cancer. Mine is stage at M1a. They have never talk about Chemo treatment with me. But like this Zytiga drug you had to have Chemo first before you could take it. Md Anderson got FDA to allow aproval use od Zytiga before. I have been on the drug for one month and my PSA is down to .3. MD Anderson Dr. are excited and me too. They said this new test is show great result and that it could keep my cancer in check for up 1 to 2 years. Or it work for only 3-to 5 month. They have to watch my liver every month. IT LOOKS GOOD
  • Kongo
    Kongo Member Posts: 1,166 Member

    One month on Zytiga
    One thing I for sure like about MD Anderson is the way they attack this Prostate Cancer. Mine is stage at M1a. They have never talk about Chemo treatment with me. But like this Zytiga drug you had to have Chemo first before you could take it. Md Anderson got FDA to allow aproval use od Zytiga before. I have been on the drug for one month and my PSA is down to .3. MD Anderson Dr. are excited and me too. They said this new test is show great result and that it could keep my cancer in check for up 1 to 2 years. Or it work for only 3-to 5 month. They have to watch my liver every month. IT LOOKS GOOD

    Great news,
    Ralph,

    That's great news. There are some potentially significant side effects with Zytigia as your medical team may have explained to you, but your results so far are fantastic.

    Here's a handy reference on potential side effect I think you should bookmark.

    http://www.drugs.com/sfx/zytiga-side-effects.html

    K
  • dcpowders
    dcpowders Member Posts: 2

    One month on Zytiga
    One thing I for sure like about MD Anderson is the way they attack this Prostate Cancer. Mine is stage at M1a. They have never talk about Chemo treatment with me. But like this Zytiga drug you had to have Chemo first before you could take it. Md Anderson got FDA to allow aproval use od Zytiga before. I have been on the drug for one month and my PSA is down to .3. MD Anderson Dr. are excited and me too. They said this new test is show great result and that it could keep my cancer in check for up 1 to 2 years. Or it work for only 3-to 5 month. They have to watch my liver every month. IT LOOKS GOOD

    zytiga
    Glad for you, do you know of any foundation or help in paying for Zytiga, we have the Part D drug coverage but even with that it will be 4700 out of pocket per year, and then at least 250 per month, that can wipe a savings out really fast, please help if you can, thanks
  • mrspjd
    mrspjd Member Posts: 694 Member
    dcpowders said:

    zytiga
    Glad for you, do you know of any foundation or help in paying for Zytiga, we have the Part D drug coverage but even with that it will be 4700 out of pocket per year, and then at least 250 per month, that can wipe a savings out really fast, please help if you can, thanks

    assistance paying for Zytiga
    dc,

    Welcome here. Have you tried the Zytiga site or through Zytiga's pharma manufacturer, Johnson & Johnson?
    http://www.zytigahcp.com/zytigaone-support-for-patients
    http://www.zytiga.com/support_and_resources/zytiga_coverage.php

    You might also try doing an internet search (with google, etc) using the words "zytiga financial assistance." Hope these suggestions prove helpful. Good luck.
  • dcpowders
    dcpowders Member Posts: 2
    mrspjd said:

    assistance paying for Zytiga
    dc,

    Welcome here. Have you tried the Zytiga site or through Zytiga's pharma manufacturer, Johnson & Johnson?
    http://www.zytigahcp.com/zytigaone-support-for-patients
    http://www.zytiga.com/support_and_resources/zytiga_coverage.php

    You might also try doing an internet search (with google, etc) using the words "zytiga financial assistance." Hope these suggestions prove helpful. Good luck.

    I will certainly give it a
    I will certainly give it a try, thanks so much
  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,736 Member
    Zytiga

    A buddy (71 years old) has been Stage IV with prostate cancer for some time. His prostate was cut out about 12 years ago, and treatments of every kind (radiation, hormonal, chemo)have been off and on pretty much since.

    His PSA was an incredible 260.00 (this is NOT a typo; his PSA always runs over 200.00) when he started Zytiga about three months ago. At his most recent check, the PSA was down to around 40, a very dramatic drop, of course. He feels great (always has), and the drug has had no side effects so far. He is taking four pills a day at home.

    max
  • lookin4aMiracle
    lookin4aMiracle Member Posts: 2

    Zytiga

    A buddy (71 years old) has been Stage IV with prostate cancer for some time. His prostate was cut out about 12 years ago, and treatments of every kind (radiation, hormonal, chemo)have been off and on pretty much since.

    His PSA was an incredible 260.00 (this is NOT a typo; his PSA always runs over 200.00) when he started Zytiga about three months ago. At his most recent check, the PSA was down to around 40, a very dramatic drop, of course. He feels great (always has), and the drug has had no side effects so far. He is taking four pills a day at home.

    max

    Zytiga - PSA readings question
    Inquiring on behalf of my father... Anyone seen PSA's rise a bit after being on Zytiga for about 6 weeks? I hear this can happen, but wondering if there are any cases/examples someone can give. Looking for anyone who has had an initial dip, then temporary rise, then decreasing PSAs from there.

    thanks!
  • lookin4aMiracle
    lookin4aMiracle Member Posts: 2

    Zytiga

    A buddy (71 years old) has been Stage IV with prostate cancer for some time. His prostate was cut out about 12 years ago, and treatments of every kind (radiation, hormonal, chemo)have been off and on pretty much since.

