Following the CSPC Prednisone recommendations from Zytiga?

[Joes-dad]

I know that this has come up before so I apologize for bringing it up again. I'm wonder if anyone is following Section 2.2 in the Zytiga dosing document recommendations for CSPC?

2 DOSAGE AND ADMINISTRATION

2.1 Recommended Dose for metastatic CRPC

The recommended dose of ZYTIGA is 1,000 mg (two 500 mg tablets or four 250 mg

tablets) orally once daily with prednisone 5 mg orally twice daily.

2.2 Recommended Dose for metastatic high-risk CSPC

The recommended dose of ZYTIGA is 1,000 mg (two 500 mg tablets or four 250 mg

tablets) orally once daily with prednisone 5 mg administered orally once daily.

I'm currently CS but my MO has me on two 5mg's a day and not the recommended 1 per day.

What are you CS folks doing?

[Tall_Allen]

One 5-mg of prednisone was the replacement dose given in the STAMPEDE and LATITUDE clinical trials of abiraterone for mHSPC. His potassium levels should be watched closely - if it gets too low, add more prednisone.

[Joes-dad in reply to Tall_Allen]

Thanks. I didn't know about checking the potassium levels. Maybe we can't reduce it to 1 per day then. While taking two 5 mg per day, my potassium level has been 4.0 - 4.2 mEq/L since February. That seems close to the low end of the 3.5 - 5.0 my results list as the normal range. Thoughts?

[Tall_Allen in reply to Joes-dad]

You can try a lower dose if the higher dose is bothersome - increase if potassium falls too low, or if hypertension or edema.

[Joes-dad in reply to Tall_Allen]

I'm truly glad that you are so well versed in this. Before my treatment started, my blood pressure was always "good" but since starting my treatment of ADT, Z&P, I'm in the pre-hypertension range but staying steady there. It sounds like a balancing act to get everything right.

[Joes-dad]

Thanks for the link tango65! I reached out to my MO to get his reasons for putting me on 2 per day. Did he have reasons or was it a oversight? I included what I posted here from the Zytiga dosing document. I'm sure he has it though. I can't wait to hear back. Part of me is testing him and his knowledge on this. The other part of me is making sure I'm taking the right amounts and trying to stay in charge and educated in my treatment.

[tango65 in reply to Joes-dad]

When taken Zytiga the adrenals can not produce cortisol . This could lead to and increase of ACTH. ACTH is the hormone that stimulates the adrenals. The increase in ACTH could cause an increase of aldosterone, the hormone causing retention of sodium and fluids and increasing elimination of potassium. Taking prednisone can decrease the ACTH and the increase in production of mineralcorticoid hormones and help to control hypokalemia, hypertension and fluid retention.

ncbi.nlm.nih.gov/pubmed/235...

[Canoehead]

My MO is a researcher, and when I started early Zytiga, he immediately told me to take only 5 mg/day of prednisone. I have not had any problems.

[npaulson1]

5 mgs prednisone daily works for me, and I'm on 500 mgs of Zytiga (two tablets) per day. The regular dose made my liver unhappy and my MO is fine with being off the trial's standard. Things are fine after a year at those levels.

[leo2634]

My doctor put me on Zytiga at first 1000 mg per day as my first line of treatments.

When my liver count went into the high range he cut the Zytiga to 750 mg. ,Prednisone is still at two per day with meals.PSA dropped to undetectable in one month, No significant side effects other than the normal ADT bothersome ones. I Did ask him about the Prednisone amount and his answer was that 10 mg. Is the recommended dose but if I showed any severe changes we would look into lowering dosage or replacing with another medication

But for now we both agreed if it's not broken don't try and fix it

Never give up never surrender

Leo

[Mkeman]

My MO said new studies showed that 2.5 mg of prednisone twice a day was adequate so she cut me down to that from two 5mg tabs. It had

Immediate positive effect on my blood sugar which had sky rocketed on the higher dose.

