urgent question

[Simonapo]

What is the equivalent of 10 mg Prednisone if it gets replaced with Dexamethasone. My Dad has been for 3.5 years on Abiraterone and Prednisone (10 mg daily). We are trying to see if replacing Prednisone with Dexamethasone would help, but the oncologist prescribed only 0.5 mg Dexamethasone. Is this enough? I sent a message questioning the dose and the nurse responded that this is what the doctor prescribed and it should be fine. I am concerned that maybe the doctor is used with everyone taking 5mg Prednisone and forgot that my dad is taking 10 mg daily. Please advise.

[Gearhead]

My understanding is that the equivalence is Dex/Pred = 1/10.

[Simonapo in reply to Gearhead]

Thank you

[Doctorsceptic]

0.75mg dexamethasone is equivalent to 5mg prednisone. This is only approximate.

Your normal approximate equivalent of prednisolone to daily cortisol physiological production is 7.5 mg of prednisolone.

So 0.5mg dexamethasone looks low in terms of physiological replacement . Better discuss with doctor. Not really sure what they expect to be gained by switching to dexamethasone.

[Simonapo in reply to Doctorsceptic]

Thank you, reaching out to dr

[CAMPSOUPS in reply to Doctorsceptic]

Switching to dexamethasone is worth a try. It might not work or it may on the other hand extend the benefit of abiraterone for months or a year. Longer in some here on the forum.

[Simonapo in reply to CAMPSOUPS]

Thank you

[CAMPSOUPS in reply to Simonapo]

Keep that filter on sister and thank you for taking care of another brother here, your dad.

❤️❤️❤️

[Simonapo in reply to CAMPSOUPS]

Aww thank you so much ❤️

[WisdomSeeking]

5 mg of prednisone = 0.75 mg of dexamethazone

[OverW3RK3D]

decadron 0.5mg is a good start. It can always been increased. Dexamethasone “hits harder” in my experience. Too little is better than too much.

I don’t tolerate Dexamethasone as well as I do prednisone. Side effects are really rough on my GI tract from the top to the bottom. In other words: go easy on Decadron at first and increase as tolerated.

[Simonapo in reply to OverW3RK3D]

Thank you, that’s good to know.

[CAMPSOUPS in reply to OverW3RK3D]

I was wondering when I read you. Are you indeed taking Dexamethasone as the steroid replacement for the effects of abiraterone or for some other reason?

[OverW3RK3D in reply to CAMPSOUPS]

No, I took Decadron with casodex in the very beginning of my ADT with Lupron.

[Derf4223]

@Simonapo you may want to check with an endocrinologist about prednisone vs dexameth vs whatever for cortisol management, or switch from abiraterone to orgovyx which does not cause adrenal issues. I am not a doctor

[Simonapo in reply to Derf4223]

Thank you

[CAMPSOUPS in reply to Simonapo]

I guess you could consider changing from Lupron/Eligard to Orgovyx but that's not on you or your dads plate now. Orgovyx is not a replacement for abiraterone at all. Completely different.

[Sisto]

Dex seems to be quite a bit more potent than Pred, so I would start with what Doc prescribed. I did get almost an extra year out of Abi thanks to Dex, but the SEs of Dex were, for me, like Pred on steroids. (Sorry). It does seem to be more powerful. I gained some weight with Pred, but with Dex I got to my heaviest.

[Simonapo in reply to Sisto]

Thank you, sorry to hear about dude effects, but getting an extra year in Sbi sounds amazing

[Proflac in reply to Sisto]

Hi. What side effects in addition to weight gain?

[Sisto in reply to Proflac]

My normal pre-ADT weight was 165#ish. Abi plus pred I was 180ish, with dex I hit a high of 192. Slight hypertension, sleep deprivation, and general slight malaise all got a bit worse with dex. I have always been an iADT type, so I tapered the steroids each break. For me, I think the abi was pretty benign. The pred/dex caused me more problems, I think. No regrets, though. Abi lasted more than five years.

[Simonapo in reply to Sisto]

Wow great results, thank you so much.

[Professorgary]

.5 is the standard dose. Please remember that dex is much more potent as an anti inflammatory and has a longer half life which is why prednisone is given in two doses. The studies done were done using .5 mg of dex.

[Simonapo in reply to Professorgary]

Thank you, great info.

[CAMPSOUPS in reply to Professorgary]

Its being given as replacement therapy due to effect of abiraterone. Not given as anti-inflammatory in this case.

[CocoTheAlphaCat]

Switched to Dex a year ago as PSA was trending up, and it drove the number straight down--so of course I'm a fan. Dex is about 10X as powerful as Pred; of course consult with the Doc...

[Simonapo in reply to CocoTheAlphaCat]

Thank you, are you still in Dec, did it work for one year? What about side effects?

[CocoTheAlphaCat in reply to Simonapo]

It's been more than a year. No difference in side effects from Dexa, but everyone is different.

[Simonapo in reply to CocoTheAlphaCat]

Wow, that’s amazing, so happy for you.

[Professorgary in reply to CocoTheAlphaCat]

Are you taking .5mg or 1mg?

[Simonapo in reply to Professorgary]

Nu dad was on 10 mg Prednisone, just switched to 0.5 mg Dex

[CocoTheAlphaCat in reply to Professorgary]

I'm at 0.5 mg.

[Simonapo in reply to CocoTheAlphaCat]

Sane 0.5 mg

[Professorgary in reply to CocoTheAlphaCat]

Thankyou. That is the dosage I started two weeks ago. I was on 5mg prednisone once a day. I think the dex may have increased my appetite.

[Simonapo]

my dad, sorry typo