I was on Mepron for a little over 2 months(with Rifampin and Zithro and Plaquenil---I love the Mepron!!!) and now my LLMD wants to switch me to Doxcy and go off the Rifampin and says that Mepron cannot be taken with Doxcy so to switch to Malarone.
Anyone know why? I always thought that Mepron and Zith were the way to go after Babs.
I am also to start Bicillan shots too. Just wanted anyone answering to have the whole picture. So I would then be on Bicillan shots, Malarone, Zithro, Doxcy and Plaq.
Thanks in advance for any help.
Stacy
Posted by disturbedme (Member # 12346) on :
Actually, you're not supposed to take Mepron and Rifampin together.
Mepron and Zith though are FINE; many LLMDs have their patients go this route.
Posted by MariaA (Member # 9128) on :
Mepron and Malarone have the same active ingredient, atovaquone.
Doxy and rifampin both interfere with atavoquone.
Posted by Stacyb (Member # 13084) on :
Hi,
Thanks for the reply so soon. I did know about the Rifampin and Mepron interaction and called him on this and he said he has done it this way for many and it works. I did like the 2 together with the Zithro and got great results.
I know that Mepron and Zith is a good combo but do you or anyone out there know why Mepron and Doxcy cannot be taken together??? He wanted me to switch from Mepron to Malarone b/c of the Doxcy.
Stacy
Posted by Stacyb (Member # 13084) on :
Maria,
Thanks I must have been replying at the same time you were LOL.
Ok so both Mepron and Malarone have the same ingredient but isn't Mepron prefered (for Babs)and has another component to it?
I will have to look it up but thought there was talk about this issue before. A search here did not bring it up though.
Stacy
Posted by disturbedme (Member # 12346) on :
All I know is Mepron is a bit stronger against Babesia than Malarone.
Posted by JKMMC09 (Member # 15795) on :
My daughter has taken Mepron w/ Rifampin (also Malarone w/ Rifampin and Doxy)...it really matters on how closely you are monitered.
There is no "fatal" interaction with Rifampin/Mepron, the Rifampin just lowers the Mepron by about 52%, so the dose needs to be adjusted accordingly and blood levels need to be checked bi-weekly. Best of luck!
Posted by Stacyb (Member # 13084) on :
Thanks JK and D,
JK, Are the blood levels ck for the atovoquone levels bi weekly? Dizzyup told me about this but Lab core does not run that test. Think she said Quest will.
My LLMD had no idea about the blood levels ck. But he did write me a Rx for it. May I ask how long your daughter has taken the Rifampin and the Mepron or Malarone?
PM me if you like as I would like to know who your daughter sees for an LLMD? Is it Dr J?
Stacy
Posted by david1097 (Member # 3662) on :
FYI- Mepron is bascically straight atavaquone. With the appropriate number of tablets (3 for 750 mg) Mepron is the exact same dose of ataviquone but it also has proguanil hydrochloride mixed with it, a combination that is better for malaria. One is not stronger than the other, except perhaps from the absorption of a liquid vs a tablet.
I have found doxy to severly impair the effect of the malarone. I have asked around and there is not a consensus among the lyme Dr's about this effect. Originally I though it might be due to stomach effects due to the tough to take doxy but even in IV doxy this effect was noticed.
The proguanil hydrochloride in malarone might have something to do with your doctors comments. You might want to look up drug interactions with that combo.
Posted by Rianna (Member # 11038) on :
Mepron should not be taken with Rifampin as on average Rifampin lowers Mepron levels by 52%+
In your Mepron Drug Interactions insert it normally says do NOT take Mepron with Rifampin
AVOID: Coadministration with a rifampin may decrease the plasma concentrations of atovaquone. The exact mechanism is unknown but may be related to the enzyme-inducing effects of rifamycins. With rifampin (600 mg orally every 24 hours) resulted in a 52% decrease in the average steady-state plasma atovaquone concentration and a 39% reduction in atovaquone half-life (from 82 hours to 50 hours) compared to administration without rifampin.
MANAGEMENT: The use of atovaquone in combination with rifampin or rifabutin is not recommended.
