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Isoniazid/Rifampicin/Amoxicillin/ Doxicycline/ Roxithromycin
Posted: Tue Dec 06, 2005 6:17 am
by gibbledygook
Hi all,
I think I have stabilized and am beginning to see teeny weeny walking improvements amongst others on the Doxicyline/Roxithromycin/Nacetyl cysteine/Quercetin/pulsed Flagyl protocol. However as I think I may have levelled off I persuaded my doctor to prescribe Rifampicin, Amoxicillin and INH (Isoniazid). I am still in a bit of a muddle as to whether or not to take ALL the antibiotics at the same time. Could someone clarify? I'm also a little bit frightened of the side effect profile of the Rifampicin/INH pill which looks considerably more dangerous than any of the illegal drugs I used to enjoy taking!! Did anyone who has taken Rifampicin and/or INH have monthly blood tests? My doctor didn't request these for me.
Posted: Tue Dec 06, 2005 9:28 am
by SarahLonglands
Copied this from CPn Help because Katman is temporarily locked out of this site!.......Sarah
Gibbledegook
I hope you get this.
My abx is: Rifampin, Doxy, Azithromycin, and pulsed Flagyl. I also take Avonex about every 9 or 10 days. Yes, my dr. wants my LFT just about every month . I take ALL on their prescribed schedule. This means Rif 2xD, Doxy 2xD, Azith 3x week, Flagyl 5 D every 3 weeks (this time I started 1 week early- working really well). This week I will be taking all of them when I get LFT. I have done this before and shown all only slightly elevated. They are most elevated after Avonex- big spike. More and more I maintain I would give up Avonex before abx at this point.
When you come to a fork in the road, take it. Yogi Berra
.
Posted: Tue Dec 06, 2005 9:49 am
by Katman
Goofed. Trying unsuccessfully to delete this accident
Rica
Posted: Wed Dec 07, 2005 1:54 am
by yguner
Hi Gibbledygook,
I have used different combinations until now but i have never taken 6 antibiotics at the same time.When i was on the combination of INH,rifampicin and flaggy(continuously) i had the hardest herx reaction until today.Because INH is more toxic ,i had LFT two times during that three months which came out normal.And also i had red spots on my cheeks when i started INH but they disapeared after i changed my diet.Now i am on the combination of Doxicycline, Roxithromycin and pulses of flaggy which my body tolerates better and can be taken for a long time without harming the liver.I think the length of the therapy is more important than the combination of the abx when eradicating this bacteria.
Take care,
Guner
Posted: Wed Dec 07, 2005 11:32 am
by SarahLonglands
Hello Alex,
To start with, if you take all of these things at once, you run the risk of completely obliterating your bowel flora, which means taking acidophilus by the ton. I took rifampicin for six months, in place of doxycycline, not as well as. You can't take it intermittently as you can doxycycline. I have never had a liver function test, but I only took rifampicin for six months. This and INH are not pleasant to take for most people. You don't really need it, because you are taking NAC, but you could possibly add amoxicillin.
You will find that you go through various stages where you find yourself levelling out, even going slightly downhill, (I know!) but if you stick with it and don't overload yourself, you will come out the better in the end.
Have a gin and pom!
Sarah
INH Protocol
Posted: Thu Dec 08, 2005 1:17 pm
by Jimk
In conversations with Dr. Michael Powell, he has found INH to be so much more effective in eradicating Cpn that he often uses it as first line. Like NAC vs amoxi, INH does not effect bowel flora, so you avoid the candida issues this way. It does have potential liver toxicity, and he takes monthly liver panels. If toxicity shows up, he gives a 2 week break and then back on. He also uses milk thistle to support the liver while using INH.
From the Cpn site:
CPn Help/?q=node/162
Dr. Powell finds most patients improve on a standard combination antibiotic protocol for Cpn. Rheumatologist have apparently been using doxycycline for many years with success for inflammatory arthritis but there is evidence that using doyxcycline in combination with rifampin is even more effective. Some patients plateau after about 8 months of treatment he has found variations in the treatment protocol have made a difference. One protocol he uses involves the use of NAC 600 mg twice daily, INH 300 mg once daily before breakfast, and metronidazole 500 mg twice daily pulsed with 5 days on and two weeks off. It is essential to start each agent separately and gradually increase the dose over weeks or months as tolerated. The use of Vitamin C 500 - 1000 mg four times daily (the half life of vitamin C is 30 minutes and little remains after 3 hours) to offset the release of toxins during therapy. B6 is important to control INH related peripheral neuropathy. Monthly laboratory evaluation of AST, ALT, Cr, and CBC are recommended for all who engage in this protocol. It is not uncommon for liver enzymes to show a mild elevation during the initial stages of treatment. Antibiotic therapy should be temporarily discontinued during periods of toxicity, should it arise. He emphasized the importance of insuring that yeast and fungal infections do not overgrow during protracted antibiotic use. He recommends the use of acidophillus, nystatin, diflucan, oregano oil, and/or grapefruit seed extract as needed to prevent secondary opportunistic infection during treatment.
