I got a new script protocol. My LLMD prescribed Amoxicillin 875mg 2xs/day & Azithromycin 300mg 2xs/day...but both only on Monday, Wednesday, and Friday...nothing any other other days of the week.
I've never seen anyone else mention beig prescribed anything like this.
Any thoughts or any help to make sense of this?Thanks.`
Posted by TF (Member # 14183) on :
Amoxi and zith is a great lyme treament combo. The only problem is that you are with a "low dose" doctor, so you are not getting the proper dosages.
Your doc is doing exactly what Dr. S, her mentor does. He likes to "pulse" antibiotics--meaning the M, W, F routine.
See what Burrascano says about giving the patient 2 different antibiotics, like zith and a penicillin (amoxicillin is a penicillin). Here is a quote for you:
"COMBINATION THERAPY
Treatment of chronic Lyme usually requires combinations of antibiotics. There are four reasons for this:
1. TWO COMPARTMENTS- Bb can be found in both the fluid and the tissue compartments, yet no single antibiotic currently used to treat Bb infections will be effective in both compartments. This is one reason for the need to use combination therapy in the more ill patient. A logical combination might use, for example, azithromycin plus a penicillin." (page 12)
So, you are on a good combo.
But, then read the proper dosages on page 18:
"*Amoxicillin- Adults: 1g q8h plus probenecid 500mg q8h; doses up to 6 grams daily are often needed"
In English, that means 1 gram (1,000 milligrams) every 8 hours plus probenecid 500 mg every 8 hours; doses up to 6,000 milligrams per day are often needed.
I was on 1,500 mg of amoxi, 3 times per day every day for a total of 4.5 grams of amoxi per day. I took it with probinecid as required above. The probenecid keeps the amoxi from quickly leaving your bloodstream and being eliminated by the body. This way, the med is in your body for the full 8 hours.
Then, flagyl was added. That's how I got rid of lyme disease. (I am allergic to zith, so no zith for me.)
You are on 1 3/4 gram each day that you take the amoxi.
Then, Burrascano gives the proper dosage for the zith:
"Azithromycin- Adults: 500 to 1200 mg/d"
That is 500 to 1,200 milligrams per day.
So, don't be afraid to take these meds, but don't expect these dosages to cure you.
Posted by ablyme (Member # 42350) on :
That is what I was thinking. I have a few bottles of Augmentin from previous unrelated infections...which I know has an additional med to amox added in it to help keep the blood levels constant.
I am tempted to add that in and take it more days a week as well. I know being your own Dr. isn't the best idea but I don't really know what else to do.
I wasn't tolerating the Mino well, and needed something else before being able to get to my new LLMD.
Posted by ablyme (Member # 42350) on :
I wonder if the zith dosage is supposed to be twice a day or once. I have 600mg pills that I'm supposed to half and take half of twice a day. I could take it once a day if that is better. Guess I need to try to look that up.
Posted by Lymetoo (Member # 743) on :
She has the dosage in her post above.
Posted by ablyme (Member # 42350) on :
Lol. That was me asking. I didn't mean dosage but how many times to take it. Sorry for confusing.
Posted by TF (Member # 14183) on :
Since Burrascano says 500 mg to 1200 mg per day, I am assuming that it doesn't matter if you take it once or twice per day, just so you achieve the stated dosage.
I looked up azithromycin on Google, and many sites say you can take it once per day. It has a very long half-life--68 hours.
That means that half of it is gone in 68 hours (almost 3 days). So, you can see that once per day dosing will be fine.
Posted by ablyme (Member # 42350) on :
Ok. So I'll decide how often I want to take it...maybe it has something to do with upset stomach why she suggested 2xs a day.
So as far as the pulsing...maybe the zith is ok every other day...but I don't see how the amox is cause I know it doesn't stay in the blood that long.
I was wrong though about the dosing of the amox too. The script bottle said 1 pill 2times a day. But the protocol dosing sheet she gave me says 2 pills 2 xs a day...so over 1700mg 2xs a day. That sounds like a more effective dose...but still concerned about 3 times a week only.
Posted by ablyme (Member # 42350) on :
Maybe I will take the augmentin on the between days so I get 5 days of amox....3 days of zith and take the weekend off. I know I cant take 4 doses of augmentin though so I would take 2-3 a day on tues and thurs.
That sounds better right?
Thanks for looking the info up on zith TF.
Posted by tickbitt (Member # 33753) on :
Frankly, I think it's a poorly designed protocol, and unless there are lots of people using it with success I'd look for another LLMD.
The reason I think it's poorly designed is because the half life of zith is so long, and the basic design of ramping drug levels up and down is a good way to make the bacteria quickly resistant to the drugs.
By taking zith every other day you're essentially just getting a long-term low dose of zith. It never gets that high, and you're never really without it,
By taking amoxicillin every other day (half life:1 hour, a little longer when taken with probenecid) you're exposing your lyme to very low levels of amoxycillin very regularly. That's exactly how bacteria become resistant to drugs, and why you're supposed to take all of an antibiotic prescription even if you're feeling better.
I'll change my mind if I see some evidence, but it looks like a really bad protocol to me.
Posted by ablyme (Member # 42350) on :
Yeah, I am waiting to see another LLMD...but gotta deal with what I got in the meantime. That's why Im trying to figure out how to tweak the protocol to make it better.