Prednisone, Plasmapheresis, and IVIg

April 28, 2007 at 3:54 pm


[COLOR=black]The side effects of prednisone are really different for each person. I believe that if you read up on the effects and prepare for them, they are much more manageable. The best site I have found discussing prednisone is [URL=””%5D%5B/COLOR%5D

[COLOR=black]I experienced many of the side effects. All of them were minor compared to the effects of CIDP. The severity depended on the dose and how long I had been at that dose. Some of them went away as my body adjusted to the drug. [/COLOR]

[COLOR=black]Prednisone dosage is almost always based on your body weight. My neurologist is not comfortable with doses above 1 mg/kg every other day, and with reason. At that dose, the side effects were tolerable. When that dose was no longer effective, we went with 0.75 mg/kg every day. That is when the side effects got particularly severe. Decide for yourself if the dose is too high for your weight. If it works out of more than 1 mg/kg every other day, ask your neurologist to let you try a lower dose. [/COLOR]

[COLOR=black]My neurologist believes in control and prevention from the get-go with higher doses. As a result, he prescribed famatodine (Pepcid), Fosamax, and calcium along with the prednisone. I check my blood sugar every day. I have a bone density scan every year and am referred to an ophthalmologist every 6 months. If things ever look they are starting to get out of control, we will wean me off.[/COLOR]

[COLOR=black]After a while, I found that I needed something more than prednisone, so we started plasmapheresis. The “invasiveness” that people are always worried about is twofold. If you have good vascular access, pretty large needles must be used (to avoid hemolysis). Most consider the large needles invasive. If you have poor vascular access, like I do, then a central line catheter is needed. Such a catheter is almost the definition of invasive, but it is manageable. As with everything, some people can tolerate the catheter and some can’t. If you can, and if you keep it well maintained, I find that it is not particularly annoying. If the prednisone does not work well, and if your neurologist is reluctant to continue IVIg, I would encourage you to try plasmapheresis. One of your objections was time off work to do PP. I find that I take less time off for PP than for IVIg.[/COLOR]

[COLOR=black]Still, in the long run, I would ask your neurologist to try IVIg more frequently, on the schedule you originally suggested. I would also experiment with the brand of IVIg. Your rash might be a reaction to the brand you are using. If you got rid of the rash and showed improvement with more frequent IVIg, that would be a good path to follow.[/COLOR]