[newpluggersue]

Pomalyst, Velcade, and dex - which dex dose?

by newpluggersue on Sun Nov 17, 2013 9:11 pm

My husband just started the drug Pomalyst on a 21 week schedule and 1 off, combined with 12 mg dexamethasone weekly and Velcade once a week. He had previously tried the Pom­a­lyst and dexamethasone without good results so doctor added Velcade two weeks ago. My husband was diagnosed with multiple myeloma almost 6 years ago.

In my basic research, I note that most patients are taking 20 mg dexamethasone if over age 75 or 40 mg weekly if under 75. My husband is 71 and also has kidney failure caused by the multiple myeloma.

My question is: Should the dexamethasone dose be increased from the 12 mg my husband currently takes? I am quite concerned and am hoping that the tweaking of the meds could per­haps produce better results.

Thank you.

[Dr. Jason Valent]

Re: Pomalyst, Velcade, and dex - which dex dose?

by Dr. Jason Valent on Mon Nov 18, 2013 1:56 pm

The dexamethasone dose can be adjusted based on tolerance of this medication. If significant side effects have occurred on higher doses, I have used the 12 mg weekly dosing, although this is not standard. Generally the 40 mg once weekly dosing is considered relatively standard in combination with Pomalyst and weekly Velcade.

[Babs]

Re: Pomalyst, Velcade, and dex - which dex dose?

by Babs on Wed Nov 20, 2013 6:09 pm

I have worried about Dex dose as well. My husband is on 25mg Revlimid, 3 weeks on, one off and 20 mg Dex. once weekly.He was not tolerating the 40 mg so it was reduced to 20 and although he still struggles with the "crash" days he is tolerating it better.I worry that the treatment will be less effective and wonder if he should gradually try to build up again to 40 mg He relapsed 2 years after his ASCT and started this treatment in Sept..