Prednisone Dose

[vintage42]

For the past 7 months I have taken 1000 mg of abiraterone and 10 mg of Prednisone, and tolerated it well. Testosterone has been completely suppressed.

I understand that abiraterone (Zytiga) requires one to take the steroid Prednisone to replace cortisol that has also been suppressed, and to counteract hypertension and liver injury. I just wish I could understand Prednisone dosing.

Many take 5 mg, someone just said they take 2.5 mg , and my urologist said he prescribed 10 mg for me because 7.5 mg was the ideal and I would not be happy with the effects of less.

Considering the undesirable long term effects of Prednisone, it seems less of it might be better. So why is 2.5 mg OK for one person, 5 mg works for so many, but I get 10 mg?

[Mascouche]

I am not sure how the dosage is picked by the MO but I took 10mg too so you are not alone.

[Tall_Allen]

The standard dose is 5 mg for mHSPC, and 10 mg for mCRPC. Due to individual variation in what cortisol level is normal for you, you may need more or less. Symptoms of insufficiency include high BP, low potassium and edema.

prostatecancer.news/2019/06...

[vintage42 in reply to Tall_Allen]

Thanks. I just started ADT and Abi last winter and am very castrate sensitive. At next appointment in 3 weeks I am going to ask to switch from 10 to 5 mg.

[vintage42 in reply to Tall_Allen]

So I switched myself from 10 to 5mg three weeks before my lab and urologist appointment. The labs were fine, I felt fine, and I showed him the article about dosing. So he agreed to 5 mg.

[Gimmishelter]

I was on 10mg of Prednisone for almost a year, along with 1000mg of Abiraterone. I complained to my MO that I was bruising from the slightest bump and bleeding from even tiny scratches on my arms to the extent that I was carrying bandaids in my car and pockets when going out. My MO reduced my Prednisone to 5mg and within a few weeks my problems were resolved.

[westobutch123 in reply to Gimmishelter]

A while ago, same here. My arms weren't quite the battlefield as at 10mg.

[vintage42 in reply to Gimmishelter]

My arms also have brown bruise blotches, and skin tears that take weeks to heal. And my A1c has risen from 5.6 at the top of the normal range, to 6.0 which my Primary Care says is pre-diabetic. My MO said is could be from meds, and I do read that 10 mg can cause insulin resistance.

Did you just drop the dose from 10 mg to 5 mg, or was there a gradual transition. Were there any adverse effects from the lower dose, such as ankle edema?

[Gimmishelter in reply to vintage42]

Straight to 5mg from 10. I saw my MO yesterday and my BP is good, but I have been on meds for years, so they are working. I do have slight ankle edema, but my MO is not concerned about it.

[vintage42 in reply to Gimmishelter]

So that 5 mg prednisone is with 1000 mg abiraterone?

[Gimmishelter in reply to vintage42]

Correct.

[Gimmishelter in reply to vintage42]

Correct.

[jmarsh]

I got down to 5mg but BP went up. Had to increase BP meds to regulate. But I preferred that over the 10mg of Pred.

[leo2634]

My Doctor lowered my dosage of Zytiga to three tablets and Prednisone to 5mg in the morning with breakfast and 2.5 or half tablet with dinner due to blood level numbers being low . I've been on this dosage since 2018.Side effects are many but tolerable. Never give up never surrender Leo

[jfoesq]

I have been in the 5mg dose for years.

[TuffNuttoCrack]

For what it’s worth I am at 2.5mg per day and a very crude inconsistent break of the pill with my thumbnail. Like you I saw complications such as increased belly fat and propensity to develop diabetes with the standard dose of prednisone. Somebody else recently posted that they should have considered this info as they developed diabetes. Now tall Allen presented a link some time ago in prostate cancer news that guys at the higher doses of prednisone did better. For me I felt better at the higher dose to my back problems. But I asked my oncologist if I could go lower and she said yes. It took weeks to wean off to a lower dose, you can’t just turn off the faucet.

It’s good to have a conversation about this. But the lower dose is not for everyone and you have to be closely monitored.

[Wgly in reply to TuffNuttoCrack]

I think I also saw a link from him that said 0.5 mg of methylprednisolone had fewer side effects and extended the useful life of abiraterone. Is my memory right or wrong - I don't bet any more

[TuffNuttoCrack in reply to Wgly]

Here’s the link, Doctors choice on prednisone vs methylprednisone.

prostatecancer.news/2019/06...

I don’t know which is proven better.

[Wgly in reply to TuffNuttoCrack]

I found another promoting dexamethasone

bjui-journals.onlinelibrary...

[Pford62 in reply to TuffNuttoCrack]

I can’t tell any difference, I’m supposed to be on 5mg , I’d rather do 2.5

[gsun]

I was on 5mg for a few years and was feeling crappy after a while. Doc increased it to 10MG and am feeling much better. I was off abi for a few months and my cortisol level never came back so being on abi for so long gave me Addison’s where it will never come back.

[garyjp9 in reply to gsun]

Me too, brother. Do you now take hydrocortisone, to replace the cortisol?

[gsun in reply to garyjp9]

Went back on prednisone.

[garyjp9 in reply to gsun]

same dose as before- 10mg?

[gsun in reply to garyjp9]

Yes.

[Ron53 in reply to garyjp9]

that's what my oncologist put me on

[doc1947g]

When I used to get COPD exacerbations, my Pneumologist would put me on 50mg of prednisone with an Antibody for 5 to 10 days.

Now that I receive Privigen IgG 45g every 4weeks, NO more excacerbation.

I was not getting enoug Imunoglobuline (IgG) that generate your own Antibody.

[Hotrod65]

Not sure why such high dose...I had PD1 checkpoint inhibitors and put me into Adrenal insufficient, i have to take 5 mg daily ..4 mg in morning , 1 before bed with snack, help prevent low sugar mornings, would like to be weaned off at some point if my body can again produce Cortisone, also have to carry an injection of dexamethisone with me at all times.., the prednisone itself doctors are telling me has damaged both my optic nerves and have open angle glaucoma both eyes being treated for...I can't imagine what 10 mg would have done?, 5 bad enough..ask your doc about possible eye damage from it.

[MomOfMaisy]

My husband is on 1,000 mg abiraterone and 5 mg (1 tablet) of prednisone a day. Has been since December 2023.

[Pford62 in reply to MomOfMaisy]

How’s he doing ? I’m same , but I don’t like the Abi at all

[MomOfMaisy]

He has responded remarkably well. He also has an Eligard injection every 3 months. Other than the normal loss of libido and some body hair loss, as well as a bit of muscle mass loss, he doesn’t have any side effects. No personality changes or mood swings or other issues I’ve heard other men talking about. So far, so good. All labs are normal, as well as undetectable PSA. He had 28 IMRT radiation treatments, as well. Stage 4, metastatic, advanced, Gleason 9.

[Max24 in reply to MomOfMaisy]

Hello Mom Of Maisy: change Eligard for Lupron and my story is identical to yours...hope we both keep it up...(sorta...

[Jbooml]

I’m trying to find a prednisone dosage that relieves my constant joint pain and weakness after 5 yrs taking and recently dropping Zytiga. It seems my cortisols haven’t been restored after dropping Z but I cant confirm my titres as I haven’t had them checked by blood testing…it’s a painful mystery, reminiscent of my first couple months of ADT treatment when my hip joints seemed so weakened I thought they would pop. Anyone similarly affected? Thinking of switching to dexamethasone as a possible Hail Mary.

[Jbooml in reply to Jbooml]

Should say I stopped Z more than a year ago for cardio reasons and only resumed prednisone a couple months back as my joints worsened