abiraterone and prednisone

Hi Startiblast,

I'm just having a conversation with my OH about Prednisolone as his bloods this month have come back a bit iffy. He really doesn't want to take the full amount of prednisolone and often cuts it down to half, 5mg instead of 10mg a day.  When he takes the prescribed amount his blood test results are always in the "Reference limits [ ]" as soon as he changes them down his bloods are all over the place. I know he's being sneaky as I can see a yellow glow coming on. He has an idea that he can stop taking prednisolone with Abiraterone. But he needs it to counteract the side effects of Abiraterone (and fatigue)  This blood test shows his red blood cells under, his Bilirubin over and his Lymphocyte count way under (T-cells). Luckily we are having a Consultant meeting this week so it's something to have a chat about. Is it the effects of low Prednisolone or is it something else? Is the lack of steroids potentially damaging his liver with toxins?

I know this doesn't answer your question and I've over shared, but OH has been on a journey on the last couple of years with halving, doubling up and taking half on alternate days, all in an attempt to get the balance right or in his mind having no prednisolone eventually,  I think he needs to just stick to his prescribed 10mg at this point. 

Your amount is so low 2.5mg= tiny amount ,and yet its causing problems. It may be worth looking to change over to Enzalutamide, certainly asking the question at your next meeting as I think that may be the better option for diabetics, does the same thing but with no steroids.

Hope you get some answers

Best wishes Lorraine

Hi !

I think Slartibartfast meant that he has 2 tablets of 5 mg per day so, in total 10 mg. But I can be wrong 

Ah yes!!! I see that now. so the same as BW  Well in that case maybe he should try the 5mg? definitely a question for the consultant. Though BW never seems right on the lower dose.

L

Hi !

Yes I know there is two treatment regims, 5 mg and 10 mg so, could be good to consult the MO 

Best wishes - Ulf

Thanks for the info
I like to get as much information as possible as this is new to me and diabetes control is always a balancing game

BTW I'm on the same dosage as your OH. 10mg.  I should have been clearer in my original post 2 x 5mg ;-)

D'oh - I read this after I replied to your original reply

Hi Slartibartfast Hope you’re doing okay. I was prescribed Arbiraterone along with degralix. I was told take 5 mg Prednisolone an hour after taking the Arbiraterone. I wasn’t really wanting to take a steroid.

So I decided on my own accord to not to take the Steroid I did this for a couple of weeks and there wasn’t any side effects at all. My body excepted.

Then I made the decision to just take the 5 mg. And every thing was still fine.

But at this moment I am not diabetic so I see where you’re concern is about the Steroid.

Abiraterone is an amazing drug my Psa was 3761 now it is 0.9 with no Radiotherapy ( Stage 4)

Wish you well.

Arnie.

My OH was type 11but reversed it by diet and exercise  well before his diagnosis . He lost 43KG. 

He is on  Prostap injection every 12weeks and Aberaterone 1000mg and prednisone 5mg daily ( advised to take the steroid 1hour after aberaterone)   He has put in 2kg since he was diagnosed so trying to be careful and still walking 10 miles a day . He is pretty fatigued and feels the cold more. His PSA was 14 on diagnosis and down to 0.1 no other issues with his bloods . 

hope you feel better soon 

Best wishes 

Liz & OH xx

Hi.

Like you i am also on similar combined therapy. I am on abiraterone, prednisone, and relugolix.

Prednisone is reqd when onw is taking abiraterone. This is to take care of cortisol deficiency. But prednisone being a steroid is bound to bring its own side effects.

We need to watch our blood sugar, liver enzymes, and lipid profile.

In my case with one month of treatment, my blood sugar is now pre diabetic. Hba1c is now 5.9.

My bilirubin has inc slightly and so haa my triglycerides.

Now I am already on statins so may have to meet my GP and see what needs to be done.

But my advice is dont stop prednisone. Coz its reqd when we are on abiraterone.

Just doing a follow up on the question of Prednisolone. I wasn't able to go to the consultant meeting so I sent a list with Mr BW. I'm slightly hopping mad as since HT Mr BW is as bad as me in retaining any important information and has completely forgotten most of the answers now he back!! What I did get is that Prednisolone (long term) is not great, which we sort of knew and the fact that BW is trying to keep it low is a good thing , because he will be taking it with Abiraterone for life ( or as long as it keeps working) Abiraterone is such an excellent drug at keeping people alive that it's the pay off ( BW's words) My other concern is that his bloods are all over the place atm, and was his liver struggling to process any toxins from the use of the drugs he's taking, would the lowering the prednisolone cause his liver to be more vulnerable to any minor damage and be the perfect "seed bed" for micro metastatic seeds that are looking for a home?  Answer= unlikely as secondary Liver cancer is extremely rare with Prostate cancer. ( which is good to know). Apparently Mr BW is doing really well at this point  "better than expected," ( I really wish I'd been there as would have asked, "What is expected?" so none the wiser.  

So summing up _ long term not ideal, but thats why your bloods and liver should be monitored. Most people have it short term, so probably not such a problem. Personally I would ask about Enzalutamide as a swap because of the Diabetes and if there's advantages. At the end of the day it's just being curious and asking questions about your treatment, nothing wrong with that.

L