I have been taken off Bicillin and Biaxin by my LLMD and am to start Ketek in 2 weeks, after completing 2 weeks of Diflucan.

I am to take 800mg Ketek Mon-Fri and Diflucan 200mg once a week, on the weekend.

So, even if you have already posted about how you are doing on Ketek on various other threads, perhaps you could do so again on this thread so we have a centralized Ketek thread.

My first question is - is it a good idea to start out slowly with this drug, like maybe 1/4 dose first day, 1/2 dose second day, etc?

DLL

Because my LLMD knew I am sensitive to drugs, he had me start Ketek 400mg. once a day for a few days, and then increase to 800mg. once a day.

Some people have problems with this, and take it 400mg. twice a day. He said this is fine too.

He told me that if I need to take Diflucan as well, the Ketek dose needs to be cut back to 400mg. daily because the Diflucan makes the Ketek stronger.

I am curious about your dosing schedule with Diflucan, it actually makes sense to me and might just be needed to keep the yeast in check. I had initally gotten the yeast very badly when I started Ketek and had to get off it completely for a while.

I am going to start Ketek today 800 mg/day; I am already taking mepron-artemesia, levaquin-prevacid, bicillin and nystatin.

I am going to start the Ketek full dose; usually my LLMD tells me if I should start something slowly but he didn't say anything about the Ketek.
Hopefully I won't be totally useless after taking it.

DLL: Why were you taken off bicillin? Is there a conflict between bicillin and Ketek or some other drugs?

Maybe we should start a Ketek buddies thread again, anyone up to that?

I asked my LLMD if Diflucan was going to be a problem with Ketek, because I thought it was a problem with Clarithromycin, which is related to Ketek.

He said that Diflucan is not a problem with Ketek, but that some other antifungals, and lots of other drugs are (he gave me a list of which drugs are a problem, fluconizole is not on it).

Lymster- I'm confused, why start another Ketek buddies thread?

I was taken off Bicillin for 2 reasons: I have had sciatica since around the time of stgarting Bicillin and one small concern was that for some reason the bicillin is 'leaking' and irritating the sciatic nerve (although unlikely) and also because I have been very ill for about a month, and gone backwards, and he thought it MIGHT be serum sickness.

It doesn't mean I'll never take it again (assuming I do not have serum sickness).

But first, a disclaimer for newbies. The antibiotics listed below are all very strong, will probably cause massive herxes the first time you try them, and require some getting used to. Especially flagyl. They are offered both as my own experience, and as a starting point for your own research, not as the whole shebang to start taking right away.

Again, I worked my way up to this combination, tried a lot of other things that did not work, and want to get off this combination as soon as possible.

As you have heard ad nauseum, DLL, I have Lyme and two co-infections. Here's the doses:

Lyme: ketek 400mg/2x day, because I'm five feet tall and will be felled by a full ketek dose

omnicef 2x/day, flagyl 250mg/2x day

Babesia: mepron 10ml/2x day, artemisinin, ketek

High quality liver support, high quality probiotics, omega 3-6-9's and phosphatidylcholine, vitamins, minerals

Since diflucan would be heavy to add on this protocol, I take nystatin and an antibiotic herb called coptis for yeast. Its active ingredient is berberine, which is also found in grapeseed extract and--in smaller amounts--goldenseal.

The ketek is integral to this maintenance abx routine. I have decided that in my case, it's better to risk the consequences of taking strong antibiotics than to continue being disabled, since I live alone in a big city and do not have the option of being dependent on a family or having someone else take physical care of me.

With that perspective, I'm happy to report that this abx combination has taken me farther in one month than any previous drugs have taken me in the past five years. Since I'd tried most of these drugs before, the only difference seems to be that I'm hitting the co-infections at the same time, and I substituted ketek for zithromax, which is also a fine antibiotic. Some Lymenet people have written that ketek can help with babesia and bartonella, in addition to Lyme.

I found the ketek did not work for me without a cephalosporin (sp?) Together, the two are a powerful combination. The ketek produced a two-week herx that was like a continuous cold. Even now, seven months after I started taking it, it produces coughing and sneezing about two hours after I take it.

[This message has been edited by liz28 (edited 25 April 2005).]

[This message has been edited by liz28 (edited 25 April 2005).]

I've been doing cleanses and detoxification (which is not easy to fit in around all the orals!) which I think have helped keep me from being prostrated.

While your toughness and determination are admirable, please be cautious with the levaquin/ketek/mepron/bicillin combination. Levaquin is one of the strongest drugs out there, and is usually only prescribed with one other weak antibiotic, like doxycycline or biaxin.

