Prednisone Caution

[middlejoel]

In January of this year, I started adding Zytiga and Prednisone to my meds. I also continued Lupron and Avodart. I also have vision/eye issues including Macular Degeneration and I have regular eye injections, and less not forget heart problems.

I subscribe to a monthly publication titled "Worst Pills Best Pills" and in their December 2019 publication there is article about CORTICOSTEROIDS. and it reads......Prednisone (RAYOS) normally used to treat inflammatory and allergic conditions.

It says that long-term use cause a variety of eye disorders, including cataract, glaucoma, and retina detachment. I have seen my vision get much worse since I started prednisone. I don't know why its used in combo with Zytiga, I plan on discontinuing its use and discuss it with my onco, does anyone know of a possible replacement?

jal

[Hidden]

Dexamethasone is a replacement but don't stop taking Prednisone cold turkey, wean yourself off it after a discussion with your MO.

[Tall_Allen]

Don't discontinue suddenly - that is DANGEROUS!! What you read does not apply to you. You are only taking a low replacement dose to replace what the Zytiga takes away. It should have no effect on your eyesight.

[middlejoel in reply to Tall_Allen]

Thanks Tall_ A., I will continue until I meet my DO next month. What happens if I don' take any corticosteroids? I know its been discussed herein but, unfortunately, my memory is just another process that, thanks to ADT meds, is nowhere what it used to be,

jal

[Tall_Allen in reply to middlejoel]

That could damage your health - hypertension, hypokalemia and edema are the first results.

[JamesAtlanta]

When I was on prednisone with Zytiga, I had recurring ocular migraines. And I had a couple of events of blurred vision.

Switched to dexamethasone and my issues went away. Dexamethasone was much easier for my body to tolerate. I’d give that a try, as Fran2020 suggests.

Good luck!

James

[AlanMeyer]

Here's an article on why prednisone is given with Zytiga. It's what Tall_Allen said.

paact.help/adding-prednison...

People react to drugs differently. Although the dose given with Zytiga is relatively low and replaces the expected natural (non-prednisone) corticosteroid deficiency caused by Zytiga, you may be particularly sensitive to prednisone. I suggest that you call your doctor, explain the problem, and ask about switching to dexamethasone. It might be useful to get blood tests before and after the switch to see if anything can be detected that is good or bad regarding the switch.

Best of luck.

Alan

[middlejoel in reply to AlanMeyer]

Thanks everyone for your reply. below is my doctor's reply, I plan on continuing the 5 mg of prednison

Hi,

The dose of prednisone you are on is replacing what your adrenal glands no longer make. It does not give you higher than normal levels so it should not cause this problem with cataracts (the eye damage you’re referring to). That being said about 20% of people can tolerate abiraterone without prednisone.

If you’d like, we can start by cutting the 5 mg pill in half and see how you feel for a few days.

Yours,

Tanya

[AlanMeyer in reply to middlejoel]

I like the cutting in half idea.

1. It might reduce the cataract symptoms with little or no adverse effects.

2. If it doesn't reduce the cataract symptoms then that is some evidence (enough? who knows?) that the prednisone is not causing them.

You might check out the FDA drug label for more info.

Go to: accessdata.fda.gov/scripts/...

Enter the drug name (prednisone, prednisolone, whatever they gave you) in the search box below "Search by Drug Name, Active Ingredient, or Application Number".

Best of luck.

Alan

[middlejoel in reply to AlanMeyer]

Actually Alan, I do have cataracts but they are not the real problem, its the Wet Macular in the back of the eye that is my problem. Wetness as it relates to Macular Degeneration are tiny blood vessels that leak blood inside the eye and affect the vision. The injection into the eyeball is intended to dry the blood.

Thanks for the info and I will check out the source that you provide, I have an appointment with Dr. Dorff next month and I will press her on this.

jal

[j-o-h-n]

FYI from google:

Prednisone side effects

Get emergency medical help if you have any of these signs of an allergic reaction to prednisone: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

blurred vision, eye pain, or seeing halos around lights; <===<<<

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 05/19/2020 7:04 PM DST

[westjl2]

I have been on this combo of Zytiga and 10mb of prednisone for 15 months. My last eye exam in November showed a cataract forming on my left eye. So pretty sure this is from the predisone since I have no history of cataracts prior to starting the predisone which is a brutal drug in so many ways.

But the predisone is said to be necessary as a replacement for what Zytiga does to our cortisol. I would be cautious about going off of it as there are other issues with reduced cortisol.

I just got my PSA results back and it has gone up to 3.9 after staying steady at around 3.4 for the past 6 months. I envy all of you with PSA’s below 1. Hopefully this is lab variation but we will see.

Meanwhile my wife and I are enjoying some of the best days of our lives. I refuse to let this thing take me out, even though it tries to.

[middlejoel in reply to westjl2]

Attaboy west,, attitude is very important now. You say that you take Zytiga with 10 mb, is that mg? Do you take 4 Zytiga pills daily? I take only 1. Cataracts are not my problem had them for years. I wish it was that easy. As explain earlier its the macula. What are your plans if your PSA keeps rising?

[westjl2 in reply to middlejoel]

Yes that is 10mg...I spent to many years working on computers!🤪 I take 4 Zytiga pills every morning on an empty stomach. Then the two 5mg prednisone pills after eating breakfast. I also continue getting an Eligard shot every 4 months. Have been since 2016 when they first diagnosed me with stage 4...all 12 samples were 8 & 9 Gleason scores and mets to Lymph and bone.

I will probably get another 6 rounds or so of Docetaxel when the PSA gets too high AND the bone mets go active again. The mets have stayed stable for 3 years now. I withstood the docetaxle well the last time. Each new treatment is buying time. So I try and spend it well..

The next bullet in the typical treatment belt would then be the new drug called Apalutamide (Erleada). After that it gets murky...😟