Prendisone side effects / Rituxen

[PattyL]

I have been on prendisone for 4 mos.Started 40mg now tapered to 20mg as I started rituxen just had my second infusion Dr may taper again on the Aug 20th visit to 15mg. Seems like I have just as many side effects on the lower dose, now I am having trouble remembering things at times, does anyone else have this problem? I understand it could take about 6 weeks for Rituxen to take affect. I'm hoping this will get me into remission. What has been your experience?

Thank you,
PattyL

[Birdie]

Seems like I have just as many side effects on the lower dose, now I am having trouble remembering things at times, does anyone else have this problem?

What has been your experience?

My experience is:

1) You can blame prednisone for earthquakes so don't be surprised about side effects, just make sure to discuss with your doctors.

2) Don't ignore any new or sudden symptoms.

3) Contact your doctor immediately for anything extreme or scary.

I had major prednisone induced eye problems after a couple months of 80mg but many other symptoms seemed even worse at the time. And hey, don't be in too big of a hurry to get off it, don't expect too much too soon and be disappointed. When reducing it may be far better to go slow.

[morningsunshine]

Hi there!

I am also in RTX-induced remission, using RTX and prednisone (my last four infusions were in April). I've noticed in the last few weeks that my thinking is not as clear as it normally is. In particular, I've been misspelling words, and things like finding files and writing emails at work are happening at a slower pace than normal.

I haven't seen this as a side effect of RTX or Prednisone, but I am definitely experience some sort of mental deficiencies, and I suspect it's one of the two! Let me know if you have any more specific symptoms or if you figure out what is causing them.

Also:

I was on 20mg/week of MTX last year and noticed significant brain fog then--it was very noticeable when I finally got off the MTX and could suddenly think clearer. I feel like that brain fog has set in again, even though I'm not on MTX anymore.

[vdub]

I don't think you can blame the pred for that. Of course, you never know for sure, but I think it would be very unlikely.

[drz]

Brain fog or chemobrain can result from various meds. Usually it clears up when you stop the drug or drugs causing it but sometimes the effects linger on for a long time. Of course certain drugs, usually those often used for street use and abuse, can cause permanent changes in brain functioning. A good neuropsychological evaluation can assess your cognitive functioning and neurological exam can identify any problems that need to be addressed. It is rare but sometimes physical problems do impact our brain eg tumors, Wegs can attack it, strokes, and other things that require our attention. Like our departed guru Jack often said, just because you have Wegs doesn't mean you can have something else too. Of course we know that Wegs can cause many different problems and should always be a suspect but not the only thing to evaluate.

[Pierre42]

Mood and Cognitive Changes During Systemic Corticosteroid Therapy

"... particularly deficits in verbal or declarative memory."
"... poor concentration ..."
"Even severe cognitive impairment consistent with dementia or delirium has been reported"
"... who developed significant and widespread reversible cognitive function deficits, including attention, concentration, and verbal memory, while taking 20 to 100 mg of prednisone daily."

Yes, prednisone is a spectacularly evil nasty toxic drug with a wide range of unpleasant side-effects, however the alternative (ie not taking prednisone) is .... permanent.

Pierre(The GoogleFU is strong with this one)42

[PattyL]

Hi,

I am pretty sure this is caused from prednisone I am experiencing the same things. I just had my last infususion of RTX I had the brain fog before the RTX I am now being tapered from prend. was at 40 now down to 15 hope this will help. I have not felt the benefits of RTX yet I understand it will take about 6 to 8 weeks.

[MaxD]

As others have said, prednisone can cause some (reversible) memory loss, among a whole host of other side effects. Rituxan will take few months to bring you into remission. Almost all the side effects you notice will be from the prednisone, and will become noticeably worse when you taper down to a low level. At that point even though you will be in remission, you may feel miserable from prednisone withdrawal. Eventually you will recover from withdrawal symptoms but give it time (a few months).

Good luck!

[Pete]

Hi Patty,

When you taper off pred, do it very slowly. Otherwise, you may experience more severe withdrawal symptoms.

When I got down to 15 mg, my taper was -2.5 mg/month down to 10 mg. From there, it was -1 mg/month down to where I noticed disease symptoms returning (3 mg in my case). I went back up to 5 mg and called my rheumy. She put me on four weekly rtx infusions and took me off mtx. I finish this round of rtx on Thursday. I'll stay on 5 mg/day of pred until I see my rheumy again in early November.

Other than some sleeplessness caused by solumedrol (steroid given with rtx), slight fatigue the day following each infusion, and an episode of heartburn (calmed with peptobismol), I feel great.

[WG mom]

I wish it only took 6-8 weeks for rtx to bring about remission. My daughter has had 3 infusions, two of them 6 months apart and this last one in May. For that, the doc did one mega infusion instead of the traditional once a week for 4 weeks. Still not in remission. Another one shot mega dose is scheduled forcOctober and she was told she would likely need one more in January to
reach remission. Prednisone has been decreased to 10 mg now for about 6 months. When she tries to get lower dosages, the headaches are too severe.
So, is it true rtx is usually effective in just 4-6 weeks because if that's the case, not sure why it's taking so much longer for my daughter. Thankfully, thus far, inflammation has remained localized in sinus and not spread to other organs.