It's mind-boggling that my LLMD was adamant that Diflucan and Ketek don't mix, and if I hadn't insisted on at least lowering Ketek, he would have taken me off it totally while I was on Diflucan. He felt both together were too hard on the liver.

I can only go by the sheet my LLMD gave me, and what he said about Diflucan and Ketek, however, I guess it wouldn't hurt to research this to make sure it is not a problem. Ask your doc maybe to point out anywhere where it states Diflucan cannot be taken with Ketek (even if it is on the days off Ketek).

I don't like liver 'cause it is Y-U-K-K-Y

I was also supposed to be taking Omnicef with the Ketek so I tried the Omnicef first (just happened to be what my pharmacy had enough of to fill first). I did 2 days of 300mg a day (supposed to be at 300mg twice a day) but had to stop after the 2 days because I was getting severe diarrhea (it was really terrible) and I was very concerned about getting dehydrated which is never good but is even worse for me because I have an autonomic dysfunction condition. I see IVs in my near future...if my insurance company will cooperate.

Peace and healing,
Annie

------------------

Lyme Out Retreat Website

Lyme Disease Awareness Products

Click here to join Lyme Pals.

It says not to take if you have irregular heart beats - does heart skips and palpitations (with normal EKG fall into this category?)

It also says that it is not compatible with Valium which I sometimes take for sciatica. Does anyone else take Valium ?

In addition it says that it may not be compatible with many herbs and supplements and low magnesium. Now, most of us take many herbs and supps - how can we find out a complete list of what is not good to take with it? Also, most Lymies have low magnesium.

These things were not on the list from my LLMD but on the Ketek site.

Have any of you quit any herbs supplements due to Ketek? Also do you suffer palpitations, and heart skips?

quote:

---

Originally posted by lhm312:
Well, it's no wonder we who are already confused get further confused by our LLMDs.

It's mind-boggling that my LLMD was adamant that Diflucan and Ketek don't mix, and if I hadn't insisted on at least lowering Ketek, he would have taken me off it totally while I was on Diflucan. He felt both together were too hard on the liver.

Dontlikeliver, are you on Diflucan as a preventative? And why don't you like liver?

---

There is a difference between a dangerous drug interaction and two drugs together being too hard on the liver. Many drugs are hard on the liver, and it's why we should have monthly blood tests. People on Mepron usually have weekly or bi-weekly blood tests.

I believe the anti-fungals that have an interaction with the Ketek increase the potency of the Ketek. Therefore, you have a stronger drug in your system which can cause problems quickly.

I'm not saying that potential liver damage should not be considered in your rx. My liver enzymes did rise after a couple months after starting Ketek. I cut my Diflucan from 200mg a day to 100mg a day and completely cut out alcohol.

I was good for the first 6 months of treatment, then started law school and 1 drink a month turned into 1 a week and then 2-3 a week. Since this test result at the end of December, I've had 1 beer and 1 glass of wine. My enzyme levels have decreased, but we are still monitoring them.

I was told there MAY be an interaction between Ketek and Diflucan. When I asked if there might be an interaction even if I have the day off the Ketek, they said they did not know.

As far as any herbs/chinese herbs, they also did not know what might interact and what might not, and I was advised to check with the manufacturers of any of the herbs (which is not really possible for some of the herbs I have where the packaging is in Chinese).

Does anyone know where I can read (and understand) a prescribing handbook or something, online?

DLL

The fact that the manufacturer said there may be an interaction, suggests to me that maybe we should all be careful with this mix. They are obviously concerned about a potential liability, or they would have said there was no interaction.

Why not call your LLMD and ask directly?

I took Ketek for about 5 months with very good results. I had more energy and less symptoms. My LLMD had me add in minocycline and I went downhill.

When I took the mino, I started having heart skips and palpatations that only went away after about 3 days off all abx.

Part of me wonders if the Ketek had something to do with the heart problems since they are listed as possible problems with Ketek.

I now can't take any abx at all without having severe heart issues. I've tried Ketek alone, mino alone and a very low dose of zithromax alone and all have caused heart issues. Since trying the zithromax, my heart has never gone back to it's original normal state as it had previously.

DLL-Did you have the heart skipping and palps pre-lyme, pre-dx or since treatment? You're the only other one I've seen that has these problems. Have you had them checked out? Is there some other cause than TBD's for them? Neither of my docs think anything of them. They definitely take away any energy I may have had before.

Thanks,

I forgot to mention what my LLMD told me about taking clonapin (a valium cousin) and Ketek.

