starting Rifampin

[ShaesMom]

The Staph infection is back in what use to be my breast. Two weeks of Doxy didn't work so now I'm starting Rifampin-300mg X 2 a day. This is double what my LLMD wanted me to start on back before this whole breast cancer surgery for the Lyme.

 

So-what can I expect from this drug? What doses are you taking for your Lyme?

[LNN]

DS9 (65 lbs) started rifampin last week 150mg/dose, twice a day. So far, only a mild herx. It can turn your pee and tears orange.

 

I hope it helps. You're in my thoughts all the time.

[NancyD]

Shaesmom,

 

First, let me tell you how deeply saddened I was to read about your breast cancer. I cannot begin to fathom how you are dealing with everything already on your plate. My heart, thoughts, and prayers go out to you!

 

I started on 300 mg Rifampin once daily in August and then went to twice daily one week later. I started herxing within 2 days really badly with headaches, sweats, fatigue, moodiness, and feeling like crap! My foot started hurting more, i had difficulty falling asleep at night, and I felt like I was going to jump out of my skin. I started feeling a better in about two weeks and continued so over the next few months. Other than occasional fatigue I am feeling great now!

 

Of course everyone responds differently and with all you are dealing with your recovery may be slower. Epsom salts baths and saunas helped, and lots of naps!

 

Wishing you a speedy recovery!!!

[ShaesMom]

Thanks Ladies.

 

Unfortunately, I can't take baths right now because the stitches are not completely healed. So aside from the lemon water I'm not really sure what else to detox with.

 

Should I be taking Milk Thistle right now too?

 

I'm not really sure what I should do if I start herxing. My body has been through He-- in the last two months and nowhere near healed.

[NancyD]

You can't take milk thistle with Rifampin. Although not nearly as good as the milk thistle I suggest curcumin. How about Epsom salt foot baths? Dry saunas are great for detox. I got a portable one online and it works great. Also, magnesium is good (but take at least 2 hours away from abx). And we take springreen detoxificant No 77 (made from bentonite clay).

 

Thanks Ladies.

 

Unfortunately, I can't take baths right now because the stitches are not completely healed. So aside from the lemon water I'm not really sure what else to detox with.

 

Should I be taking Milk Thistle right now too?

 

I'm not really sure what I should do if I start herxing. My body has been through He-- in the last two months and nowhere near healed.

[mdmom]

Why can you not take Milk Thistle with Rifampin? My whole family is currently being treated for Bartonella on our Lyme journey and we just added in Rifampin and have remained on Milk Thistle during this current therapy. Is it contra-indicated for some reason?

[rowingmom]

This in vitro study found that milk thistle significantly reduced the activity of CYP3A4 enzyme in human hepatocyte cultures:

 

http://www.ncbi.nlm.nih.gov/pubmed/11038151

 

This study found that milk thistle and black cohosh appear to have no clinically relevant effect on CYP3A activity in vivo:

 

http://jcp.sagepub.com/content/46/2/201.abstract

 

My DD10's liver enzymes were elevated after taking bactrim. After switching to biaxin and rifampin and taking milk thistle daily they returned to normal. Whether it was the switch to biaxin/rifampin or the milk thistle, I am not sure. I showed these articles to my LLMD when she suggested milk thistle with rifampin, but she said to go ahead with the milk thistle. We have had no problems with liver enzymes since.

[Santi]

My 9 year old son has been on this for about 2 months. It has helped with his anxiety. However, he is being taken off because he has become extremely hyper and his eosiniphil count is elevated significantly. According to his LLMD, Rifampin can do strange things to the blood. But, it does work great on Bartonella, in our case at least. Good luck! Andrea

[RNmom]

Shaesmom,

My heart goes out to you for dealing with breast cancer and Lyme. Rifampin is a good antibiotic for staph as well as Bartonella. Also, we do not talk about this much but it is also helpful for Lyme. Nancy gave you good advice when she said to take naps. They will help youget through the Herxing.

 

Expect to experience a flare of Bartonella symptoms: Headache, visual disturbance, brain fog, alterations in mood, bilateral joint pain, soles of feet sore (especially in a.m.), muscles aches, and low grade fevers to name a few.

 

I asked our LLMD about milk thistle and was told it is o.k. to take it. Two family members being treated for Bartonella are taking it (I am one of them) and we are doing fine so far.

 

300mg 2 tx / day is a good dose for Bartonella and also for staph. I hope the treatment helps you - it does take time (@ 6 months or more to treat Bartonella).

[LNN]

The issue with rifampin and milk thistle, as I understand it, is that milk thistle can speed up the metabolism of some drugs thru the liver and decrease the metabolism of others. Milk Thistle decreases the metabolism of rifampin (if I'm understanding correctly) and thus elevates the amount of rifampin in your body that's higher than the intended dosage. However, taking rifampin with food can decrease absorption by 36% (per wiki). It does not seem to be effected by magnesium the way other abx are. The way to tell if absorption is at its best is the color of your urine. If it's less than orange, absorption is less than it could/should be.

 

I really like the benefits of milk thistle, especially given the long term combo abx we're on. So I think I'm going to have DS continue to take milk thistle, but away from the rifampin. The half life of rifampin (with normal metabolism) is 2-4 hours.

[mdmom]

Thanks for the explanation LLM. I give Milk Thistle 3 hours before Rifampin (which is dosed at bedtime away from food). It has done a good job at keeping our livers happy

[ShaesMom]

Nancy-like the foot bath idea Thanks!

 

So it looks like the milk thistle is okay-how much should I take? If I take the Rifampin at 8 am/pm then milk thistle with lunch should be okay right? I can just pick this up at Walgreens-I don't need some special brand or anything do I?

 

My pee is already orange and I'm having some of the herxing sx after just one pill! I think I will be sleeping most of the day. I haven't herxed yet on any of the other meds so this will be a new experience for me. My kids haven't herxed much either.

[LNN]

Your plan/timing sounds reasonable to me. I don't think you need any special brand. I personally like NOW Foods when I have a choice because they're a GMP manufacturer (Good Mfg Practice) which means they follow specific guidelines for quality control. They also claim on their website to inspect/work closely with their source providers. So it's my little way of feeling better about quality at an affordable price. But any milk thistle is fine. We use 300 mg. Ours also includes dandelion root. Dandelion can help the kidneys.

[ShaesMom]

Your plan/timing sounds reasonable to me. I don't think you need any special brand. I personally like NOW Foods when I have a choice because they're a GMP manufacturer (Good Mfg Practice) which means they follow specific guidelines for quality control. They also claim on their website to inspect/work closely with their source providers. So it's my little way of feeling better about quality at an affordable price. But any milk thistle is fine. We use 300 mg. Ours also includes dandelion root. Dandelion can help the kidneys.

 

Thanks!

Edited November 17, 2011 by ShaesMom

[sf_mom]

I just wanted to reach out and wish you the best of luck with treatment and couple of prayers coming your way for full recovery!!!! My heart aches when I read your most recent update. Like you, I had Fibro like symptoms and I have felt great over the past year with treatment. I will also say with experience of many antibiotic rotations under my belt came a herx... mostly fatigue/headaches that would suddenly set in throughout the day. As words of encouragement, manage symptoms (advil, detox, salt baths), nap when needed..... it will get better in time, I promise.