Prednisone on Abiraterone withdrawal?

[Proflac]

Hi. Does anyone one know how long to continue with Prednisone (5mg) after stopping Abiraterone. I assume it takes a while for the body to start making cortisol? Thanks

[Tall_Allen]

Let your oncologist give you a schedule for that. It usually entails slowly reducing the number of days a week you take it over a period of 2-3 weeks. Be vigilant for signs of high blood pressure and edema.

[Proflac in reply to Tall_Allen]

Thanks, will keep on eye on those. I wonder if such a low dose 5mg per day, is in any way harmful to keep on going?

[Tall_Allen in reply to Proflac]

Yes, it does long-term harm.

[Magnus1964]

Your doctor should give you a schedule to ease off. It usually takes two weeks.

[Proflac in reply to Magnus1964]

Thanks, seeing to discuss soon

[Blackpatch]

See sensible replies above... or you can be a complete idiot, like me, and just stop!

When I saw the MO a month or so later and asked why I was feeling horrible (tired), he said "Oh, didn't I tell you, you should take a couple of weeks to taper that stuff down... Oh well, it's too late now... just use Hydralyte for a few weeks to restore potassium in your system, and you'll survive."... and he was right, I did.

[j-o-h-n in reply to Blackpatch]

Take that back, you're not a complete idiot...

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 12/02/2021 6:22 PM EST

[Poowater]

Your MO has the experience to answer all your questions.

[Grumpyswife]

I see there is a warning on the bottle to taper off prednisone.

Would it be the same for dexamethasone, ie needs to taper off? I was unaware tapering was needed for such a small prednisone dose.

[slpdvmmd]

I have continued to be pretty active on abiraterone/pred/decadron but found on long days in the backcountry I was on occasion having a pretty dramatic collapse similar to an Addisonian. I saw an endocrinologist who provided me with some good recommendations. The point is I would consider talking to an endocrinologist as at some point you should probably get corticotropin response test to evaluate your adrenal recovery. There are some academic centers that have endocrine people who routinely consult on cancer patients receiving various hormonal or hormonal suppressive therapies but they are few and far between.

[Proflac in reply to slpdvmmd]

Many thanks

[Proflac]

Thanks for the info.

[treedown]

Having recently done this I wish I had TA's response. My MO said no need to taper and nothing I could find online addressed anything about tapering off a dose as low as 5mg per day. So, I tapered for 1 week by taking it every other day. Doesn't sound like the right choice anymore, but I can't tell if anything I felt had to do with the short days this time of year or the low cortisol. I was never tired other than after exercise and never felt an extreme difference at an time. That doesn't rule out smaller differences. Its clear we are all different on this subject as well and at this point I hope I didn't do any permanent harm.