She said that the Ketek causes the liver to metabolize much more quickly so take a 1/2 or 1/4 dose of clonapin if I need to.

I had taken one to help me sleep and I felt like I was hit by a truck for 2 days. I didn't take any clonapin with Ketek after that. I was too scared of the consequences.

Take care,

I have had palpitations and skips on and off for several years. I had 2 EKG's about 10 days ago, and nothing abnormal, just tachychardia showed.

Previously, I once had a 24 hour tape, also no abnormality showed.

It FEELS abnormal when it happens, but apparently not a disease I guess.

Yes, I have had these symptoms for a few years - all as a result of Lyme, I'm sure. I was misdiagnosed witgh CFS for 14 years prior to getting the Lyme dx/positive WB.

I will try to avoid the Valium or take a tiny dose if I need it for pain.

I had the same response when I took vicodin. It never used to make me tired, but the few times I took it on Ketek, I was exhausted.

Now I just take ibuprofen when needed.

I also visited yet another pharmacy to be sure, the pharmacist was very nice and went through his pharma books with me, and he said there is no evidence that there is any problem with Diflucan and Ketek, having cross referenced both drugs.

How long have you been on it and are you on any other abx?

quote:

---

Originally posted by dontlikeliver:
Kara,

How long have you been on it and are you on any other abx?

DLL

---

I had a couple months where symptoms seemed to increase, but now I'm doing better. I think it was stress more than Ketek. I don't remember the last time I took a prescription pain killer.

I've been able to really strengthen over the last few months through yoga. I really think it was the Ketek that helped me do that. Especially since I was on Levaquin before the Ketek, so I was scared to push myself.

I am 3.5 months into it and have improved considerably and with no bad side effects or problems.

I feel and look healthy for the first time in years! I've gone from 30mg of Flexeril at night to 10mg which means I can wake up not feeling hung over for the first time in 18 months.

I can put a suitcase in the overhead compartment of an airplane by myself again. I think I'm stronger than I ever was.

I've been on Ketek since November. We think the Lyme has been gone for about a month now. I remained on Ketek while I added amoxycillin back in to target salmonella. Figured it was better to stay a bit longer than stop a bit short.

Is Flexeril a sleeping pill? (or if not, what it is?)

Keep me posted on how it goes.

Tara, so do you think the Ketek was responsible for the delayed improvement or that it didn't do anything?

Porsche, Yes, I was religiously (and in a paranoid ways ALWAYS) checking for blood before injecting the Bicillin.

I was told that if one hits a tiny tiny vessel, just by slightly wiggling the needle, a bit (tiny bit, enough to make you feel ill/weird) can leak in. Or, even on pulling the needle out it is possible, as well as injecting into a recently injected scarred area.

This was not why I was taken off though. I had 3 really unpleasant experiences, but don't let that put you off. Others have done hundreds and not had any unpleasant experiences. Likewise, I know one person who has been on them 2.5 years and she has had loads of them, yet is alive and fine and 99% well now.

I was taken off because we weren't sure if I'd developed serum sickness.

Since January I have been taking ketek (800 mg per day) with diflucan (200mg per day) without a problem.

My LLMD wants to shift me to another antibiotic soon, due to concerns about the drug stop being effective after a while.

I can understand your fear of quitting something that has changed your life for the better (I'd feel the same). Let us know how you get on though, please.

I am surprised you are on 200mg of Diflucan a day. I am on 200mg Diflucan on Saturdays. I take Ketek only Monday-Friday. Some people say Diflucan does not go with Ketek. I have got various answers depending on what pharmacist I ask, but basically that it is OK, or not to take at the same time, i.e. so a day apart is OK. But, as Diflucan stays in your system for up to 48 hours I wwonder if that counts as taking them at the same time(??)

Glad to hear that has not caused you any problems though and I guess you don't have any yeast problems either, do you?

Now he has me on Bicillin IM shots once a week. back on Ketek 800mg and tinidizole compounded 500mg 3 times a day every other week.

Im off all meds on weekends.

It has helped me get rid of my nasty itchy rash. Not completely but almost.

THe biaxin/flagyl/levaquin combo worked but I flared back so he put me back on Ketek.

I also take oil of oregano for yeast issues. I take the tincture 3 drops 2 times a day at LEAST 2 hours away from ABX.

I think the Ketek was responsible.

I was told to take the diflucan a couple of hours apart of the lyme, not to be too hard on the liver.

I still have yeast problems, despite taking diflucan every day, eating/drinking absolutely no sugar, including fruits.

I found that taking the ketek 2x a day rather than 800 mg 1x/day helped somewhat with the yeast problem.