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Cellcept dosage and Prednisone
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An_241727 posted:
Hi,

I have posted this on the tip section but wasn't sure where it should be so i will repost it on here for some advice.

I am a 35 years old male living with lupus for 15 years. Recently, my kidney have problem with 9g of protein secretion causing very swollen legs. I had a kidney biopsy and there were no kidney damage in the result. My doctor recomended to take 3grams of Cellcept with 30mg of Prednisone. I understand it's important for the kidney to treated but wanted to seek a opinion of whether 3grams of Cellcept is consider a reasonable dosage to take in my condition and what might the side effect of such dosages does if any? Thanks in advance for your advice.

Also, there are some facts i wanted to know about having taken Prednisone. When I was first diagnose with Lupus, i was on Prednisone as high as 100mg and reduce slowly over the years. I remebered it was a horrible experience for about 5 years and was wondering for that length of time being treated with Prednisone, what are the chance having lower rate of sperm count? Would i be less likely to fertile consider i was treated with Prednisone for that length of time and dosage? Does the the body somewhat recover after the treatment has stopped or is there a long term effect that will remain? Thanks!
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lupylisa44 responded:
I believe the dosage of cellcept for lupus nephritis is aywhere from 500mg to 4000 mg. I am currently taking 2500 mg and my doctor would like me to increase it to 3000 because my lupus nephritis is active. Unfortunately I am not able to tolerate the higher dosage because it causes stomach upset. I have been on Cellcept for 10 years and other than the stomach issues, which only occure at high doses, I have had no trouble with it at all

lupylisa
With love, with patience and with faith, we'll make our way.
 
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R Swamy Venuturupalli, MD, FACR replied to lupylisa44's response:
Lupus nephritis presenting with high levels of proteinuria is a difficult condition to control. The studies available so far suggest that 3 grams of cellcept is the target dose for this condition. In my experience, my patients mainly complain of gastrointestinal issues. Additionally, it is an immune suppressant and infections should be adequately assessed and treated. Some formulations of the drug are better than others in this regard. Additionally, taking a stomach protective agent (PPI) may help you tolerate the drug better. All the best!
 
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agroom responded:
I'm probably a little late in replying to you, but maybe can help anyone else who comes along.

I'm currently 34 (35 in 2 months) and have been on both prednisone and mycophenolate (cellcept) since I was 21. Well, I was on Prednisone almost non-stop up until I was about 32 with doses as high as 120mg/day, but the last several years doses were typically between 10-60mg depending on if I was in remission or not. I have been on 3g (1.5 2x daily) of mycophenolate for the last several years and finally was reduced to 1.25g 2x daily about 6 months ago.


Comparatively, mycophenolate is like a vacation in the Bahama's while prednisone was like a sentence on the rock (presumably). Since I haven't actually not been on medication for over 13 years, and at the time being 21 I was very healthy, extremely in shape and generally very happy with life, I think it would be near impossible for me to compare it to what I would 'normally' have been at ~35 w/o medication. But I will say that in general being on mycophenolate has been relatively easy.

Some things I will comment on are though, I definitely have GI issues; however, I remember also having them semi-frequently though my teens too. I also have issues sleeping, which I've also had for years prior to starting medication, which I'm sure it's not helping anything. I also have a loss of motivation and general loss of energy, but having gained a significant amount of weight while on Prednisone, and a recent back injury thats restricted my exercise for the past 3 years I feel are major contributors. Like I said, I was very in shape at 21, so much of my comparisons are to my 21yr old self.

But back on topic. My wife and I had been trying to conceive for the past year or so. After no luck, I went to see a specialist and found out I've got a severely low sperm count. This was based off a single sample though, with no other tests or diagnosis done. I've setup more tests over the next month to determine potential issues with my testes (infections, etc.) due to prolonged use of immunosuppressants, genetic defects, lowered hormone levels, etc. My Dr. also told me he's never heard that prednisone has any issues with lowered sperm count.


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