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» LymeNet Flash » Questions and Discussion » Medical Questions » how long does diflucan herx last

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Author Topic: how long does diflucan herx last
gigimac
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I read that diflucan stays in your body for up to 3-4 days. So, I am wondering if the diflucan continues to kill off yeast for the whole three or four days causing a long herx.

Does anyone know??

For those who had improvement with diflucan, how long did it take to get improvement and did you take it everyday?

Posts: 1533 | From Greensboro NC | Registered: Aug 2011  |  IP: Logged | Report this post to a Moderator
Maryland Mom
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There would not be much Diflucan left in the body after 3-4 days. Here is some info from Davis' Drug Guide:

Half-life for adults is 30 hours. Also, >80% is excreted unchanged by the kidneys; <10% is metabolized by the liver.

Peak blood levels occur in 2-4 hours after ingestion of PO doses, with duration of therapeutic blood level being 24 hours.

Length of treatment time varies with type of infection. For systemic candidiasis, 400 mg is recommended for initial dose, then 200-800 mg/day for the next 28 days.

I used to be prescribed the full 28 day regimen, but usually started feeling some improvement within the first day or two.

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gigimac
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Thanks Maryland Mom! So, you were taking 400 mg? That is a lot higher dose than mine.
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Maryland Mom
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I only took 400 mg the first day; after that I took 200 mg/day. A big loading dose up front just helps in getting blood levels up to a point that is fungicidal--or in layman's terms, to a level capable of killing yeast, instead of just preventing its replication.
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'Kete-tracker
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Diflucan does stay around for a couple few days & will continue to kill off yeasts & related bugs.
That's why it can be taken every few days. It's "half-life" is longer than most meds. ;-)

BUT, it's not "herxing". That's strictly a delayed effect experienced when killing spirochettes (only)... whether Lyme, relapsing fever, syphilis or other some other borrelia.
(I do notice the term is mis-used/ over-used quite a bit on these boards... by everyone.)

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Maryland Mom
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You're right, 'Kete-tracker, diflucan's half-life is longer than many meds. Amoxicillin, for example has a half-life of 0.7-1.4 hours, in comparison to diflucan's 30 hours.

After a day or two, there will be some diflucan still in the system, but depending on the dose that had been taken, it may be only enough to be fungistatic instead of fungicidal, but still that is helpful.

Something you said about the term herxing being used so much prompted me to point out that dizziness may sometimes be a side effect when taking diflucan--I think some may think this reaction is a herx, and it is not. Thanks for pointing out what a "herx" actually is caused by; I suspect there is some confusion about this, and hopefully your comment will help.

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gigimac
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I understand I probably do overuse the term "Herx," and that usually a genuine herxheimer reaction is when there is die off of spirochetes, like lyme and syphilis.

From wikipedia: The Herxheimer reaction (or Jarisch-Herxheimer reaction) resembles bacterial sepsis and can occur after initiation of antibacterials such as penicillin or tetracycline, or treatment of tick-borne relapsing fever. An association has been found between the release of heat-stable proteins from spirochetes and the reaction. The same can be true for Candida die-off when toxins from the dying candida leak into the body. Typically, the death of these bacteria and the associated release of endotoxins occurs faster than the body can remove the toxins.

I guess the die off from candida can feel so similar to a herx that it is just easier to call it that. I suppose it would be appropriate to call it a die off reaction.

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'Kete-tracker
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Re: "call it a die off reaction"
YUp! And there are also allergic reactions, toxicity reactions (to a buildup of a medicine or toxin in the blood), and reactions to mixing of certain drugs which can be the most dangerous of all.
A lot to sort out, especially if on multiple meds, which is why you add them 1 at a time!

I also want to point out that one can have a quick die-off reaction when 1st starting a (borrelia) bacterocidal drug like doxycycline.

You zzzap thne 'ketes in the bloodstream 1st. This can cause a "rush" that can be disconcerting to say the least, which is why one should always *start* abx for Lyme treatment in the morning or afternoon so you can get to sleep... & be rested when the REAL herxing begins the next day!

Posts: 1233 | From Dover, NH | Registered: Sep 2008  |  IP: Logged | Report this post to a Moderator
   

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