OK, I had my first and pretty bad 41 hour AFib last Friday, Im stopping Abiraterone for at least 8 weeks, the Onco will reassess then.
Im now taking Metoprolol which Abiraterone increases the effects of it.
Still taking Prednisone, will start wean tomorrow.
What's your favorite taper/wean plan.
TA, I know you've heard plenty, lets hear yours.😇
Stopped cold turkey with no ill effects. Just my experience
"Stopped cold turkey with no ill effects."
So your adrenal system recovered immediately from being suppressed by the Prednisone. How long had you been on the Prednisone?
I was on 5 mg/day. My MO prescribed 2.5 mg pills and I took them for a few days before stopping completely.
Take the time your body needs. If you go too fast you will have adrenal insufficiency which makes you more fatigued and less resilient to exercise. It took me six weeks after being on it for a year or so.
Slower is better. 2.5 every day, then 2.5 every other day, then 2.5 twice a week, then 2.5 once a week.
Oncology/Ambulatory Pharmacist say, "we tell all Abi patients that stop to just stop Prdnisone too, no need to wean, only 5mg"!!!
The pharmacist is wrong.
"On discontinuation of abiraterone the prednisolone dose should be slowly tapered down and patients should be monitored for adrenal insufficiency. "
swagcanceralliance.nhs.uk/w...
I did 2.5 everyday all last week. Thinking of splitting it once more, and doing 1.25 a day for a week.
So far no sign of adrenal insufficiency.
Just had cardiologist cut back my AFib meds, I was falling asleep (or passing out) heartbeat and BP was way too low!!! 3 mile walk, heartbeat wouldn't go past 70, can you say lack of oxygen?
Im hesitant about going back to Abiraterone (20 month stretch so far) , and thinking of one of the 'lutamides. PSMA/PET has been NED last 6 months. Might just see if Lupron might be enough?
" Might just see if Lupron might be enough?" How could you possibly know if it is enough? Several trials established that the combo prevented progression longer and improved survival compared to ADT alone. What makes you think that you are different from men in those trials?
Wasnt that 24 months Abi and 36 months Lupron?
Ive done 20 months Abi.
Yes. That is in conjunction with whole pelvic radiation.
My fault, my bio isn't filled in.
Yes have had whole pelvic, including lymph nodes to the aortic bifurcation
RP over 6 years ago, one internal iliac LN recurrence 22 months ago.
Started 6 months of Lupron and Abi back then, prior to IMRT. (UCLA)
Now Im at Kaiser.
Sidenote: I am totally impressed on my Kaiser ER, and hospital stay for AFib. I was taken in without wait, immediate drugs to drop heart rate (was at 187) then CT scan within minutes, then an immediate echocardiogram. The room I was in had 2 EMTs, and 1 MD at all times. Until the MD admitted me to ICU, then 2 days in hospital until I regained sinus rhythm. Same MD visits twice daily, and 1 Cardiology MD per day. Nurse called for follow up 24 hours after discharge, and drug management appointment 2 days after that. Im now wearing a heart monitor for 2 days.
I have no issues with Kaiser. Except removing those connective pads on my chest (in case I needed cardioreversion.
Or the adrenal insufficiency will land you in the ER in "septic shock" followed by days in ICU. Happened to my husband twice.
Sorry, septic shock?
I understand septic shock will cause adrenal insufficiency, not the other way around.
Im only asking peoples prednisone taper plan.
Right now, after a week of 5 daily, Im now on 2.5 daily.
What a shock, still in shock regarding septic shock?
Good Luck, Good Health and Good Humor.
j-o-h-n
Shocking!
"Septic shock" is in quotes because that was the ER's diagnosis on the paperwork, what they treated him for. The adrenal insufficiency was a side effect of Keytruda. The maintenance dose will not cover stress to the body. He was unable to take an extra pill (or any pills) when he became unresponsive after his first (and hopefully last) alpha gal crisis.
Finishing my two years on Abi/Pred 5mg at the end of May. Just met MO at Duke on Friday. He said take 5mg every other day for two weeks and then stop altogether. For what it's worth
TA answered this not long ago. I believe he said slower was better. But double check that directly with him.
Depends on how long you have been taking it and the dose. I was taking 10 mg/day for six years and then found out I couldn't stop because my adrenals shut down the production of cortisol.
For most men, TA's suggested approach is the safest one. Some men can get away with just stopping, but it I believe it is a risk not worth taking. I tapered slowly and still developed adrenal insufficiency.
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