Mike tells me that INH is particularly useful in plateau on the other meds, and Stratton's research indicates it's much more effective than anything else in clearing macrophages, monocytes and endothelial smooth muscle. He says there's about two weeks big reaction, then significant improvement. Now, remember, he is treating mostly CFS, FMS, and RA, not neurological diseases. The bigger die-off in the nervous system with MS might be a significant wack. That's especially why I wouldn't take it in combination, other than with the NAC and flagyl pulse, until you know how it effects you. But you may get more rapid improvement too.
I would not take Rifampcin and INH together. The stronger kill effect with INH is enough. I might continue with azith or doxy, given their immunomodulatory effects, but I've had better counter to the inflammation using Benicar (if you can tolerate lowering blood pressure). [/quote]
Posted: Thu Dec 08, 2005 2:19 pm
by bromley
Yguner,
I recall that your MS was very advanced - I'm sure you said that you had PPMS and were paralysed from the neck down. You have been on the abx regime for some time - what effects are you seeing e.g. any changes in the disability you have?
Hope you are seeing some results.
Ian
Posted: Fri Dec 09, 2005 4:04 am
by yguner
Hi Ian,
I have been on the abx regime for almost 18 months and my progression had stopped since then.I am feeling strange activity in my spinal cord (tingling,burning,itching) which i have never felt until starting abx regime.And another thing i realized during this 18 months is, i had the infection all over my body instead of just the spinal cord.I had the pain started first in my lungs after a while it moved to my bowel area then to my legs and feet.In the 9th. month swelling started on my feet and legs which ended 2 months later.At the moment i have no pain in any part of my body except my spinal cord.If i have to summarize ,i feel my legs and feet are very light and painless,my lungs are clear (no need to breath too much) and no need to urinate often.My spinal cord is still not cleared from the infection but i am about to get there.13 years of damage in my spinal cord would need long time to heal thats why i didnt expect or have any changes in my disability yet.
Take care,
Guner
Posted: Tue Dec 13, 2005 4:15 pm
by EricJohnson
Gibbledygook,
I am wanting to use INH, but am hesitant to let up on the doxy + tini I have used daily for the last 6 months, gaining major reversal of my once-severe CFS. So I am currently researching the safety or lack thereof of concurrent use of doxy and INH. (And tini, re which CYP450 interaction with INH may require a dose change for me.) I have some citations I havent read yet, but one abstract says concurrent use of tetracycline seemed to be a risk factor for INH hepatitis; how big a factor I dont know yet. If anyone has info on this area, hit me.
Random comments about my reading on INH:
Quantitatively, as far as I can see, the liver risk from INH used alone with proper lab monitoring, for my demographic (25 year old male, clean liver history, not pregnant or postpartum), is not daunting to me. But I personally would not use INH without the monitoring - without which the risk might be higher.
One paper I skimmed suggested that knowing the clinical signs of hepatitis (some of which overlap herx), and stopping INH rapidly if hepatitis signs appear, could be of use in reducing the odds that liver distress will progress to damage. However, by no means did the paper suggest that such a course of action was alone sufficient to mimize risk, or could take the place of the labwork.
INH Use
Posted: Tue Dec 13, 2005 8:10 pm
by Jimk
Hi Eric-
I know that Mike Powell, who has a lot of clinical experience using INH for CFS/FM/RA finds it very effective. He uses monthly liver monitoring, and stops immediately if there are enzyme changes for about two weeks, then restarts. He says this usually is enough unless there are other problems.
I think he uses NAC, INH and Flagyl as the protocol, no cyclines, which may minimize the p450 risks. Since NAC is also liver supportive as a glutathione precursor, and he also adds milk thistle, he finds he has little in the way of liver problems with the majority of patients.
Posted: Wed Dec 14, 2005 3:53 am
by gibbledygook
Well, I visited my groovy Irish doctor who said not to worry about the liver function tests until 3 months into treatment!!! I did indicate that I drank quite a lot (up to 4 bottles of red a week!!!) but although he suggested I drink rather less he still suggested 3 glasses of wine a day was absolutely fine. He does seem to have rather a laissez-faire attitude to alcohol. Perhaps that's what I pay him for; good bedside manner. At any rate he put my mind at rest about the likely severity of the rifampicin and INH and as the INH comes with Rifampicin in it anyway I shall take NAC, INH, Rifampicin and Amoxicillin from January but I'll have a few beers over Christmas before then! Mind you I shan't be drinking very much red next year, just in case.