Topic: Opinions of Combination Therapy Possibilities
seekhelp
Frequent Contributor (5K+ posts)
Member # 15067
posted
If anyone can comment on their successes/failures with the following combination Abx therapies, I'd love to hear it:
Options:
Biaxin with Plaq
Biaxin with Sulfa (guessing Bactrim DS)
Biaxin with Amoxicillin (3,000 mg daily)
Flagyl with Bactrim DS
Cipro with Minocycline
Zithromax (low-dose 250 mg) with Malarone (4 tablets)
I'm trying to decide where to go next with treatment. I'm not ready to stop Biaxin yet, but may pump up my dose past 1,000 mg.
I think I'm in for some rough rides with these drugs.
I'm very nervous as to what is the right combination / co-infection to go after. The reason is I HAVE NO IDEA I HAVE ANY OF THEM!! lol. I cannot get a doc to look me in the eye and say, 'yes, YOU have symptoms of xxx or I am 99% sure you have YYY.' I asked and asked and asked to try to get reassurance.
This is super duper important to me and I feel completely needed from any doc. I know most people think/say they have 1-3 co-infections, but these drugs like Cipro have serious risks and guessing doesn't sit well with me. No serological proof whatsoever on these.
I was reassured no one needs to be on drugs like Mepron / Malarone for more than 4 months to rid Babesia. That was good news because I hear stories here of people on these hard-core drugs for 1-2+ years @ $1,500+ monthly. Apparently, these co-infections aren't that resistant.
Posts: 7545 | From The 5th Dimension - The Twilight Zone | Registered: Mar 2008
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sutherngrl
Frequent Contributor (1K+ posts)
Member # 16270
posted
I took Flagyl with Zithromax 500mg each a day. I didn't have problems with that combo. The Biaxin was harder for me than the Zith, even though they are in the same family.
Posts: 4035 | From Mississippi | Registered: Jul 2008
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posted
I took Biaxin with Plaquenil and Amoxy, and Mepron. Probenecid also makes the amoxy work better (took that too).
And, Wow, I wish someone would tell my babesia that it's not supposed to be resisitant. I was on Mepron/Malarone for 20 months and still test positive energetically for babs. Every time I stopped babs drugs, I relapsed quickly.
-------------------- sixgoofykids.blogspot.com Posts: 13449 | From Ohio | Registered: Feb 2007
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sammy
Frequent Contributor (5K+ posts)
Member # 13952
posted
Seek, why are you needing to make decisions like these? Your doctor should be looking at your symptoms and adjusting your protocol based on your response to treatment. He should be the one weighing the risks and benefits to recommend the best combination for you. How frustrating this must be for you!
If Biaxin is working you should definately stick with it. You could add Plaquenil, Amoxil, and a Sulfa if you'd like. That would theoretically hit Lyme, Babesia, and Bartonella.
I was on a similar protocol for awhile Biaxin, Bicillin, Plaquenil, Mepron, and Bactrim. Didn't tolerate the Bactim well so I only took it for a month or two before moving on.
Good luck Seek, I hope your doctor gives you more guidance in the future.
Posts: 5237 | From here | Registered: Nov 2007
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Hoosiers51
Frequent Contributor (1K+ posts)
Member # 15759
posted
Do you have any of the classic Bartonella symptoms? Which ones?
If the answer is no, I would treat Lyme first before taking Cipro.
So if you haven't plateaued on Biaxin (i.e., it is still doing something or helping), stay on it. Maybe add Plaquenil, because that will make Biaxin work better (penetrate cells or something like that....I posted the medical abstract about macrolides and Plaquenil on LN at one point).
If you have no proof you have babesia, and do not have night sweats....you could always focus on Lyme and hope babesia will get better once Lyme is under control. Sometimes babesia is "self-limiting" if the babs infection is not bad. Depends greatly on the case.
Some people can get babs under control with just herbs, if it is not their main problem. Those words come straight from my well-respected LLMD's mouth.
So I would do Biaxin plus Plaquenil. Then if you want, you could try adding Bactrim DS. Bactrim DS is supposedly not very effective against Lyme, but you can try adding it to see if it hits something else. Lots of people herx strongly on it (what is it killing? who knows...bart, BLO, babs, babs-like...take your pick). It will hit a lot of non-Lyme infections out there. If it does something, it should work pretty quickly.
Minocycline is a good one. Not sure if it combines well with Biaxin. I would check drugs.com Interactions Checker. That drug is worth a shot at some point because it's good for Lyme.
If you didn't put Mino with Cipro, I have seen it commonly put with Zithromax or Rifampin. The Rifampin would hopefully hit possible bart or BLO. Some report clearing of brain fog-type symptoms on Rifampin.
Amoxicillin can be added to just about any protocol as long as it doesn't involve a tetracycline class drug like doxy or mino...and (in my opinion) Amox not very hard on the organs aside from herxing and watching the candida overgrowth. So IMO it is not a dangerous drug but is useful against Lyme, so like sammy (bicillin) and sixgoofy said, you can pair it with a big long protocol and still be okay.
