Hi Everyone -
A couple questions for the group about methylprednisolone (Solu-Medrol) -
1. Is anyone taking this steroid instead of dex?
2. Is there a difference between this and "prednisone"
I'm on maintenance therapy of Velcade and 1 gram of methylprednisolone. My doc (out of Northwestern Hospital in Chicago) put me on that instead of dex. I did dex for my induction therapy. I just don't seem to hear about too many people taking this particular steroid and wonder if anyone else is.
Side effects seem to be lots of hiccups and insomnia for a couple days followed by a big crash. Which was the same as what I had with the dec.
I also have amyloidosis but am currently in complete remission for both diseases.
Thanks,
Ray
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RayGunter - Name: Ray Gunter
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Sept 2011
- Age at diagnosis: 38
Re: Methylprednisolone (Solu-Medrol) - some questions
Hi Ray,
Methylprednisolone is rarely used for myeloma/amyloidosis. But, it is a corticosteroid and closely related to prednisone and dexamethasone, which are more routinely prescribed in myeloma. I don't know why your hematologist/oncologist chose methylprednisolone, but it certainly a reasonable drug to use because it has anti-myeloma effects similar to prednisone and dexamethasone. Prednisone is better tolerated by older and more frail patients than dexamethasone and for that reason prednisone is often the steroid used in treatment of older patients.
Your dose of Solu-Medrol (one gram) is roughly 4-5 times the dose of dexamethasone that is routinely used for newly diagnosed myeloma patients. It is unusual to use such a large dose of steroids in maintenance. I would expect it perhaps in a newly diagnosed and untreated patient. Are you sure this is the dose of Solu-Medrol you are getting?
There are of course significant potential side effects with steroids, including bone thinning, diabetes, weight gain, increased risk of infections and many others. If you are being treated by the Robert Lurie Cancer Center faculty you are in good hands though, and I am confident they have chosen this approach for a good reason.
Methylprednisolone is rarely used for myeloma/amyloidosis. But, it is a corticosteroid and closely related to prednisone and dexamethasone, which are more routinely prescribed in myeloma. I don't know why your hematologist/oncologist chose methylprednisolone, but it certainly a reasonable drug to use because it has anti-myeloma effects similar to prednisone and dexamethasone. Prednisone is better tolerated by older and more frail patients than dexamethasone and for that reason prednisone is often the steroid used in treatment of older patients.
Your dose of Solu-Medrol (one gram) is roughly 4-5 times the dose of dexamethasone that is routinely used for newly diagnosed myeloma patients. It is unusual to use such a large dose of steroids in maintenance. I would expect it perhaps in a newly diagnosed and untreated patient. Are you sure this is the dose of Solu-Medrol you are getting?
There are of course significant potential side effects with steroids, including bone thinning, diabetes, weight gain, increased risk of infections and many others. If you are being treated by the Robert Lurie Cancer Center faculty you are in good hands though, and I am confident they have chosen this approach for a good reason.
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Dr. Edward Libby - Name: Edward Libby, M.D.
Beacon Medical Advisor
Re: Methylprednisolone (Solu-Medrol) - some questions
Thanks for the reply Dr Libby.
Yes, I'm sure about the dose. It's given through IV over 1 hour. And yes, I'm treated through the Lurie Cancer Center. I've been very happy with my doctor and how things have gone (it really couldn't be better). It just seemed odd as I researched this drug that no one else seems to get it. My doctor has has a very aggressive approach with my treatment given my age and the complication of the amyloidosis.
Is this something new some people are trying maybe? When I asked my doctor about it he said it's the same thing as dex, but didn't really say why he chose it over the dex.
Ray
Yes, I'm sure about the dose. It's given through IV over 1 hour. And yes, I'm treated through the Lurie Cancer Center. I've been very happy with my doctor and how things have gone (it really couldn't be better). It just seemed odd as I researched this drug that no one else seems to get it. My doctor has has a very aggressive approach with my treatment given my age and the complication of the amyloidosis.
Is this something new some people are trying maybe? When I asked my doctor about it he said it's the same thing as dex, but didn't really say why he chose it over the dex.
Ray
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RayGunter - Name: Ray Gunter
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Sept 2011
- Age at diagnosis: 38
Re: Methylprednisolone (Solu-Medrol) - some questions
I read this article: http://myeloma.org/pdfs/u-dex-eng_c1-web.pdf (Thanks multibilly) and it had a nice explanation of the different steroids.
In particular it said the methylprednisolone appears to have less effects on retaining fluid. This is very important to me given the cardiac amyloidosis I have as I can be very sensitive to extra fluids.
Ray
In particular it said the methylprednisolone appears to have less effects on retaining fluid. This is very important to me given the cardiac amyloidosis I have as I can be very sensitive to extra fluids.
Ray
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RayGunter - Name: Ray Gunter
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Sept 2011
- Age at diagnosis: 38
Re: Methylprednisolone (Solu-Medrol) - some questions
I wanted to chime in with a follow-up to this thread.
I was recently watching a video by Dr. Paul Anderson of Dana Farber on the subject of steroid use. After initial use of dex in multiple myeloma treatment of a patient, he has apparently been exploring the use of Solu-Medrol (an injectable form of the steroid methylprednisolone) later in the treatment of myeloma. Solu-Medrol apparently has the benefit that it is less likely to produce the same psycho-emotional side effects associated with dex.
Dr. Berenson has also commented more than once in various discussions that Medrol (a tablet form of the methylprednisolone steroid) seems to be better tolerated than dex and produces less side effects.
This forum often talks about prednisone as an alternative to dex, but perhaps Medrol and Solu-Medrol deserves a bit more investigation and discussion with our doctors?
I was recently watching a video by Dr. Paul Anderson of Dana Farber on the subject of steroid use. After initial use of dex in multiple myeloma treatment of a patient, he has apparently been exploring the use of Solu-Medrol (an injectable form of the steroid methylprednisolone) later in the treatment of myeloma. Solu-Medrol apparently has the benefit that it is less likely to produce the same psycho-emotional side effects associated with dex.
Dr. Berenson has also commented more than once in various discussions that Medrol (a tablet form of the methylprednisolone steroid) seems to be better tolerated than dex and produces less side effects.
This forum often talks about prednisone as an alternative to dex, but perhaps Medrol and Solu-Medrol deserves a bit more investigation and discussion with our doctors?
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
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