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» LymeNet Flash » Questions and Discussion » Medical Questions » Anyone NOT pulse artemisinin?

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Author Topic: Anyone NOT pulse artemisinin?
mmcmann
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From what I have read here, everyone seems to pulse Artemisinin. But, my LLMD just prescribed it everyday.

Anyone one provide insight? Should I question my LLMD?

I also take following right now (just stopped Mepron because needed break due to severe symptoms - think Bart came out from hiding).

Zithromax MWF, 3 weeks on and 1 week off
Doxy everyday

I also take other stuff for detox, and supplements.
Thanks

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merrygirl
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I take artemisinin everyday. No breaks about 5 weeks in. I think I heard you need to stop it every 3 months to prevent resistance to it.

I could be wrong

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gatorade girl
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I take it twice a day everyday.

--------------------
gatorade girl

"I still have Mt.Everest to climb, but I have traveled across the world and arrived at the mountain".

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mmcmann
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Thanks merry and gatorade girls
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Haley
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My LL NP said to take it everyday. I decided to take it 3 times a week - TH, Fri, Sat. So I am taking it 3 X a week but that is not doctors orders. I'm trying to figure out what works best for me.

Artemisinin seems to really work well. I hope it will continue.

I also take Malarone everyday and Zith every other day.

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TF
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Do a search for previous posts on art. Others have stated previously that if you take the art continuously, your intestines will make an enzyme that blocks the absorption of the art.

If this is correct, then taking it every day is a waste.

My now famous lyme doc had me take it 3 days in a row, then 4 days off. I didn't ask him why. But, there must be something to this because, as you say, most people are taking it in a pulse fashion.

There is a doc around here who has patients taking it daily. (This could be your doc, in fact.) One patient decided to take it the way my doc told me to take it instead. That is, take it on the days that the weekly babs flare occurs. This person has had fabulous results taking the art this way. Says they will tell their doc about it so he can learn. We'll have to see how that goes.

My lyme doc got rid of lyme, babs, and bart for me in 1 year's time. I had these diseases undiagnosed for 10 years. It has been 5 years since I completed my lyme treatment and I am still symptom-free, enjoying my life. So, my doc's approach worked, and quickly.

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Lymetoo
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I took it everyday, but only for about 2 months. It finished off the babs I'd been working on for more than 2 yrs. I took zith along with it.

--------------------
--Lymetutu--
Opinions, not medical advice!

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mmcmann
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Thanks for the info. I guess I didn't look at enough posts [Smile]
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WhitneyS
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Yup-- I take it three times a day every day, and have under my LLMD's orders for about 5 months now.

If you want to I dont think it would hurt to take a week off every few months or so. I really dont see how anyone could prove that intestinal enzymes would block absorption... who would fund this sort of research?

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TF
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Here are a couple of threads for you to read:

http://flash.lymenet.org/scripts/ultimatebb.cgi/topic/1/92717?

http://flash.lymenet.org/scripts/ultimatebb.cgi/topic/1/93685?

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FunkOdyssey
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Eur J Clin Pharmacol. 2008 Mar;64(3):283-92. Epub 2007 Dec 7.
Artemisinin and CYP2A6 activity in healthy subjects.

Asimus S, Hai TN, Van Huong N, Ashton M.

Unit for Pharmacokinetics and Drug Metabolism, Department of Pharmacology, Sahlgrenska Academy at G�teborg University, P.O. Box 431, 405 30, G�teborg, Sweden.
Abstract

