Switching from prednisone to dexamethasone with abiraterone

[Gearhead]

I'm about to switch, not because my PSA is increasing, but because I'm hopeful that dexamethasone may reduce my blood pressure. Is this a sound or stupid reason to switch?

Lupron plus abiraterone with prednisone have maintained my PSA < 0.1 (from 111 at DX) for over 4 years. I have all the usual SEs, and some seem to be cumulative (specifically fatigue and BP). I'm CSMPC with one known bone met on upper spine. Over the 4+ years, I've tried prednisone at 5 and 10 mg/day in an effort to manage BP, minimize edema, and manage other SEs likely to be associated with prednisone. For the last couple of years, I've been on 5 mg/day prednisone plus 50 mg/day eplerenone (plus 2 other BP meds that I've taken for many years). At first this seemed to help my BP, but it's been slowly increasing. Lately, it averages about 150/70 (with HR ~ 55) at Dr. office and at home.

Obviously, I'd like to continue abiraterone as long as it's working. My reason for believing that switching to dexamethasone might lower my BP is based on data from publications such as Attard as summarized in an Allen Edel blog:

prostatecancer.news/2019/06...

If you've switched to dexamethasone, have you seen any effect on BP? What other effects have you experienced? Are you glad that you switched?

[Tall_Allen]

All you can do is try, right? Good luck.