[Loretta S.]

Lowest effective dose of dexamethasone?

by Loretta S. on Thu Jul 10, 2014 5:38 pm

Have been taking dexamethasone and Revlimid for six years plus non stop. I feel that my side effects of extreme diarrhea to dexamethasone may cause me to abandon this treatment.

I started out on Revlimid 25 mg and dex 20 mg for about four years. Than Revlimid 15 mg and decrease dex gradually to 12 mg for about 18 months. This will be my third month of Revlimid 10 mg and dex 2 mg. I take dex on Friday night; no problem, but do not go to sleep until about 4 a.m. on Saturday. Sunday is spent very close to a restroom due to about 8-plus bouts of extreme diarrhea regardless of the dose.

So far, all numbers of important multiple myeloma markers are great, but the treatment is so rough.

What is the lowest dose of dex that has been effective for anyone over a period of time?

[torimooney]

Re: Lowest effective dose of dexamethasone?

by torimooney on Thu Jul 10, 2014 6:32 pm

I was on 12 mg dex IV twice a week for two weeks on two weeks off. Now on 24 mg every other week. Doing well.

[gmarv]

Re: Lowest effective dose of dexamethasone?

by gmarv on Thu Jul 10, 2014 7:06 pm

Don't know if this will help you, but my treatment is once a week I get a subq shot of Velcade,
4 times a week I take 10 mg of Revlimid, once a week I take 8 mg of dex. Been on this lower dose of Revlimid and dex for over a year now. Even at the lower doses, I still have problems with both.

[Rneb]

Re: Lowest effective dose of dexamethasone?

by Rneb on Thu Jul 10, 2014 8:35 pm

While I usually have the opposite problem with dex and Revlimid (constipation), when I do have the runs for more than 24-48 hrs --I usually take several items, especially an OTC Potassium Supp (99 mgs). The stress of the "runs" usually quickly depletes my electrolytes, especially Potassium. The literature suggests that Revlimid is also hard on Potassium levels.
I'm not sure if ultra low dosage matters, once you are depleted ?

The Potassium largely helps my peristalsis quiet down in the Bowel, to a normal level. The Large Bowel, is mainly a large, vascularized muscle, with specialized ducts, tissues, transfer and transport mechanisms. An amazing organ--except when it goes on "Strike". Yuuuk!

The White toast, plain rice, Banana diet also helps.

As always, check this out with your Provider.

Congrats on the 6 year mark. A milestone !

Good Luck.