double up on dose….?

[Tommyj2]

taking Abi and pred and can’t recall if I took my AM dose of pred. Am I better off skipping it or taking the chance of doubling up?……informed opinions?

[OuttaTime]

I have had this problem too forgetting right after I take my dose of meds. I am sure I have probably taken my dose twice from forgetting. I looked up my meds and from what I can see they do not recommend taking another dose if you have missed a dose. So that is missing a dose, they say take it at the next scheduled time. I have done that with my meds when forgetting I just took it to make sure but the manufacture says don’t do it, take it the next time. Maybe figure out a way to record the times you take your meds. Heck I would forget that to! If there is someone else around who could verify when you take your meds. Personally I don’t think I would take an extra steroid. You could also count your meds from the day you started taking them and count the doses! And most of all count your blessings!

[fireandice123 in reply to OuttaTime]

I put all my meds and supplements in those pill boxes that have daily compartments. I have 4 of them. One for my Abi, which I take in the middle of the night when I wake up to pee, and one each for my morning meds and supplements, my noon meds, and my bedtime meds. That way I know that I have or haven’t taken what I should have throughout the day.

[Tommyj2 in reply to fireandice123]

Sensible idea….i HAD been really good about remembering but I’m getting worse.

[lowT163 in reply to Tommyj2]

ADT has helped with the forgetfulness for sure for me. Or I’m getting old. Forgetting easy words mostly. Always terrible with names.

[Rocketman1960 in reply to Tommyj2]

We all suffer from brain fog. Don't be to hard on yourself. What I do when I can't recall if I took something is take 1/2 dose figuring a little is better than none or a little more won't hurt you too bad.

[Bruce66 in reply to fireandice123]

I do the same. I got my pill box at the 99 cent store 😀

[MooseJawg in reply to OuttaTime]

My instructions for my meds are if you forget a dose or skip one do not double up - just take your next dose as planned.

[Tommyj2 in reply to MooseJawg]

Thank you….its a toss up now between taking it ( because it’s such a low dose) and not taking it ( because it’s such a low dose🫤) if it happens in the future I’d probably err on the side of taking it…..

[GP24]

The effect is long term. No problem if you skip it.

[Hairclubpresident]

Neither option is a problem. Missing one dose of Prednisone will not be a problem, taking a second 5mg is also not a concern.

However, what you should know, and is not always made clear, is that use of Adrenal suppression agents can lead to permanent hypofunction of the adrenals and lifelong need of steroid replacement. I think a good idea, as long as you are also on Lupron or equivalent, is to take a one week holiday from both meds every 2 months, so the adrenals do not shut down completely.

[vintage42 in reply to Hairclubpresident]

'"... as long as you are also on Lupron or equivalent... take a one week holiday from both meds every 2 months..."

The "both meds" being Abiraterone and Presdnisone? Have you done this? Told your MO? I thought Prednisone should be tapered off, so stopping for a week might have effects.

[Tommyj2 in reply to vintage42]

My MO has never suggested this……why do you suppose not?

[Hairclubpresident in reply to Tommyj2]

I suppose it is because permanent adrenal insufficiency is uncommon, but not rare, and because he/she is not the one who will be affected by it. However, I can't do more than suppose, not knowing your Oncologist.

That said, I am a physician, have dealt with adrenal insufficiency, and was not interested in developing it. I did take suppression vacations, and had no issues doing so.

[Doctorsceptic]

What dose of pred - 5 or 10mg?

[Tommyj2 in reply to Doctorsceptic]

5mg

[Doctorsceptic in reply to Tommyj2]

Ok missing a dose is neither here nor there, equally if you want to be certain just take an extra dose. 5mg is small so doubling up likewise ok. Toss a coin.

[mababa]

Amazon sells these nifty 7 day pill cases, clearly labeled “Sun” “Mon” etc., and that have a compartment for “AM” and “PM.” I now have 4 of them. By filling them all, it helps me know when to reorder, or if I’m soon to run out. And for traveling, I don’t need to carry all those bottles. And I wouldn’t sweat a day of missing the med. Yeah, brain fog, isn’t it great?

