I added flagyl to the above combo a couple of days ago. I am herxing, but not dying. I am supposed to pulse the flagyl 1 week a month.

I am also adding minocycline. Here's the question. Do I continue the mino while doing the one week of flagyl or do I stop mino for the flagyl week?

The reason I ask is because there seems to have been a lot of debate on this. Even the doc was not sure if these could be taken together.

I don't think it is a bad interaction between the two, but an effectiveness issue.

Something like mino can make the flagyl ineffective. Don't want to do that since I am only on it 1 week a month. (and it's te first time I have done flagyl.)

Don't want to bee off mino if that will give the keets ability to build resistince to mino.

So, what is the real story? Does anyone know?

I found this post while doing a search but am not sure if it still applies and what the current thought is on the subject.

Martijn
Frequent Contributor
Posts: 118
From: the Netherlands
Registered: Jan 2004
posted 17 May 2004 14:42
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Minocin (Minocycline) is a tetraycline.
Flagyl is Metronidazole.
Burrascano:
"Because there is laboratory evidence that tetracyclines may inhibit the effect of metronidazole, this class of medication may not be as useful as others in these two- and three-drug regimens." {this is from Burascano 2002 Guidelines}

The cause of tetracyclines inhibiting the effect of metronidazole:

"Metronidazole is generally bactericidal at concentrations equal to or slightly higher than the minimal inhibitory concentrations
Action/Kinetics: Effective against anaerobic bacteria and protozoa. Specifically inhibits growth of trichomonae and amoebae by binding to DNA, resulting in loss of helical structure, strand breakage, inhibition of nucleic acid synthesis, and cell death

Tetracyclines bind reversibly to the small subunits of bacterial (and eukaryotic) ribosomes where they interfere with binding of charged-tRNA to the "Acceptor" site. They are "bacteriostatic" rather than cidal"

Hope this helps,

Martijn

Please share your experiences.

robi

The only things i can tell you is from my own experience, okay? regardless of what's debated on this, or other sites, I know what happened to me with the Mino/Flagyl (M/F) and will pass the info. along to you accordingly.

First, until just Jan. this year, I had never used another primary abx. other than Mino. I had been on 400mg. Mino for over 2 years and backed down to 200mg. some months ago. You will have to judge/compare for yourself what experience has taught me...

2nd - I had a huge, HUGE die off when I started the Flagyl 9 months into tx. w/Mino and can tell you from experience that Mino builds cysts very quickly and lots of them! Do NOT, under any circumstances start with a full dose Flagyl regimen after taking Mino. for any period of time. Please, start small! My herx was so big and strong that seizures, encephalitis and meningitis ensued for 6 weeks and I truly could have died during that time. Don't you believe for one minute that M/F counteract one another. Plainly stated, I totally disagree with Dr. B. on this and have the herx experience, doctors notes and brain damage to prove it. You can take what I say with a grain of salt if you wish, but, I urge you to be very, very careful with this combo.

As to whether or not you should take Mino with all the Ketek/Plaq/Flagyl, - Why? Why add Mino? If the K/P/F combo works well for you, why muck it up with another, very tough to take abx? It sounds like overkill to me; no pun intended.

If it were me and I knew what I know now and am taking the drugs you're already taking, I'd wait until the K/P/F protocol is done, then, try Mino. This is all IMHO.

As I said, I'm not a doctor, but, will never forget what happened to me with M/F and can't stress taking care with this mix. BTW - Don't worry about the keets building resistance to Mino, ain't gonna happen with the schedule your doc has you on.

FYI - My current protocol is Zith/Mino/Mepron. When the Mepron's done, I'll begin titering up on Flagyl again.

All IMHO - ping

Which is it? Comments?

Does anyone else have experience with Mino and Flagyl?

I can say after two months on 200 mg of mino with I think it was 500 mg of zithro I took the flagyl by itself and had one really bad migraine with aura on the first day off the flagyl.

So now I am taking doxy/septra and pulsing in flagyl this week before my vacation. I did have a herx on the second day. It was miserable but not unbearable.

The brochure that comes with my Tindamax says that using oxytetracycline with it may be contraindicated. I wanted to find out why doxy and mino weren't listed also.

The drug company pharmacist said that she would research this and get back to me when she had the answer.

He didn't really sound convincing though.

1) taking Flagyl and Mino together, and

2) Mino encouraging cyst formation.

Anyone got some more insight?

If Mino encourages cyst formation and lowers the effectiveness of Flagyl, this seems like a particularly bad combo.

ping, do you have any other references to this besides your own experience?

I found this on the Canadian LDF site:
"We observed that beta-lactams penicillin G and ceftriaxone, the antibiotics of choice in Lyme borreliosis treatment, favoured the production of cysts when used with serum-depleted BSK medium. In contrast, we observed a low level of cyst formation in the presence of macrolides and tetracyclines" http://www.canlyme.com/noroc.html

I only ever saw one teeny weeny one person study (in fact it was not even a study, merely a doctor who thought the woman had failed to improve on doxy and flagyl bec they were antagonistic). I asked dr B but he could never produce any significant reasons for saying cyclines and imidazoles should not be used together. They are used together in the tx of helicobacter Pylori, and David Wheldon (after Stratton) also uses doxy and tinidazole/metronidazole together.

So unless Dr B explains once and for all why he claims they should not be used together, I suggest we stop repeating this as fact.

Nelly

quote:

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Originally posted by nellypointis:
Dr Burrascano is the ONLY source who claims that cyclines and imidazoles should not be used together. Because of this everyone is Lyme circles repeats this over and over without knowing why.

I only ever saw one teeny weeny one person study (in fact it was not even a study, merely a doctor who thought the woman had failed to improve on doxy and flagyl bec they were antagonistic). I asked dr B but he could never produce any significant reasons for saying cyclines and imidazoles should not be used together. They are used together in the tx of helicobacter Pylori, and David Wheldon (after Stratton) also uses doxy and tinidazole/metronidazole together.

So unless Dr B explains once and for all why he claims they should not be used together, I suggest we stop repeating this as fact.

Nelly

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Thank you very much Nelly! As a matter of fact, when I first started treatment, the standard from Dr. B. was guess what?...Doxy & Flagyl.

As for the pharm co. info., I've already inquired about this some time ago and there is no literature advising against a Mino/Flagyl mix. ping

I will take them together. When I have my next LLMD appt. I will run it by her and she what she says.

robi