swelling with oral cytoxan

[shadow]

i Have been ont oral ctxn fro 3 1/2 months, prednisone 4mg from 15 (4 1/2 hyears) and am now haveing major problems with swelling I have put on 16 lbs and am not eating much. has anyone had this problem? Went to ER last night bladder ultra sound normal, chest xray normal blood work only thing potassium low.
Any ideas?
Shadow

[Sangye]

Why did they do a bladder ultrasound?

[Psyborg]

i Have been ont oral ctxn fro 3 1/2 months, prednisone 4mg from 15 (4 1/2 hyears) and am now haveing major problems with swelling I have put on 16 lbs and am not eating much. has anyone had this problem? Went to ER last night bladder ultra sound normal, chest xray normal blood work only thing potassium low.
Any ideas?
Shadow

where is the swelling occurring? If it is torso I'd suspect the Prednisone over the CTX.

[Jack]

Weight gain is strongly associated with Prednisolone use, but if you are retaining fluid and have swollen feet you should get this investigated. CTX does not usually cause this sort of problem.

[shadow]

The swelling is all over but mainly leg and feet. The ultrasound was done to see if blockage due to high intake low output.
Shadow

[norcalian]

I have swelling in my feet and ankles (no pain)...I just assumed it was the prednisone.

[shadow]

I never was this bad on 15mg but have been decreasing since March have been at 4mg for almost 4 weeks droping to 3 Monday. I hate this as it makes it hard to work no comfort standing or sitting.
Shadow

[Sangye]

I suspect you've dropped the pred dose too low for your adrenals to kick in. That happened to me, and my already swollen lower extremities got much worse. Are you tired, especially in the afternoon? Do you feel tearful later in the day? Those are 2 signs of too-low pred. There are others, but those are usually very noticeable.

How long were you on 15 mg before you began tapering, and how fast have you tapered?

[shadow]

I would rather sleep then eat lunch. Can be very tearfull. I was on I have been up and down for R4 and a half years the lowest had been 7.5 then I would flair. Had been on mtx then cellcept, in Janurary this year at 7.5mg with cell cept and major flair. New doc stated never in remission and start ctx with 15mg pred droped by 2.5mg till at tmg now only 1mg every month.

[Sangye]

I would rather sleep then eat lunch. Can be very tearfull.

The swelling, sleepiness, tearfulness-- all are my indicators that the pred is too low. Dr Seo is able to tell with one look at me, and sometimes just by my descriptions via email.

You've dropped at a good pace (1mg per month). However, sometimes when you've been on higher doses for a while (ie anything above 5mg) you need to taper even slower. It also could be that you won't be able to get below 5mg or so. Being on pred for 4.5 years can make that very difficult. When is the last time you were below 5mg and how did you feel?