I couldn't even begin to name the problems it could cause. A LOT of the side effects and dangerous reactions listed were caused SIMPLY because someone wasn't taking the drug CONSISTENTLY.
I read a lot on this board that people suddenly decide to stop their medicine or take it when THEY think they need it and I wanted to remind people that this is very dangerous; Rifampin is NOT like other antibitoics.
There's a reaction realted to this in nearly every category (immunological, hematological, cardiovascular, respiratory, etc.)
So please take this medicine like you're supposed to; otherwise "bad things" could happen.
little olive
Posted by BoxerMom (Member # 25251) on :
Thanks, little olive.
Good LL docs never pulse Rifampin, for all of these reasons.
I've been told the most frequent side effect of intermittent dosing is thrombocytopenia (low platelets), which would cause bleeding problems.
Be consistent with the Rifampin!
Posted by Tammy N. (Member # 26835) on :
Wow, never knew that!!!
Hope my Lyme brain remembers if I ever go on it again.
Thanks for the info.
Posted by kidsgotlyme (Member # 23691) on :
Thanks Little Olive. I didn't know that. My daughter has been on it for four months now, and her LLMD said that we would do it for at least another two months for bart.
Posted by Starfall (Member # 26795) on :
Good to know. I haven't been very consistent with any of my abx lately--stomach bugs, reflux issues, etc.
Posted by little_olive (Member # 28063) on :
You're welcome everyone. We dont need to cause ourselves unnecessary problems when we have all this other stuff going on Posted by 2roads (Member # 4409) on :
Little_olive,
I have read a little about rifampin too, and I'm trying to decide how toxic it is to the kidneys. it seems more problematic to the liver.
We have kidney issues, in my opinion, form Bactrim now that I hope will dissipate, But I cannot afford the same toxicity.
What say you?
Thanks
Posted by little_olive (Member # 28063) on :
That site there says:
quote:There have been rare case reports of REVERSABLE acute renal failure due to glomerulonephritis and renal epithelial cell injury in patients receiving rifampin. Often in these patients OTHER immune-mediated REACTIONS OCCUR, such as hemolysis and thrombocytopenia. Antibodies to rifampin have been identified in some affected patients. Generally these reactions occur after reintroduction of the drug following a lapse in therapy, although they have also been associated with continuous therapy.
Renal side effects have included elevations in BUN and serum uric acid. Hemoglobinuria, hematuria, interstitial nephritis, acute tubular necrosis, renal insufficiency, and acute renal failure have been reported. These events are generally associated with an immune-mediated reaction WHICH OCCURS AFTER INTERRUPTION IN RIFAMPIN THERAPY.
So, just according to that, the risk is more or less associated, again, with interrupting treatment rather than the drug itself.
But I agree that it's more prone to cause side effects in the liver than the kidneys, since it's primarily metabolized by the liver. All you can do is get monitored every few weeks and watch. I get checked every two weeks for abnormal enzymes, then every month if it's a so-far-so-good scenario. (Don't forget up to 15% of it passes unchanged into the urine, so it turns urine orange!)
Also when you get the drug, it comes with an insert that explains the chance of something happening to the kidneys, if you want percentages.
Posted by cleo (Member # 6646) on :
My llmd pulses it. I refused to pulse it. It is the only drug that I refuse to do pulses with. Thanks Little Olive. I will show my llmd. I only was going on what Dr. Stratton at Vanderbilt told me about Chlamydia P which I have too. He told me never, never pulse rifampin because cpn quickly develops resistance if pulsed. I have read countless time of people ramping up this drug too. I would not do that either. We need to get on the same page here with all this bugs, otherwise we are creating stronger and stronger bugs for the next person.
Posted by 2roads (Member # 4409) on :
Thanks liitle_olive. I wonder if the unpassed rifampin which turns the urine orange has any detriment.
It sure looks bad, especially when you are treating the kidneys with fine kit gloves.
I think we will wait a few more weeks to start it, or anything, for that matter.
ugh
Posted by lpass (Member # 26781) on :
I've been on rifampin for 4 weeks and I only plan on doing two more weeks. Do I have to stop slowly? Does anyone know?