If Biaxin is no longer workign well, and you have already tried adding Plaquenil to it, you could switch to Mino as your main Lyme drug. Or Amox/Bicillin.
I would not do just Flagyl with Bactrim, because Bactrim is not a good Lyme drug, and Flagyl busts Lyme cysts. You would want to pair Flagyl with a good Lyme drug (under doc supervision, keeping in mind Flagyl drug interactions).
Posts: 4590 | From Midwest | Registered: Jun 2008
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seekhelp
Frequent Contributor (5K+ posts)
Member # 15067
posted
My LLMD did make recommendations (except some combinations I can choose the matching drug - i.e., Biaxin with A, B, or C drug). What you see are some of the options.
The problem I have is I don't know what cos I have, if any. I can take the drugs in any order over the next 4-6 months. Time is ticking for me. Every month is crucial as I've been off work a long, long time.
If I truly have Babs/Bart, I need to start ASAP on the combination that hits it. Why wait 3,4, or 5 months to do it? Again, I don't know what I have!!! I could hypothetically wait 3-4 months to treat with Malarone and be letting Babs run rampant.
Cipro scares me if I don't have Bart for real. I'm willing to try lower risk drugs like Mino (though brutal), Biaxin, Zith, etc. I will definitely continue on Biaxin for a while as it seems to be helping some. I have used Plaq in the past and will probably add some soon.
I think a cyst-buster makes good sense soon as I never used one.
Six, you need to tell your Babesia to be easier to kill. lol.
The only Bart symptom I have is anxiety at times, but other things could cause this. No main scratches, rashes, cognitive issues, headaches, etc. That's why I want a doc to list exactly the symptoms I've stated that are Bart or Babs-related.
No drug was paired with Amoxicillin like Probencid. Is it that important?
I was told mino is MUCH easier to tolerate than Doxy. I couldn't handle Doxy at all so I hope this is true. Doxy caused huge head pressure and other issues.
In my head, I have some ideas where to go. I have flexibility in the order I want to take stuff and go a long, long time between appts. Therefore, the order of the meds may be important. Do you agree? I'm basically just looking for personal opinions of patients here who may have responded favorably to some of these combos.
I'm pretty knowledgeable about the Biaxin/Plaq combo as there are many comments here. The others not as much,.
Posts: 7545 | From The 5th Dimension - The Twilight Zone | Registered: Mar 2008
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posted
Amoxicillin leaves the bloodstream quickly, so Probenecid is used to make it longer lasting. My LLMD thought it was important. He also did a peak level test to be sure the levels were high enough. It ended up that I was taking 2500 mg three times daily to get a high enough level. I had to ramp up on that. I never really felt that good on amoxy. I liked Cedax (Omnicef family) much better.
I liked mino.
I also liked Cipro, a LOT. In fact, I was on Cipro for an intestinal infection and it made me feel somewhat normal for the first time in my treatment. It took away the cognitive symptoms. That is how I got the bart diagnosis .... because of my reaction to Cipro. so my LLMD started me on Levaquin (stronger), which kicked my butt, but worked well.
I'd look over symptom lists carefully and try to figure out which coinfection is causing the most trouble for you.
-------------------- sixgoofykids.blogspot.com Posts: 13449 | From Ohio | Registered: Feb 2007
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sammy
Frequent Contributor (5K+ posts)
Member # 13952
posted
Hey Seek, I think I understand better now, you want more info on personal experiences with the combos right? I can easily help you with that.
I did try Amoxil for awhile (with Biaxin, Plaquenil, and Mepron) but was unable to keep the Amoxil levels steady so my doc opted to switch me to Bicillin LA.
Later I tried Mino with Biaxin, Plaquenil, and Mepron. Hated the Mino. Could not tolerate that one at all. I was a total mess, terrible head pressure, nausea, dizziness. Felt like I was dying from the flu. Only took it for a month.
Haven't tried Cipro but I am currently taking Avelox (another quinolone). It has helped me alot. In fact, I feel terrible if I miss one day. My symptoms (mainly neuro and GI stuff) come roaring back immediately.
I'm also on Malarone right now. It seems to be controlling my Babesia symptoms a little better than Mepron did. If I stop taking it my symptoms come back within 3-4 days. Annoying cough, chest pain/tightness, night sweats, muscle weakness, head pressure, nausea, dizziness. It is more expensive than Mepron was though.
Hope this helps Posts: 5237 | From here | Registered: Nov 2007
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posted
great information in here!! I was given Cipro and Suprax (i think it is in Cipro family) before lyme diagnosis. they thought i had typhoid. Anyway, I LOVED suprax (liquid) and cipro not bad. Has anyone else had suprax? I only took two weeks of it and i felt incredible and then fell backward afterward. Sometimes I wonder if I should go on suprax again.
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I could hypothetically wait 3-4 months to treat with Malarone and be letting Babs run rampant. 
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