bcb1200
Frequent Contributor (1K+ posts)
Member # 25745
posted
So...asked my LLMD if I could swap Zith for Ketek. Read it is THE BEST oral drug for lyme and also has good action against both Bart and Babs.
But..I have to admit I'm a little freaked out by the warnings...risk of severe liver damage and/or death. Dr. B's guidelines were written in 2008 and most of the warnings came out in 2009.
I get my liver checked every other week.
This drug definitely has its risks...but also seems to have some rewards.
Who here has tried it and would you recommend it?
-------------------- Bite date ? 2/10 symptoms began 5/10 dx'd, after 3 months numerous test and doctors
IgM Igenex +/CDC + + 23/25, 30, 31, 34, 41, 83/93
Currently on:
Currently at around 95% +/- most days. Posts: 3134 | From Massachusetts | Registered: May 2010
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karenl
Frequent Contributor (1K+ posts)
Member # 17753
posted
Never.
Posts: 1834 | From US | Registered: Oct 2008
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lymednva
Frequent Contributor (1K+ posts)
Member # 9098
posted
I used it successfully twice. I know I am a good detoxer, and was on either milk thistle or NAC while on it.
However at my LLMD appointment this week he told me Ketek has been removed from the market. I know the last time I tried to fill it it was hard to find.
-------------------- Lymednva Posts: 2407 | From over the river and through the woods | Registered: Apr 2006
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phyl6648
Frequent Contributor (1K+ posts)
Member # 28522
posted
I was just prescribed Ketek and Omnicef by my LLMD.
After reading about Ketek I am not going to try it.
Posts: 1058 | From VA | Registered: Oct 2010
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bcb1200
Frequent Contributor (1K+ posts)
Member # 25745
posted
Well..here are some links / excerpts that might be of interest:
The labels / warnings were added in 2007, not 2009 as I indicated. Info can be found here:
"Clarithromycin is more effective as an oral agent than azithromycin, but can be difficult to tolerate due to its tendency to promote yeast overgrowth, bad aftertaste, and poor GI tolerance at the high doses needed. These problems are much less severe with the ketolide telithromycin, which is generally well tolerated."
"Telithromycin, on the other hand, is stable in the intracellular acid environment, which may be why this is currently by far the most effective drug of this class, and may replace the others in the majority of patients with LB. Likewise, there is no need to co-administer amantadine or hydroxychloroquine. This antibiotic has other advantages- it has been engineered to prevent drug resistance, has almost no negative impact on E. coli in the intestinal tract (hopefully minimizing the risk for diarrhea), and it can be taken with or without food. However, there are disadvantages: 1. May interact with a wide variety of medications because it is an inhibitor of the cytochrome CYP3A4. It is vital that this be taken into account as many Lyme patients take a variety of medications concurrently, and often from several practitioners. 2. May lengthen the QT interval. This should be measured prior to prescribing this drug, and if borderline, rechecked after it is begun. 3. Can transiently cause blurry vision, delayed accommodation, and even double vision. 4. Liver enzymes may become elevated. Blood tests should be done regularly to monitor this. 5. The usual precautions of any antibiotic also still apply- risk for allergy, stomach upset, Herxheimer reactions, etc. QTc INTERVAL � QTc is the QT corrected for heart rate � Measure the precordial lead that has the best T wave (usually V-2 or V-5) � Measure from the start of the Q wave to the end of the T wave � QT interval is inversely related to the heart rate (slow pulse results in a longer QT) � QTc = QT � � RR interval � Normals: Females <450 ms, Males < 470 ms � Want K+ > 4.0, Mg++ > 2.0; avoid hypocalcemia"
"Telithromycin- Adolescents and adults: 800 mg once daily Do not need to use amantadine or hydroxychloroquine So far, the most effective drug of this class, and possibly the best oral agent if tolerated. Expect strong and quite prolonged Herxheimer reactions. Must watch for drug interactions (CYP3A-4 inhibitor), check the QTc interval, and monitor liver enzymes. Not to be used in pregnancy."
So yes..there are risks..but at the same time I don't believe Dr. B would call this drug his favorite if he felt it was a serious danger to people.
Dr. B's guidelines
-------------------- Bite date ? 2/10 symptoms began 5/10 dx'd, after 3 months numerous test and doctors
IgM Igenex +/CDC + + 23/25, 30, 31, 34, 41, 83/93
Currently on:
Currently at around 95% +/- most days. Posts: 3134 | From Massachusetts | Registered: May 2010
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posted
I took it for 4 months early on in treatment and it was fine. I remember telling my brother in-law who is a pharmacist that I was on it and he was very surprised.
My llmd usually looks at things from a risk/reward perspective. If you don't need it too badly then its not worth the risk. If it is going to possibly make a significant improvement its probably worth a try.
Good luck!
-------------------- unsure445 Posts: 824 | From northeast | Registered: Jun 2008
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posted
I was on Ketek with Flagyl for three months. At first it was a little tough, but I got used to it and did quite well. I do take milk thistle twice a day and get liver function every three months. I take Dexilant for my stomach with good results.
-------------------- DOCTOR: "I don't think you are sick." PATIENT: "We are all entitled to our opinions. I don't think you are a doctor." Posts: 697 | From Northern California | Registered: Jul 2009
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