Some bits on clavulanic acid

[nevergiveup]

Does amox help pandas? It has not been the drug of choice for any of the panda experts. Zith or Augmentin. We talk a lot about intracellular strep on this forum and I look at my kid whoms been on 500 mg of zith for 6 monthsn biaxin and cefdinir combo, augmentin at times, and at what point can I feel comfortable that the intracellular strep is gone? If she even had intracellular strep. My dd makes anti dopamine antibodies and has an autoimmine disease. If the clav acid regulates dopamine and reduces her symptoms and the zith is antiinflammatory then together may be a good thing. Plus the zith prevents strep. But u cannot take both high dose azith and augmentin for the long haul. (Too hard on liver). So just suggesting an alternative.

What about the lowest does of amox 250 or 500, half twice a day(has same amount of clav acid as Aug XR,and also zith. That's kind of what we are doing with my dd right now.

 

You lost me. What are you doing?

[EAMom]

What about the lowest does of amox 250 or 500, half twice a day(has same amount of clav acid as Aug XR,and also zith. That's kind of what we are doing with my dd right now. http://www.faqs.org/patents/app/20100099656

 

 

Okay, sorry, still confused.

 

(Plus, I thought you said you recently switched to Aug. 875mg 2x daily?)

 

You say Amoxi 250mg (or 500mg) 1/2 tablet 2x daily plus some Azith. (where is the Clav. coming in here?)

 

or

 

Do you mean 1/2 of an Augmentin 250mg (or 500mg) 2x daily plus some Azith. THe only problem here is you are not supposed to half Augmentin (unless both halves are taken at the same time).

 

I believe the reason behind "not halving Augmentin" is that the Clav. Acid isn't necessarily distributed evenly wihin the pill...so if you take half a pill, you might get all the Clav. acid in one 1/2 and none in the other (or something like that).

[EAMom]

So you are saying, Clav acid (low dose, eg. 62.5mg 2x daily) to help regulate dopamine.

 

Plus, Azith. to actually prevent/eliminate strep.

 

This would be nice if Clav. acid was available in a 62.5mg pill (not attached to Aug. XR!).

 

 

 

I suppose you could get some liquid pediatric Augmentin and give enough to equal 62.5mg of clav. 2x daily...but you'd still have amoxi. attached (not sure what amount though....too lazy to do the math at the moment).

[EAMom]

and at what point can I feel comfortable that the intracellular strep is gone? If she even had intracellular strep. .

 

 

ahhh...the million dollar question.

 

Plus, if there is strep hiding out in tonsils, sinuses, elsewhere, it might not just be intracellular. Or the "intracellular supply" might be periodically refreshed.

[Fixit]

and at what point can I feel comfortable that the intracellular strep is gone? If she even had intracellular strep. .

 

 

ahhh...the million dollar question.

 

Plus, if there is strep hiding out in tonsils, sinuses, elsewhere, it might not just be intracellular. Or the "intracellular supply" might be periodically refreshed.

 

both very good thoughts/questions!!!!

[nevergiveup]

Can only speak on my generic, its scored and can be halfed. Clav acid on top and amox on botton, can see when u cut it. Not sure what ur confusion is. Does it really matter if they get 70 mg twice a day or 62 or 75 not a big concern. However, 250 mg is a lot more than the XR. XR is not scored and they say should not be cut. But again, I don't see it as a big issue, except for XR the clav is soooo low, may want to make sure u get enough of it. Each kid is different, so docs and parents need to look at side effects and what works best. Not to mention weight. Try the aug on ur dd, do the 875, since she does not weigh enough for the XR. See if it is too much clav acid. And u can evaluate from there. Also wondering if u have done another Cunningham test since ur last ivig? I do not believe that the abx stop an autoimmune disease that is set on autodrive. Can reduce symptoms, by alterring dopamine, and antiinflammatory effects and reduce future infections while ur child stops making the autoantibodies. It can take up to a year for B cells to alter their memory. After years on high dose abx, I think the intracellular strep should be resolved, assuming titers are reduced. I cannot find one infectious disease doc to back any of this intracellular strep in panda kids. They actually have been one of our biggest naysayers. tLymes is a whole different issue and that does need abx. Immunologists get this illness, because it is autoimmune. Autoimmune diseases are triggered by infections. Many pediatric autoimmune diseases resolve as the immune system matures. Prevent reexposure to the trigger is critical. Augmentin and zith reduce inflammation and prevent a huge immune response if re exposed to strep. Now we find out Clav acid alters dopamine and serotonin. (Like haldrol, ssri etc..) Reducing symptoms again until immune system resolves it autodrive. Some kids like my dd, have a chronic autoimmune disease, she does not stop producing the autoantibodies, and does not produce the good ones(has an immune deficiency) So for her, she needs regular immune modulation to redirect the autoantibodies. Immune Deficiencies do not always show up in blood markers until preteen years. Doesn"t mean they haven't always had the immune deficiency, just cannot see it in IGG levels till later childhood. Another thing that could be of concern is PTSD, we have it, we forget our kids may have it also after all they have been through. If the cunningham test show no antibodies, it could just be residual stress related symptoms. Thats what we feel we may be dealing with my dd. She likes to stay close to home, has me concerned but this is a sign of PTSD and many cancer and even diabetes kids are well documented with PTSD. I am very concerned lately about the Lymes that has expanded our forum, with some of our most helpful advocates SFMom, LaurenJohnsonsmom, etc.... it has left me confused and concerned. Is this Lymes and co infections or an autoimmune disease triggered by a viralent strep strain or both. Swedo does not talk about intracellular strep, does Dr. K? So much to think about, test for etc..... We are all still searching.