Posted by lymeinhell (Member # 4622) on :
I was on it 9 mos and had to skip Rifampin for two days every 28 days like clockwork from severe herxing. It gave me just enough time to get through the worst and I always felt much better after the herx than I did before. Meaning, I improved. And I got better, got rid of Bart, and have my life back.
I took large doses (350mg twice a day) of Milk thistle throughout, was also on Flagyl, and not once did I have abnormal liver values.
Posted by 2roads (Member # 4409) on :
Little_olive, I think I may have just read an article about what you discovered. It seems to have to do with antibodies that build up against Rifampin.
The person in the study had taken it two years prior.
Does this mean if we took it two weeks 1.5 years ago, we may be at much greater toxicity risk?
OMG
Posted by little_olive (Member # 28063) on :
cleo: I know LLMDs woudl never purposely ignore the warnings. I think sometimes they deal with so many antibiotics they get confused as to which side effect goes to what. We do need to double check.
And yes, if the side effects of pulsing or randomly stopping and/or skipping doses aren't enough to make someone take it appropriately, it's ALSO the fact that taking Rifampin intermittently allows bacteria to become resistant to it, and very quickly in fact! Bartonella can become resistant to it after just two lapses in therapy!
Lpass: I'm not sure what on earth you're treating with just 6 weeks of Rifampin, but if it's bartonella, you need at LEAST six months on it.
2roads: It might help to understand that Rifampin doesn't literally TURN things orange, but the color of Rifampin is red, so when it gets diluted with other liquids it shows up as orange.
But yes, what you said is true, that some people develop antibodies against Rifampin if they take it for a while, stop it, and then then have to take it again. But I'm not sure for how long that person had to have taken it the first time, to possibly create problems in the future.
I'm not here to incriminate Rifampin, though. We could start a thread on each antibiotic and have outrageous lists of all the things that "could" happen, even though the side effects are generally less than most all the new medications they're coming out with these days for other things like blood pressure and depression. If you NEED the medication, you need it, and the most you can do is monitor for side effects with your doctor until you are off of it.
The way I see it, we have more of a chance (1 in 10) that bartonella will cause endocarditis than of Rifampin causing rare side effects. And 10% of bartonella-induced endocarditis cases are fatal. So!
Posted by 2roads (Member # 4409) on :
Thanks for the pep-talk little_olive, I needed it.
Amen to what you said.
Hugs
Posted by little_olive (Member # 28063) on :
((( )))
Posted by 17hens (Member # 23747) on :
quote:Originally posted by lpass: I've been on rifampin for 4 weeks and I only plan on doing two more weeks. Do I have to stop slowly? Does anyone know?
The way I understand it, you should never stop abx slowly. Just cold turkey. Rifampin included.
Posted by tiredmom21 (Member # 28479) on :
does anyone know if it is okay to take the two doses of rifampin at once in the evening or if you have to take it twice a day. I get such terrible headaches that have not resolved since starting this medication almost a month ago. I had been pondering asking my LLMD at our next appt, but when I saw this thread I thought I'd ask. Thanks.
Posted by 17hens (Member # 23747) on :
Hmmm, well I certainly couldn't say yes or no to that question, not being a medical person...
but I can tell you that when 2 doses of Rifampin were too strong for my DD's stomach (acid), our LLMD had her back down to one dose just once a day in the evening and that worked well for her.
Posted by little_olive (Member # 28063) on :
You can take it once a day. I take 600mg once a day instead of 300mg twice a day. Of course twice a day is best, because the half life is around.. seven hours, I think? But my LLMD said this was fine becuase I herx so severely. Just don't forget to take it at the same time each day. Posted by lpass (Member # 26781) on :
little_olive - I've been treating bart with 8 months of zith and was doing pretty well except my head wooziness so my llmd wants me to try 6wks of rifampin to see if it helps. I guess I can potentially take it for a longer time.
17hens - thanks, good to know!
Posted by little_olive (Member # 28063) on :
Oh! That's much better then! Posted by tricia386 (Member # 29623) on :
what happens you you stop rifampin bc you are done taking it....just wondering?
Posted by little_olive (Member # 28063) on :
The infection comes back. And since it's bartonella, it comes back very quickly. This event has left me in the ER before, as well, but from a different antibiotic (not Rifampin). Not completely treating the infection meant a HUGE relapse 10 days later.
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