[Leapord77]

Hello, i am 72, prostate/bone cancer.. zytiga 4 250 mlg /day.. 2 prednisone tabs/day. take them at night before bed.. morning take electrolyte supplements emergency-c packets at walmart $ 10/ 30 packets.. the meds will wipe out your electrolytes..must keep them topped off every day.. also taking high grade carbohydrates with electrolytes used for gym workout..KARBOLYN HYDRATE. $45 at vitamin shoppe..take one scoop each morning will give you more energy.. Stopped taking oxycontin..2/day for 3 years.. too much constipation.. helped bring up energy.. Started loading with creatine( i worked out at golds gym many years) take 1 teaspoon creatine 4 times /day..do it for 1 week..then take 2 teaspoons each day.. for maintenance..this causes cells to take in more water and nutrients.. must drink more water.. So now am back in the gym and have been increasing intensity of my workouts which are total body and last 2 hours.. To do this i take 2 scoops of C-4 workout powder mixed with water and fill a bottle with 3 scoops of karolyn carbohydrates.. this jacks me up and supplies muscles with complex carbs for sustained energy.. I start with 20 minutes on treadmill at 3.0 mph.. the more you do this the more your energy will increase.. Doc started me on anti-depressants ZOLOFT.. works really good for me.. takes about 2 1/2 weeks to really kick in but then downer thoughts are gone..

take 1/2 pill of 100 mg pills..they break in half easily.. HOPE THIS WILL HELP BUT WE ARE ALL DIFFERENT IN CHEMISTRY AND HABITS..

[Leapord77]

Hello, i am 72, prostate/bone cancer.. zytiga 4 250 mlg /day.. 2 prednisone tabs/day. take them at night before bed.. morning take electrolyte supplements emergency-c packets at walmart $ 10/ 30 packets.. the meds will wipe out your electrolytes..must keep them topped off every day.. also taking high grade carbohydrates with electrolytes used for gym workout..KARBOLYN HYDRATE. $45 at vitamin shoppe..take one scoop each morning will give you more energy.. Stopped taking oxycontin..2/day for 3 years.. too much constipation.. helped bring up energy.. Started loading with creatine( i worked out at golds gym many years) take 1 teaspoon creatine 4 times /day..do it for 1 week..then take 2 teaspoons each day.. for maintenance..this causes cells to take in more water and nutrients.. must drink more water.. So now am back in the gym and have been increasing intensity of my workouts which are total body and last 2 hours.. To do this i take 2 scoops of C-4 workout powder mixed with water and fill a bottle with 3 scoops of karolyn carbohydrates.. this jacks me up and supplies muscles with complex carbs for sustained energy.. I start with 20 minutes on treadmill at 3.0 mph.. the more you do this the more your energy will increase.. Doc started me on anti-depressants ZOLOFT.. works really good for me.. takes about 2 1/2 weeks to really kick in but then downer thoughts are gone..

take 1/2 pill of 100 mg pills..they break in half easily.. HOPE THIS WILL HELP BUT WE ARE ALL DIFFERENT IN CHEMISTRY AND HABITS..

[Leapord77]

Hello, I just tried a different energy enhancement combo.. For get up and go in the morning, take 1 scoop of N.O.EXPLODE PRE WORKOUT STIMULANT.. 30$/30 SCOOPS.. 1 SCOOP KARBOLYN HYDRATE.. THIS SHOULD DO THE JOB FOR YOU EVEN IF YOU DONT GO TO THE GYM.. BUT GOOD IDEA TO GET AS MUCH EXERCISE AS POSSIBLE.. I took 1 scoop N.O. Explode and 1 scoop of C-4 pre workout stimulant last time i went to the gym and had no problems..

[jdm3 in reply to Leapord77]

If I understand this correctly, it seems we should be careful with electrolyte drinks if they add too much sodium to the system. Good perhaps to get the potassium but maybe not too much more sodium while on Z and P.