The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Content within the patient forum is user-generated and has not been reviewed by medical professionals. Other sections of the Melanoma Research Foundation website include information that has been reviewed by medical professionals as appropriate. All medical decisions should be made in consultation with your doctor or other qualified medical professional.

How to Mitigate Side Effects of Prednisone

Forums General Melanoma Community How to Mitigate Side Effects of Prednisone

  • Post
      Happy weekend, all. I have still only had My first of four infusions of the Ipi/Nivo combo due to continued brain swelling from recent SRS and need to be on Dexamethasone and now after a number of symptoms a diagnosis from the melanoma specialist that I am having late onset side effects from the first (and only!) infusion. He put me on 60 mg of Prednisone for 2 days to tamper down the autoimmune issues and now am on a very slow taper off the Prednisone for 30 days. Knowing that steroids can have their own host of bad effects on the body, what can I do to mitigate this? Am doing frequent exercise, have gone off coffee and am drinking tea while taking pepcid with my daily steroid, and work to maintain a pretty good high fruit/veg/fiber diet. What else can I be doing?
    Viewing 3 reply threads
    • Replies
          Cindy, sounds like you are doing everything right. I eat sourkrout, I make myself. I eat it every morning. to keep my guts in check.
          I would drink lots of water to flush everything out of my system everyday.
              Thank you! I eat live sauerkraut along with other things in my diet, to try to have as good a microbiome as possible for the immunotherapy. And water, , good reminder!
              HI Cindy, I have been on 10 mg prednisone for 5 weeks after my first infusion of Keytruda caused terrible knee arthralgia. I have had no side effects from this lower dose of Prednisone. I’ll see my oncologist in two days and for 2nd infusion; will find out if I should stay on Prednisone or not. I also eat a clean diet including kraut, and thankfully am healthy otherwise. Another consideration I ponder is quality of life. We have to balance the side effects of treatment and side effects of treatment for the treatment.
              Cindy K.
                  Wow that’s great. I am still at 40 mg, after one week on the prednisone so it is quite possible that I will have some effects from it. Best to you!
                  Cindy it sounds like you are doing pretty much everything you could. With long term steroid use there is a risk of osteoporosis so I would make sure you take vitamin D and calcium. Vitamin D helps with Covid as well, so you kill two birds with one stone.
                  Hoping you are off the steroids soon since I know from experience how nasty they can be.
                    I hope these comments do not apply to you, but I never saw this experience posted before, so I share here. I was on Prednisone (80mg) and IV Synthroid (similar) for an extended period due to side effects including colitis from the combo.

                    Apparently at high prednisone levels, almost 20% of patients develop symptoms of manic depresssion/psychosis. I know I had a very strong reaction, got super angry and then broke down in tears daily (like over TV commercials about calling Grandma). With so much going on, I think this warning can be overlooked, its great you are aware, I wasn’t.

                    One doctor finally mentioned something casually about circadian rhythms and how steroids can exaggerate your natural cycles. This was the “aha” moment for me. I started keeping a journal about my strange moods and my highs and lows and it became pretty obvious there was a pattern and how I should respond. I would try to do vigorous exhausting exercise in the morning to blunt the high part of the cycle (a few hours after taking the full dosage in the AM after a good – even heavy – breakfast to also blunt the arrival – which a pharmacist suggested) and then just prepare for some quiet time (avoiding conflict) when I knew I was cycling downward after peaking in the late PM. This would happen 2x daily with a second lesser peak by 8 pm and eventually I was able to get 4 hours of straight sleep after midnight – which was further being interrupted by the colitis. I used .5 mg Xanax for short term relief on occasion to get to sleep. I was told it’s not the ideal anxiety med for this, but I was familiar with it from another experience and xanax didn’t prevent me from waking in the night – which had to happen multiple times a night.

                    I felt like a “pod person” until I tapered to under 20 mg, which was after several months of treatment. The way it effected my appetite was insane; I lost all this weight from colitis and was often very hungry, but then by the time I got the food on my plate my appetite was off entirely.

                    So, again, this is maybe more for people with severe adverse reactions – hopefully not you. Steroid side effects are a secondary concern when you are fighting melanoma, but it is a mistake to not be attentive to significant personality changes. That can happen. So give yourself room.

                    After I made a point of it myself , my MD kinda shrugged, “oh yeah, steroids can do that”.


                Viewing 3 reply threads
                • You must be logged in to reply to this topic.
                About the MRF Patient Forum

                The MRF Patient Forum is the oldest and largest online community of people affected by melanoma. It is designed to provide peer support and information to caregivers, patients, family and friends. There is no better place to discuss different parts of your journey with this cancer and find the friends and support resources to make that journey more bearable.

                The information on the forum is open and accessible to everyone. To add a new topic or to post a reply, you must be a registered user. Please note that you will be able to post both topics and replies anonymously even though you are logged in. All posts must abide by MRF posting policies.

                Popular Topics