Reducing prednisone ?

[reconjj]

Hello All , Im on Eligard , Zytiga ( 250 mg ) , prednisone ( 5mg ) . Can I reduce the pred in half as there is a groove on the pill that i can break in half or can I just take the pred every other day ? I want to reduce that drug if possible or eliminate it . Is there some chemistry between Zytiga and pred that they must be shared to give the Zytiga a boost ? or is it for reducing side effects from Zytiga ? Thanks

[GP24]

You take it to avoid side effects from Zytiga. Zytiga blocks glucocorticoid production by the adrenal cortex. Therefore you add prednisone to compensate this. Not taking prednisone is bad for you, although it takes quite a while until the side effects can be noticed.

[Papa1 in reply to GP24]

In addition to the intended effect, the low dose of prednisone was enough to eliminate arthritis pain in my knee and hip and get range of motion in my shoulder from 50% to 90%. My physiatrist said she’ll keep me on it even if I go off of Abiraterone. I’m probably too old for long term cumulative effects to be of concern —78.

[GP24 in reply to Papa1]

Prednisone suppresses inflammation. This is probably the reason why it helped with your arthritis.

[Magnus1964]

Prednisone replaces what zytiga takes out of you. The dose is or should be 5mg.

[Tall_Allen]

You should not reduce or stop prednisone. It supplies what Zytiga takes away. It has no effect on you. Without it, your BP would be sky high, your potassium low, and you would suffer from edema.

What put such a crazy notion in your head?

[reconjj in reply to Tall_Allen]

I just was wondering about reducing it or stopping it . That why I come to our site to get educated . Thank You Allen

[Tall_Allen in reply to reconjj]

You aren't the first patient to wonder that. I think what happens is that patients read about prednisone on the Internet and don't realize that taking it with Zytiga is a replacement for the cortisol that Zytiga reduces, and is not at all like the situation in men who are taking it for other reasons.

[hansjd]

Hi reconji, as others have said it is necessary to take prednisone with Zytiga. Some take 5 mg others 10 mg. I’m on 10 mg. My MO explained that the amount needed to replace what is stopped by the Zytiga is actually about 7.5 mg. But pred also helps to ‘fight’ the cancer, so the extra 2.5 mg is good.

[Hotrod65]

Bad idea, as always check with your MD, myself being on Prednisone for almost 7 yrs now has caused me alot of side affects , damage to both my optic nerves , causing vision issues currently, but it's required due to the Immunotherapy I'm still on, that causes issues with cortisol..I have been able to reduce dosage to 4 mg from 5 as my Endocrinologist indicates my body is making a small amount on its own now, due to only 2 annual maintenance doses of Pembrolizimab from every 3 weeks/6 week regimen...stopping cold turkey or reducing on your own is a very bad idea..Good luck

[Grandpa4 in reply to Hotrod65]

The normal daily production of steroids is the equivalent of about 4 mg of prednisone a day. We have no data on the efficacy of 4 mg a day but it is intriguing and would likely lower long term steroid side effect like cataracts, thin skin, glucose intolerance and infection. Hopefully someone will do a trial someday. I am also on prednisone but I am not reducing the dose. There Is no rationale for going to 2.5 mg. That is definitely to low.

[Hidden]

I agree that it is necessary to provide replacement steroids when taking Zytiga. Everyone needs to be aware however, that getting off of them after stopping Zytiga isn't always simply a matter of tapering the dose. Longterm use of even low doses can desensitize the adrenal gland's natural production of steroids. It's well worth taking Zytiga IMO, but everyone who does needs to be aware of adrenal insufficiency and be watching it when they are getting off the steroid.

[slpdvmmd]

You could have a pseudo Addisonian type collapse if you acutely stop or decrease the pred. The effect of adrenal suppression is clearly under appreciated by the MO community. If you have a cortrosyn stimulation test you may find that your adrenal response is totally flat and even if you came off zytiga your adrenals may not fully recover. Since I have really tried to remain active by backpacking, backcountry skiing, biking and climbing despite my disease, after a couple of very real backcountry episodes I asked for an endocrinology consult which was well worth the effort. The endocrinologist performed a cortrosyn stimulation test, found me completely suppressed, and made some very good recommendations on electrolyte supplementation and steroid supplementation during times of stress that have been very help for me in my efforts to remain active and doing what I enjoy. Endocrinology has been slow off the mark but they now are developing a subspeciality in oncological endocrinology that addresses endocrine side effects of cancer treatment similar to the earlier development of oncologic cardiology to manage cardiovascular side effects of cancer treatment. Sadly these people are still few and far between and largely isolated to academic centers. However, all endocrinologists have an understanding of adrenal suppression and its side effects and anyone of them could potentially help with your quality of life.

[reconjj in reply to slpdvmmd]

Thanks for that information . We all might need some sort of help like that down the road .

[GummyToad]

I got off it by switching to Nubeqa.

[reconjj in reply to GummyToad]

Was there a reason you got off predisone ? And did the MO agree ? Thanks JJ

[GummyToad in reply to reconjj]

Yes, no mood swings, no hot flashes on Nubeqa... plus, biggest bonus, lower blood pressure

[GummyToad in reply to GummyToad]

My oncologist said no steriod is needed with Nebeqa. So, one less pill or, potential issues with side effects from long-term steriod use. I doubt anyone her thinks that's a bad idea to switch out of Abiraterone to Nubeqa...same effacy