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» LymeNet Flash » Questions and Discussion » Medical Questions » Missed a few doses of rifampin!

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Author Topic: Missed a few doses of rifampin!
rkbb2004
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I have been taking rifampin for about 4 months now and had to slowly work my way up to the full dose. It's potent stuff! I have been on full dose for almost 2 months now....

My question is I came down with the flu and was sick for 2 days. I couldn't even think about downing abx! I read something about never ever skip your dose of rifampin! Am I doomed? Now I'm totally freaked out!

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karawhite
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oh wow...im scared as well about that - I missed 5 days of it once....is it really so bad?
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WPinVA
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I don't think you're doomed. I missed a lot of doses here or there for similar reasons.

And my LLMD had me pulsing it so he clearly didn't buy into that.

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Judie
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You're not doomed. I had to stop rifampin for a week and start back up (because of a health issue unrelated to Lyme).

Stopping the rifampin for a week while I dealt with this other thing was my LLMDs advice.

It's not a big deal. Just start back up again.

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gmb
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I too agree, This is my second round with Rif and other combos. Stuff happens and you have to take breaks, (ie elevated liver enzymes, bad herx, or simply treatment fatigue).

While its best to maintain a consistent dosage in your systems, skipping a dose, or skipping for a few days occasionally should not be an issue.

I think that where this comes from is that it is not OK to pulse Rifampin like you can with other ABX during treatment.

Also most ABX instructions do say to never skip a dose and always finish the script even if you are feeling better. This comes from the fact that most ABX are prescribed for 10 to 30 days max, not like for months at a time the way we need to treat.

...only my opinion, and not an expert.

gmb

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beths
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If you see under the advice for AIDS patients with TB, it says skipping a dose of rifampin can cause flu-type symptoms. I think this is where the "don't skip a dose" comes from. Many LLMDs pulse it...so who knows!
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canefan17
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The issue is with resistance if I recall. Which is why LLMD's don't ween you off abxs... they have you stop cold turkey.

My Doc even told me don't even ween off of an abx. Just stop it.

Resistance issue makes sense to me.

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rkbb2004
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So is ramping up to start bad too?
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rkbb2004
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Thank you for all of your knowledge! I appreciate this board so much!! [Smile]
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gmb
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Ramping up is recommended for most ABX and Herbs. Dr S's Lyme Disease Solutions book recommends 300mg Rif 1x/day for first week, then full dose 2nd week.

Some folks have trouble starting even at 1/2
dose.

gmb

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didogs
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I too had to stop rifampin for a week when I was on it. I went back at half dose for few days then up to a full dose.

Good luck!!

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rkbb2004
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Thank you! While we are on the topic of rifampin I have another question. The Full dose seems too strong for me even tho I have been on it awhile. Does anyone have any experience with backing down after trying to tolerate a full dose? I feel so blessed to be able to communicate with people in the same shoes!
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rkbb2004
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Thank you! While we are on the topic of rifampin I have another question. The Full dose seems too strong for me even tho I have been on it awhile. Does anyone have any experience with backing down after trying to tolerate a full dose? I feel so blessed to be able to communicate with people in the same shoes!
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canefan17
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Rifampin can weaken your adrenals pretty quick - make sure you support adrenals while on Rifampin.

I think the medication clears cortisol at a high rate. Probably has something to do with speeding up phase 1/2 of the liver.

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Judie
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rkbb2004 - What do you mean it seems too strong at full dose? What are your specific symptoms?
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rkbb2004
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Insomnia mostly...I have anxiety at night as well. Feel like I keep getting adrinaline rushes while trying to sleep!
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