OBJECTIVE: To investigate whether the antimalarial drug artemisinin affects CYP2A6 activity in healthy subjects and to compare the utility of coumarin and nicotine as in vivo probe compounds for CYP2A6. METHODS: Twelve healthy male Vietnamese subjects were given coumarin or nicotine in randomized sequence before and after 5 days of a repeated oral administration of artemisinin during two different treatment periods 1 month apart. Sequential blood samples were drawn at baseline 7 days prior to artemisinin treatment and on the first and fifth day of artemisinin treatment during both treatment periods. Plasma concentrations of 7-hydroxycoumarin glucuronide (7-OHCG), nicotine, cotinine and artemisinin were analysed by high-performance liquid chromatography and those of coumarin and 7-hydroxycoumarin (7-OHC) were determined by liquid chromatography-tandem mass spectrometry. Urine, collected in two time intervals on the days of coumarin intake, was treated with beta-glucuronidase and analysed for 7-OHC levels. RESULTS: Artemisinin AUC(0-infinity) values decreased significantly to 23% [95% confidence interval (CI) 18%-28%] on the fifth day of artemisinin administration as compared with the first. The sum of renally excreted 7-OHC and 7-OHCG increased by 1.55-fold (adjusted 95% CI 1.08-2.23) in the 3- to 8-h interval compared to baseline 7 days before. The 7-OHCG/7-OHC plasma AUC(0-infinity) ratio increased by 1.72-fold (adjusted 95% CI 1.16-2.54) following 5 days of artemisinin intake. There was no significant change in the cotinine/nicotine AUC(0-11 hr) ratio between study days. CONCLUSION: Artemisinin significantly increased the sum of renally excreted 7-OHC and 7-OHCG in one of the two collection intervals, suggesting an induction of CYP2A6. A significant increase in the 7-OHCG to 7-OHC AUC(0-infinity) ratio indicates artemisinin to be an inducer of glucuronidation.

PMID: 18064444

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FunkOdyssey
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Artemisinin induces enzymes which accelerate its clearance, as you can see you would need to take a five times larger dose on the fifth day to achieve the same concentration as the first day. Impractical and probably unhealthy.

Hence, pulsing.

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canefan17
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Buhner recommended I take 400mg/day for 30 days.

I'm gonna give this shot... considering my babs is mild case.

After these 30 days I'll take a week off and start crypotlepis for a month or so.

: )

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pj1954
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bhunner recommends in his book not to take it more than 21 days otherwise you build up an immunity to it !

so if you pulse it it keeps working !

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nefferdun
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I took it twice a day every day for several months until I did not remember to reorder and ran out. I don't have the babs symptoms any more so not worrying about it.

--------------------
old joke: idiopathic means the patient is pathological and the the doctor is an idiot

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troutscout
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I have read 3 pills a day for ten days.

In fact....Ive heard that about 75% OF THE TIME

tROUT

--------------------
Now is the time in your life to find the "tiger" within.
Let the claws be bared,
and Lyme BEWARE!!!
www.iowalymedisease.com
[/URL]  -

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KH111
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You can take it every day for about 2 weeks or so, but should not take it every day for months on end. You will build up resistance. I think I took it for 3 weeks at a time and then off one week, while taking mepron and zith. I also took one course Riament also called Coterm (sp). Have been off abx for 5 years now.
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Lauralyme
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If it's taken with grapefruit juice an immunity doesn't develop

--------------------
Fall down seven times, get up eight
~Japanese proverb

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NMN
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I responded brilliantly to Art and took it everyday but it stopped working and panned out pretty much like FunkOdyssey's study seemed to suggest. I would pulse it for sure.

--------------------
Pos BB and Bart(Q & H IGG pos)
Began treat 1 year after start of illness. Diagnosed Feb 2007.

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Remember to Smile
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quote:
Originally posted by KH111:
You can take it every day for about 2 weeks or so, but should not take it every day for months on end. You will build up resistance. I think I took it for 3 weeks at a time and then off one week, while taking mepron and zith. I also took one course Riament also called Coterm (sp).

Have been off abx for 5 years now.

Great news for you, KH111! Good to hear.

I need advice.

Just started Artemisinin yesterday, and it dragged me almost to the ground. Wanted to lie down on the floor in exhaustion several times right where i was (including bathroom floor!)

Had to sit on toilet lid to brush teeth 'cause no strength to stand. Walk thru my house like an 85-yr-old nursing home resident (SLOW & bumping hands along the wall, resting by gripping onto chairs or door jambs).

