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» LymeNet Flash » Questions and Discussion » Medical Questions » Zithromax - once or twice a day?

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Author Topic: Zithromax - once or twice a day?
Jill E.
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Hi everyone,

I recently started Zithromax, working up to 500 mg. a day.

For those of you on this dose, do you take 500 mg. all at once, or split it into two doses of 250 mg. each per day?

My prescribing LLMD said it's more effective at 500 mg. all at once.

However, my liver enzymes went up a bit, and I'm trying to reach both of my Lyme doctors. I'm still within normal range but just barely. This is a concern because I had been in liver failure with Ketek in 2005, and all my doctors, including my hepatologist, were concerned that any macrolide, including Zithromax, is loosely related to Ketek and I would have to be monitored very frequently.

I have one friend who splits her dosage, and I'm thinking that might reduce the stress on the liver, but is it still effective in killing the bugs?

Thanks,
Jill

--------------------
If laughter is the best medicine, why hasn't stand-up comedy cured me?

Posts: 1773 | From San Diego | Registered: Apr 2006  |  IP: Logged | Report this post to a Moderator
Vermont_Lymie
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I have done it both ways, and it seemed to me equally effective. My doctor was fine with either way. After a couple of months taking it in the morning and evening, it was best for me to take it all at once at night since it made me a bit tired.
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Keebler
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-

Jill,

I can't answer your question however, since you were in liver failure with a previous drug, I hope you are taking supplements to help with liver protection and support.

This may also prevent some ear ringing that can sometimes go with zith. B-6 and NAC are the best things that might help prevent that from happening as they offer more protection than just for the liver.

More details about liver support in Singleton's book:

======


This book, by an ILADS member LLMD, holds great information about treatments options and support measures:


http://tinyurl.com/6lq3pb (through Amazon)

THE LYME DISEASE SOLUTION (2008)

- by Kenneth B. Singleton , MD; James A. Duke. Ph.D. (Foreword)

You can read more about it here and see customer reviews.

Web site: www.lymedoctor.com


-=====

You can also search "liver" in the articles at www.vrp.com

Good luck.


-


-

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Jill E.
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Vermont and Keebler,

Thank you both for your quick replies. I'm glad to hear, Vermont, that splitting the dose is OK with your Lyme doctors. I'm still waiting to hear from mine but I am hoping that is the solution.

Keebler, yes I'm taking as many liver protective supplements as I can tolerate (I have detox issues). I do have Dr. Singleton's book, so thanks, I will look up his recommendations. I had heard about ringing in the ears from Zith so it is something I was concerned about.

Jill

--------------------
If laughter is the best medicine, why hasn't stand-up comedy cured me?

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tdtid
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Jill,

Just thought I'd go ahead and chime in here. How are you?

When I was on oral zith, I was at 500 a day and the pharmacist said that it had a longer half life than most of the other abx I was taking.

Due to that, it was going to stay in the system and build up, but also meant that yes, you could split a dose, especially in your case where you are concerned for your liver.

Obviously your doctor would have to say for sure, but I know mine was like VT Lymies and was fine either way.

Good luck with the zith.

Cathy

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"To Dream The Impossible Dream" Man of La Mancha

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nomoremuscles
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I have taken it both ways.

I do, however, think I remember Burrascano saying that with protein-synthesis inhibitors -- unlike cell-wall inhibitors -- a single dose was better than sustained blood levels.

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lymednva
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Since the half life is in days, not hours, it really shouldn't make a lot of difference if you take it in one or two doses.

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Lymednva

Posts: 2407 | From over the river and through the woods | Registered: Apr 2006  |  IP: Logged | Report this post to a Moderator
Jill E.
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Thank you everyone. I will look at Burrascano's guidelines, I had forgotten about that. But I'm leaning toward splitting the dose until I hear otherwise and until I have my liver enzymes checked again.

Jill

--------------------
If laughter is the best medicine, why hasn't stand-up comedy cured me?

Posts: 1773 | From San Diego | Registered: Apr 2006  |  IP: Logged | Report this post to a Moderator
   

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