    His PSA was an incredible 260.00 (this is NOT a typo; his PSA always runs over 200.00) when he started Zytiga about three months ago. At his most recent check, the PSA was down to around 40, a very dramatic drop, of course. He feels great (always has), and the drug has had no side effects so far. He is taking four pills a day at home.

    max

    Zytiga - PSA readings question
    Inquiring on behalf of my father... Anyone seen PSA's rise a bit after being on Zytiga for about 6 weeks? I hear this can happen, but wondering if there are any cases/examples someone can give. Looking for anyone who has had an initial dip, then temporary rise, then decreasing PSAs from there.

    thanks!
  • VascodaGama
    VascodaGama Member Posts: 3,511 Member

    Zytiga - PSA readings question
    Inquiring on behalf of my father... Anyone seen PSA's rise a bit after being on Zytiga for about 6 weeks? I hear this can happen, but wondering if there are any cases/examples someone can give. Looking for anyone who has had an initial dip, then temporary rise, then decreasing PSAs from there.

    thanks!

    Bad administration could be the cause
    Miracle

    Zytiga is an inhibitor of the enzyme 17 α-hydroxylase/C17,20 lyase that is required for testosterone production. This is a drug capable of intratumoral activity, stopping the production of testosterone within the cancer cells (their androgen factory) along with the production at the testes and adrenal glands, inducing the cancer to die from “starvation”.
    An increase of the PSA due to active cancer would mean that your dad is experiencing hormone treatment failure. Chemotherapy and immunotherapy would be his next choices to control any advance of cancer.

    Nevertheless, a small rise could be due to a variety of other factors. Bad administration or bad metabolism/absorption of the drug may cause it not to function properly in stopping the production of androgens. The drug is recommended to be taken together with prednisone to avoid liver problems (causing hypokalemia), and it should be taken on an empty stomach for proper metabolism but low levels of acidity may cause the drug to be badly absorbed. Taking other medications may also cause interaction with a result of bad absorption of Zytiga. Doctors may prescribe higher doses in such cases or adopt other means to control acidity.

    I recommend you to discuss with his doctor or an oncologist specialist in targeted medication, before drawing any conclusion.
    Constant vigilance of lips is important (liver health, etc).
    I wonder what are the levels of PSA you are describbing. Can you share info on his case, status, age and reason for taking Zytiga?

    Wishing you find peace of mind.

    VGama
  • ralph.townsend1
    ralph.townsend1 Member Posts: 359 Member

    Bad administration could be the cause
    Miracle

    Zytiga is an inhibitor of the enzyme 17 α-hydroxylase/C17,20 lyase that is required for testosterone production. This is a drug capable of intratumoral activity, stopping the production of testosterone within the cancer cells (their androgen factory) along with the production at the testes and adrenal glands, inducing the cancer to die from “starvation”.
    An increase of the PSA due to active cancer would mean that your dad is experiencing hormone treatment failure. Chemotherapy and immunotherapy would be his next choices to control any advance of cancer.

    Nevertheless, a small rise could be due to a variety of other factors. Bad administration or bad metabolism/absorption of the drug may cause it not to function properly in stopping the production of androgens. The drug is recommended to be taken together with prednisone to avoid liver problems (causing hypokalemia), and it should be taken on an empty stomach for proper metabolism but low levels of acidity may cause the drug to be badly absorbed. Taking other medications may also cause interaction with a result of bad absorption of Zytiga. Doctors may prescribe higher doses in such cases or adopt other means to control acidity.

    I recommend you to discuss with his doctor or an oncologist specialist in targeted medication, before drawing any conclusion.
    Constant vigilance of lips is important (liver health, etc).
    I wonder what are the levels of PSA you are describbing. Can you share info on his case, status, age and reason for taking Zytiga?

    Wishing you find peace of mind.

    VGama

    Vigilance
    Miracle, I have been on Zytiga since 02/2012 and the psa from my test has been at 0.3 down to 0.2 and holding. As VGama said that need to be careful in when he takes the Zytiga VS predinisone. My Doctor from MD Anderson said eat some food in morning and take the Prednisone after you eat and start a 2 hour alarm clock and when the time is up take the 4 Zytiga pills and start a time 1 hour before eating. Never miss your Prednisone!!!

    With all the medicine I'm on, I forget to follow my schedule. So I make sure of my alarm clock.

    Good luck, would also like to know his status psa, gleason scores, age

    God bless :-)
  • Samsungtech1
    Samsungtech1 Member Posts: 351

    Vigilance
    Miracle, I have been on Zytiga since 02/2012 and the psa from my test has been at 0.3 down to 0.2 and holding. As VGama said that need to be careful in when he takes the Zytiga VS predinisone. My Doctor from MD Anderson said eat some food in morning and take the Prednisone after you eat and start a 2 hour alarm clock and when the time is up take the 4 Zytiga pills and start a time 1 hour before eating. Never miss your Prednisone!!!

    With all the medicine I'm on, I forget to follow my schedule. So I make sure of my alarm clock.

    Good luck, would also like to know his status psa, gleason scores, age

    God bless :-)

    Congradulations
    Ralph,

    Really good news. I am really happy for you. Wish you continued success. Keep it up.

    Happy Fourth, I hope you enjoy your day.

    Mike
  • VascodaGama
    VascodaGama Member Posts: 3,511 Member

    Congradulations
    Ralph,

    Really good news. I am really happy for you. Wish you continued success. Keep it up.

    Happy Fourth, I hope you enjoy your day.

    Mike

    Time-schedule for drugs
    Ralph

    I recall you telling us about other pills you are taking. Could you explain about your daily time-schedule to take them including any meal?

    Your above comment is important for all of us (the ones on the drug and to the ones like me that will surely follow your suit), and I am aware of the interaction/reaction between drugs which may be toxic if not properly administered.

    Appreciated.

    VG