V.A. Zytiga, & pred

[reconjj]

Hello All , Im sticking with V.A. Hines Hospital for my advanced cancer care . I had a visit w/ Dr. Szmulewitz , U of C about 3 weeks ago and he wrote a script for 250mg of Zytiga , 1 5mg of prednisone . 1 pill each a day . So I visited V.A. with their MO , Dr. Elizabeth Henry and showed her the script . She said Ok to the same except she added a 5mg of prednisone at the evening meal ? I didnt discuss that at out meeting because that the 2nd pred she did not mention . The pills were delivered today with that script on the bottle . Anyone here take 2 preds in 1 day along with abi ? Thanks all .

[Tall_Allen]

Was your BP high? Low potassium? Edema? If not, the extra prednisone may be unnecessary and contribute to side effects. Prednisone in the evening may keep you up all night.

[PBnative in reply to Tall_Allen]

Allen , my BP was elevated before I started Orgovyx and Zytiga with 5 mg of prednisone . Would more prednisone possibly lower it ? BP is somewhat controlled by meds.

[Tall_Allen in reply to PBnative]

No. If Zytiga is given with inadequate prednisone (which is biosimilar to natural cortisol), the lack of cortisol causes the pituitary to pump out a hormone that causes BP to rise. The prednisone only lowers BP caused by that, not by other causes.

[PBnative in reply to Tall_Allen]

Gotcha , thanks

[Hidden]

Welcome aboard the Titanic! Us in the band keep playing through ! Let the party begin for you friend . Keep active as possible .. we can tell you things the doc won’t .. Good luck Sir! 🙏

[tango65]

There is confusion with the dose of prednisone since the clinical trials for castration sensitive cancer were done with 5 mg a day of prednisone and the clinical trials for castration resistant cancer were done with 10 mg of prednisone daily (5 mg twice a day).

Besides the FDA says abiraterone should be administered with prednisone 5 mg twice a day.

pubmed.ncbi.nlm.nih.gov/256...

accessdata.fda.gov/drugsatf...

nejm.org/doi/full/10.1056/N...

I would try 5 mg a day and check the blood pressure and if there is swelling around the ankles and request electrolytes check periodically. If there is an increase in the BP, or edema around the uncles and legs or low potassium your should increase the dose of prednisone to 5 mg twice a day.

[reconjj in reply to tango65]

Hey , Tango , great information , Thank You , this all new to me and that is why this site helps us .

[Scout4answers]

You decided not to deal with Dr szmulewitz?If so any particular reason?

[reconjj in reply to Scout4answers]

Im still going to see Dr. S , Feb. 25. This is my second visit. I can stay with him until I see what the on going radiation and new drugs do . . I wanted a complete team for care going forward . I have been in the VA system for many years . So I have Dr. Hirsch , IL. Cyberknife doing the 25 , IMRT , soon , Dr . Szmulewitz U of C , Dr, Henry , MO , at VA . , Dr. James Welsh , Chief of Radiology , VA , and my Uro . So I decided for now the VA way and see where this takes me , and it seems so much easier having a complete team in one place . . The VA treats us real well .

[Scout4answers]

Something valuable that I learned from someone on here was take the prednisone in the morning it will boost your energy level. I take 4 zytiga when I get up to pee the first time generaly around 1am as they will make you tired.

[CAMPSOUPS in reply to Scout4answers]

I wish lol. I take the 5 mg once a day to counter the cortisol production loss from Zytiga. I was hoping to get a boost from it but no such luck ha, ha.

I take all of it (the four Zytiga' s and one prednisone around the time of my 6 a.m. pee. ) 9 times out of 10 I go back to sleep. Get out of bed around 7:30 to 8:00.

I assume there is a steady state level of Zytiga in my system so trying to avoid getting tired from it can't be avoided by taking it in the middle of the night.

[Tommyemily in reply to CAMPSOUPS]

I was instructed always to take the arbiraterone at least two hours after a meal and the prednisone no earlier than one hour later with food. As a result of this regimen over a period of 6 months, combined with Firmagon every 28 days, my psa went from 143 on diagnosis to present 0.02 ng/ml and a total testosterone reading of less than 0.4 nmol/L No side effects other than slight hot flashes from time to time.

[Chrisbaird in reply to Tommyemily]

I’m on same treatment as you for almost a year working well hot flushes in summer months can be hard to cope with PSA has remained low but finding winter months not enough exercise a problem with weather conditions hence weight gain and tiredness factor more

[Concerned-wife in reply to Tommyemily]

The important aspect is 4 abi on an empty stomach. That is why taking it when getting up to pee seems to be convenient.

[CAMPSOUPS in reply to Tommyemily]

Yep good instructions.Abi/Zytiga needs to be taken on a empty stomach.

For some people the prednisone is tough on digestion and is better taken with food.

[Foldem]

I’m on that regimen. I take prednisone with my breakfast and another with lunch. Then 4 Zytiga at bedtime. I have a little trouble swallowing the Zytiga because it’s uncoated and my swallowing muscles are weakened from a throat cancer I beat in 2013. My doctor tells me I can take one Zytiga with my low-fat breakfast and that should be enough because the food amplifies it’s effects. Watch your blood pressure and phosphorus tests. I bought a cuff to check often. Good luck.

[Hidden]

I did on 2004 clinical trial for six months. Besides the two different chemotherapy infusions and two different orals, I took 20 mg of Prednisone in the morning and 10 mg of Prednisone in the evening. I was told that Prednisone has prostate cancer cell killing attributes. To me it was simply part of the trial. However, I did gain 80 pounds.

GD

[Lizardskin]

Been on 5 mg prednisone twice a day since May, 2020 with abriateron. Only problem is made me a diabetic.

[PBnative]

I leave 4 Zytiga out on bedside table so I know whether I’ve taken them . The idea is to take them when I wake up to pee in the night ( 4 x a night at least ) because that’s the only time I have an empty stomach .😂 I take 5mg of prednisone with Orgovyx when I wake up .If I forever to take them in the night I just go ahead and take them first thing in the morning and eat breakfast as usual.

Currently trying Oxybutynin and Desvenlafaxine for nasty hot flashes . My shrink suggested the latter when I told her I had to stop Effexor, even tho it stopped my hot flashes , because it made me feel awful . Desvenlafaxine is like Effexor but better tolerated by many people .

I’ve had a breakthrough Omicron infection this week ( had Covid in Jan 2021 , then monoclonal antibodies , 2 J and J’s and a Pfizer) . I’ve been pretty sick this week but no hot flashes . Was feeling better this morning on day 7 and got a major full sweats hot flash signaling that Covid is passing . I’d rather have hot flashes !

[Texan423]

Yes for about 2 years now with good results PSA.1 and minimal side effects