Alternative to prednesone?: I am taking... - Advanced Prostate...

Advanced Prostate Cancer

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Alternative to prednesone?

spencoid2 profile image
16 Replies

I am taking prednesone not near bed time and am still having difficulty sleeping. Predbesone is supposed to be essential with Firmagon and Aberaterone. My primary called freaked out when she heard I was on prednesone considering all my side effect from the whole mess but many can be attributed to prednesone.

Have a message into MO to see if I can get on something else.

Anyone whoe what the options might be?

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spencoid2
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16 Replies
Tall_Allen profile image
Tall_Allen

Your primary doesn't understand that it is only a replacement dose. I think all corticosteroids have that effect.

spencoid2 profile image
spencoid2 in reply to Tall_Allen

so the 5mg twice daily is not that horrible and changing to another steroid would have no benefit unless i had specific side effects that another might not have?

Tall_Allen profile image
Tall_Allen in reply to spencoid2

What side effects?

spencoid2 profile image
spencoid2 in reply to Tall_Allen

inability to sleep but that might be getting better? brain fog but that is probably due to lack of T. I am getting used to it somewhat. Not the programmer I used to be but I have so much code written I can copy and paste for most of my needs and the plan is to not take on new projects but I have said that before :)

6357axbz profile image
6357axbz

Dexamethasone Is an alternative. I switched from prednisone to that.

tango65 profile image
tango65

Abiraterone blocks the synthesis of corticosteroids by the suprarenal glands except for mineralocorticosteroids mainly aldosterone.

The drop in cortisol causes an increase in ACTH which stimulates the adrenal glands resulting in a aldosterone increase. The aldosterone increase leads to sodium retention and eventually to edema (fluid retention) and hypertension. Aldosterone also causes an increased elimination of potassium, resulting in hypokalemia which could lead to heart arrhythmias.

Prednisone is given with abiraterone to block the increase in ACTH and the subsequent increase in aldosterone.

If prednisone is not tolerated , a possible way around prednisone is to use specific aldosterone receptors blockers such as eplerenone (Inspra). If the excess of aldosterone is blocked then the consequences of the excess of aldosterone are controlled.

ncbi.nlm.nih.gov/pmc/articl...

cesces profile image
cesces in reply to tango65

Nice explanation.

GoBucks profile image
GoBucks in reply to cesces

Yeah, that's what I was going to say but he beat me to it.

fmenninger profile image
fmenninger in reply to tango65

Great job explaining Tango!!

tango65 profile image
tango65 in reply to fmenninger

Thanks. Best of luck on the journey.

tallguy2 profile image
tallguy2

I take my 5-mg of prednisone with breakfast. Taking 1000-mg of abiraterone.Be aware a side effect I have due to the 20-months of prednisone is micro-cataracts. Cataract surgery is likely in my near future.

Flash64 profile image
Flash64

I take 5mg right before breakfast every day

London441 profile image
London441

Good and interesting medical input from Tango65.

Just as good is taking it with breakfast. You say you’re taking it ‘not near bed time’. Perhaps at breakfast is that much better.

My $.02 never changes as you know:

The more you exercise the better you’ll sleep

spencoid2 profile image
spencoid2

i took it in the morning and mid day. it seems that my MO is tapering me off since i am not taking it just once a day and am probably going to be on something else? my husband is acting as intermediary to make sure it is as confused as possible.

MateoBeach profile image
MateoBeach

A single morning dose is sufficient for some men on abiraterone. That is when ACTH is highest. But must verify individually by checking BPs, and potassium. Your primary does not understand why it is necessary and that it is low-dose. Ask her to read up on abiraterone before jumping to such conclusions.

spencoid2 profile image
spencoid2 in reply to MateoBeach

she didn't jump to conclusions she was just concerned. she thought i was manic and suggested asking the MO (whom she had recommended) about meds especially prednisone. I see my MO tomorrow.

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