Dealing With Steroid Come-down after FOLFOX

Hi PeteMC.

I'm on different chemo + steriod combo but have same steriod come down challenge.

I look forward to seeing what answers you get. Great question, thanks for raising it!

Hi. You could maybe try the Ask the Nurse page? x

https://community.macmillan.org.uk/cancer_experiences/ask_the_expert

Hello PeteMC & CrumpetsOrToast

I’ve had two courses of FOLFOX, and am now on my 5th cycle of FOLFIRI. Like you, I’ve appreciated the steroid lift. And it’s tempting to ride that wave and carry on as if the infusions hadn’t happened. My advice is pacing; to do less than you feel able to while taking the steroids, and to persist for the next few days doing a tad more. The crash should be less extreme and keeping going might itself energise you. 

Would be good to know if you find this helps in your next cycle. 

Hi there. 

I have actually had 21 infusions. I’m extremely fortunate that my only real issue is the fatigue after steroid come down. 

I have chosen to carry on with work as much as possible. I’ve only taken the infusion day off thus far. 

I am currently experimenting with varying dosages for the oral steroids. Haven’t found one that works well yet. 

Best of luck to you. 

Hi again PeteMC

Sounds as though you’re doing really well (I’ve only had 17 cycles so far).  For both FOLFOX and folfiri, the oncologist regime locally  has been to prescribe dexamethasone as the steroid. 4 just before infusion, then 4 more doses of 2 (2mg pills) over the next 2 days. One at breakfast, and one at noon after a snack. Might be worth a try for you?

Hi Wellspring

I have IV steriods on day 1 then 2 x 2mg (ie 4mg) dexamethasone tablets, twice a day for next two days each chemo cycle. Sounds similar to you. They are my best days every cycle

The come down / crash used to start the day after ending dexamethasone but as chemo cycles progress the crash happens now just a few hours after the last 2x 2mg dexamethasone is taken