New headache pain, horrid neck strain, pectorals pulling on clavicles, more weakness...

My Babesia load tested "very high," so this is a good herb for me. I also take doxy, Mepron & clarithromycin all 2x/day.

My good LLMD prescribed 200 mg Art 2x/day "between meals," which i took to mean with my other supplements taken on an empty stomach.

Question: When ought I go off for the one week in relation to my Borrelia symptom pattern?

I've seen improvement (lessening of symptoms) for 3 or 4 days at the same time each month. With that in mind, when would you suggest i take the one wk off?

Looking forward to hearing from members. Thx.
Achy
Smile

Update: I felt much better on Day 3 with Art! [spinning smile]

[ 08-17-2010, 10:12 AM: Message edited by: Remember to Smile ]

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When should i schedule the one week off Artemisin?
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Hoosiers51
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I think the study speaks for itself. After 5 days, it's not very effective.

Sure, you could try adding grapefruit juice, but considering artemisinin can be hard for the liver to get rid of, I wouldn't risk it....I would just pulse.

Also, grapefruit juice interacts with many meds. Not something I would mess with unless I knew what I was doing, like if I were a pharmacist or knowledgable doctor....which I'm not.

So I pulsed mine...I think it was either 4 days on, 3 off, repeat....or 3 on, 4 off, repeat.

I would show your doctor that study. There are other studies out there too. Artemisinin has been used for malaria, so there ARE studies on it.

I would be sure to be getting liver function tests regularly while on it.

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Beachinit
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Dr B at recent conference says to take Artemisinin 2-3 wks in a row on a daily basis and then take 1 wk off.
I found out about the conference notes 3-4 wks ago and I had been taking Artemisinin Fri-Sun prior to that along with bactrim ds twice/day. I had taken it that way for 5 months and had noted some gradual improvement in Babesia symptoms. I was also taking it with clarithro or doxy at different times and I noticed a synergy especially with the doxycycline. I had not seen a reference on that but I researched anti-malarial medications and doxycycline does have low level antimalarial activity. 3 weeks ago I started taking levaquin for Bartonella and also noted some synergy with Artemisinin in reducing symptoms of Babesia. So to MMC I think you may see this synergy at well... please let us know if you do. I could tell about the synergy by the extra yawning I was doing on Art + Doxy in particular.

--------------------
Ideas not advice.

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Thanks for an update from Dr B, Beachinit! [kiss]

Scientifically, when in the life cycle of Borrelia should we take the one week off from Artemisin?

Time it on one side or the other of the up days in my monthly chart of symptoms?

What are the spirochetes [Cool] doing on the 3 to 4 days i feel a bit better?

My successful LLMD keeps up with the latest ILADS tx protocols, so i'm confident following the 3 wks on/one wk off dosing plan. Just trying to maximize everything. Guess I'll have to call...

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quote:
Originally posted by TF:
My now famous lyme doc had me take it 3 days in a row, then 4 days off. I didn't ask him why. But, there must be something to this because, as you say, most people are taking it in a pulse fashion.

There is a doc around here who has patients taking it daily. (This could be your doc, in fact.) One patient decided to take it the way my doc told me to take it instead. That is, take it on the days that the weekly babs flare occurs. This person has had fabulous results taking the art this way. Says they will tell their doc about it so he can learn. We'll have to see how that goes.

My lyme doc got rid of lyme, babs, and bart for me in 1 year's time. I had these diseases undiagnosed for 10 years. It has been 5 years since I completed my lyme treatment and I am still symptom-free, enjoying my life. So, my doc's approach worked, and quickly.

TF was treated for Lyme disease by two other LLMDs before Dr S, so she may have given him a bit of a "head start" on clearing infections. Now her quick & lasting recovery is great!

It appears the ILADS advice on Art dosing has been modified since 5 yrs ago.

I encourage everyone to check in with your LLMD, LLDO, or LLRN before changing a treatment your LLMD ordered. Work like a winning team; communicate!

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