What about the lowest does of amox 250 or 500, half twice a day(has same amount of clav acid as Aug XR,and also zith. That's kind of what we are doing with my dd right now. http://www.faqs.org/patents/app/20100099656

 

 

Okay, sorry, still confused.

 

(Plus, I thought you said you recently switched to Aug. 875mg 2x daily?)

 

You say Amoxi 250mg (or 500mg) 1/2 tablet 2x daily plus some Azith. (where is the Clav. coming in here?)

 

or

 

Do you mean 1/2 of an Augmentin 250mg (or 500mg) 2x daily plus some Azith. THe only problem here is you are not supposed to half Augmentin (unless both halves are taken at the same time).

 

I believe the reason behind "not halving Augmentin" is that the Clav. Acid isn't necessarily distributed evenly wihin the pill...so if you take half a pill, you might get all the Clav. acid in one 1/2 and none in the other (or something like that).

[EAMom]

Can only speak on my generic, its scored and can be halfed. Clav acid on top and amox on botton, can see when u cut it. Not sure what ur confusion is. Does it really matter if they get 70 mg twice a day or 62 or 75 not a big concern. However, 250 mg is a lot more than the XR. XR is not scored and they say should not be cut. But again, I don't see it as a big issue, except for XR the clav is soooo low, may want to make sure u get enough of it.

 

Our Augmentin XR is scored on 1 side. I've heard it is okay to half (to make swallowing easier) as long as both 1/2 are taken at the same time (ie not 12 hours apart). You can't see what is Clav. or Amox. b/c the whole thing has a white coating (I haven't looked inside after one has been cut, I suppose I should do that.) We've been halving them b/c the single pill is pretty huge, and it's easier to swallow the two halves separately.

 

re halving the reg. Aug.: You're right, it probably doesn't matter if it is 62 vs. 75. Assuming that what you are seeing is truly the Clav. vs. the amoxicillin. I guess it's just a little bit of an unknown b/c I've always heard not to half these (unless both halves taken together). Likely, it is just the drug manufacturers trying to scare folks and give them a hard time (to keep them from saving $ by halving pills?). Or for liability reasons since they can't guarentee even distribution. And, perhaps if taken for primarily for dopamine regulation, it especially doesn't matter if you have lots more Clav. axid in one dose vs. another, as long as it evens out over 24 hours.

 

In pictures of the smaller dose pills (500mg, 200mg) the pills look "speckled" so I'm guessing the Amox, Clav. would be fairly evenly distributed throughout the pill (but those, at least the ones pictured) don't seem to be scored http://www.drugs.com/imprints.php?action=search&drugname=augmentin although many unscored pills are still easy to cut with a pill cutter.

[EAMom]

okay, I just found this on Clav. Acid http://www.patentgenius.com/patent/6511972.html:

 

Clavulanic acid and salts thereof are extremely sensitive to the presence of moisture and free water and undergo rapid hydrolytic degradation. Therefor, the formulations of this invention should be manufactured in suitable air-conditionedproduction areas with relative humidity (RH) less than 30% and temperature below 25.degree. C.

 

So perhaps that is the main reason behind "not splitting". If you split an Augmentin (assuming it is one with a coating of some sort to protect the Clav. from moisture) then the split half is exposed to humidity and the Clav. can degrade when exposed to air.

 

I would think you are okay if you are only splitting 1 pill at a time (so the max exposure with air would be 12 hours) and maybe wrap in foil or something to protect from moisture (or put in the fridge?). But, you wouldn't want to leave a halved pill out for an extended period of time, esp. in a humid enviroment.

 

 

And all this work is assuming the "magic part" of Aug. XR is just the lower Clav. dose, and nothing to do with the time release Amoxcillin!

[nevergiveup]

Thanks

[EAMom]

[i apologize if this sound stupid..but i can't digest anymore info....

is it possible to get Clavulanic acid in time release form....

 

Ds can take aug xr..but he has to be on diflucan too as it just wipes out everything in his system..

 

is it possible to do azith and a clavulanic acid pill

or do amox at a lower dose and do clavualnic acid...i wonder if time release is the key..not the high dose..

 

again this may be what you are saying..but i can't compute right now...

 

I don't believe Clav. Acid comes in a time release form. IN Aug. XR, only the Amoxi component is time release.

 

It's also not available by itself (just Clav. acid, no amoxi) to my knowledge.

 

Does your son have the same problems with yeast on reg. Augmetin, or just the XR? Maybe it is the time release amoxi that is the problem?