[j-o-h-n]

If your meds are in a bottle, then when you take your meds just turn the bottle upside down. Turn the bottle right side up before you go to bed or first thing when you get up the next morning.

(Pill boxes by time of date are better - and can be several boxes depending on when you take the meds. i.e. Morning, Noon, Evening, Bedtime).

Good Luck, Good Health and Good Humor.

j-o-h-n

[Tommyj2 in reply to j-o-h-n]

Good idea!

[garyjp9]

Per comments above, even though I thought I was tapering off the prednisone slowly, I wound up with adrenal insufficiency. Like many of the other side effects we deal with, it sucks.

[Seasid in reply to garyjp9]

I refused to take the prescribed prednisolone, I believe it was prescribed 10 mg per day during my early docetaxel chemotherapy. I was taking dexamethasone before the chemotherapy infusions every cycle.

They didn't like it but I read that with early chemotherapy during the hormone sensitive metastatic prostate cancer taking daily prednisolone is optional.

With Abiraterone you just simply have to take 5 mg per day at least in order to avoid high blood pressure because you are simply replacing the steroids what your Abiraterone treatment is blocking. That is the way how Abiraterone is working by blocking the gland of functioning in order to prevent the testosterone production. That gland also producing steroids and that is what Abiraterone is blocking. Therefore with prednisolone you are actually replacing what is blocked. If your prednisolone dose is correct you will avoid high blood pressure.

Abiraterone has three different effects.

1. Blocking the testicular testosterone production.

2. Blocking the small amount of testosterone production by the adrenal gland.

3. Blocking the testosterone production by the prostate cancer if your cancer mutated and gained the ability to internally produce testosterone from the border cholesterol. That is why I am taking statins in order to minimise that ability of the prostate cancer by lowering my blood cholesterol levels and to force my liver to remove cholesterol deposits even from the cancer.

I am still only on ADT plus started bicalutamide 11 months ago. My PSA is stable at 2.5 after I irradiated my prostate two years ago. I am polymetastatic with distant spread in my bones and had early docetaxel chemotherapy six years ago. My only visible cancer is now in my prostate and that is why I added bicalutamide around a year after my prostate irradiation.

[Seasid in reply to Seasid]

My biggest mistake was that I didn't start bicalutamide earlier, six months after the SBRT radiation of my prostate when my PSA was only 0.25. I was waiting with bicalutamide until my PSA reached 2.0. That was a mistake.

[Seasid in reply to garyjp9]

If it was after stopping Abiraterone than the problem was that your adrenal glands needed time to become fully functional again after stopping Abiraterone because Abiraterone is blocking not just the production of testosterone but also the production of steroids.

During chemotherapy if you take prednisolone you are also suppressing the adrenal gland production of steroids.

[SillyUserName2]

I’m on abi and prednisone. The dose is low, so if you miss one it won’t cause a problem and if you double up, that won’t cause a problem either.

[Tommyj2 in reply to SillyUserName2]

Thanks….this is the kind of answer that is helpful.

[Docker53]

Im not qualified to answer your question on the possible missed dosage however I recommend a pill box that has am and pm. I check my husband's pill box morning and night to make sure he has taken his pills when he is supposed to. He is on the same meds as you. The pill box certainly helps, however if you don't live alone, I would highly recommend another set of eyes looking out for you. If you live alone, just ask Alexa or Google for a daily reminder. Alexa is also great at reminding when your favorite sports is on the tube. Lol. Like we have to remind you guys.

[Professorgary]

use pill organizers.

[Tall_Allen]

If you take it after noon, it will keep you up all night. IMO take a normal dose tomorrow morning.

[Tommyj2 in reply to Tall_Allen]

Interesting…..I’ve been sleeping lousy ever since starting Abi and pred……supposed to take divided doses so one of my doses is always in the afternoon….is there a better schedule that wouldn’t interfere as much with sleep?

[Tall_Allen in reply to Tommyj2]

Take one with breakfast and the other before noon.

[Tall_Allen in reply to Tall_Allen]

It's a genomic test on the biopsy cores.

[Tommyj2 in reply to Tall_Allen]

Pharmacist told me I need to leave at least 6 hours between divided doses……wish there were more consistency in opinions…..