Mepron (atovaquone) is known to interact with the following drugs:
I knew about the interactions with Rifampin and Mepron and called the office on it and they stated that is was fine as my dose of Mepron was high enough and they have had good results with this combo too. I was on Zithro and Plaq with it as well. I was a bit shocked that there are so many interactions that are allowed under some of these protocols.
That being said I did not want to discontinue my Bart tx as it had always been my biggest demon. So I stayed on the Rifampin (which I was on for 6 months already) and added the Mepron. I was instantly feeling so well and then the herx started after 10 days or so. Once I leveled off I was still feeling good on it.
Dizzyup--- suggested an antovoquone level ck. that is something her LLMD does too. I have not yet had that done.
I also was on Rifampin with Doxcy for awhile and Rifampin lowers Doxcy levels too even taken apart over 12 hours.
So I would love to just have my blood levels tested to see if I am getting enough atovoquone in either the Mepron or the Malarone while taking and other abx or med. I think then, I would know at least and the Mepron or Malarone could be adjusted.
David, Thanks for the info on the difference between the Mepron and Malarone. I have not gotten my script yet for the Malarone so I am not sure what the dose per day will be. I am hoping it is at least close to the levels of Mepron I was taking.
Thank you both so much, Stacy
Posted by Hoosiers51 (Member # 15759) on :
I noticed minocycline isn't on the list of drugs that interact with Mepron.
Hmmm.....I wonder if it is assumed it interacts since it's in the tetracycline class? But you would think they would have listed it because they listed doxycycline. Hmmm.....
Posted by Hoosiers51 (Member # 15759) on :
On another note......if you "love" Mepron, it seems silly to go off it. Do you feel like it has stopped "helping" and it's time to shake up the babesia treatment with a new anti-malarial?
Or are you ONLY making the switch for the sake of the Doxy? because I don't know if I would abandon something that is still in the process of working to add something that may or may not help you (the Doxy). Unless you think trying Malarone might be beneficial.
That is just an idea.
As I brought up, Minocycline isn't on the list.....maybe you could ask your LLMD if you could stay on Mepron and add Minocycline.
Posted by Stacyb (Member # 13084) on :
Hi Hooiser,
I thought it was all tetracylines too hum? I re-check the list and Mino. was not on there either. He asked me if we had tried Mino. yet and I have not but he still gave me the Doryx. Maybe b/c he knows I have been Doryx before?
I love the Mepron and it is still working IMO. So I already called the office and ask about using a different abx and staying on the Mepron, and they said his reply was the same. I will call again or ask them about the Mino. when they get back to me on another Q. I had.
I say the same as you if it is still working why change it yet?
Thanks,
Stacy
Posted by luvdogs (Member # 9507) on :
I talked with my doctor about mino and mepron the other day and he said that the solution is to double the dosage of mepron.
Yes, they do interact and I had the experience in the past of the mino almost totally canceling the mepron out.
It looks like the answer to this is to increase the dosage,whether with doxy or mino or any tetras.
Since it decreases the potency by 50% or so, then doubling the dosage would make sense.
Posted by hezzer926 (Member # 17902) on :
i am currently on rifampin and mepron.. it has been the best combo for me so far.. my fatigue lifted alot after only a few days.. right now, i seem to be herxing so ive been a little fatigued, but nowhere near how i was before istarted it.. my dr was aware of the interaction of the 2 drugs but said it works for his patients anyways..
Posted by Hoosiers51 (Member # 15759) on :
hezzer926,
Great that they are working so well together for you...I have taken those separately (Rifampin and Mepron) and neither one helped my fatigue. Do you get the sense that separately they still would have each helped yours some? Just curious.
I wonder if I would have taken them together if I would have had better success.....Mepron actually made me a lot more fatigued, and that fatigue didn't lift.
Posted by Stacyb (Member # 13084) on :
Thanks Luvdog, Hezzer and Hoosier,
Makes sense to me to double the dose too but so far my LLMD had not done that. I think a blood level test for the Atovoquone for each Mepron and Malarone is a good check for the way any other abx is reducing the levels of each. I believe that Quest labs is the one running the blood level cks. and I would guess that monthy or more often would be the way to go.
As far as the fatigue from Mepron that came after the great feeling I had as in a herx after the first 10 days. The fatigue has leveled off now and I am still feeling good (I still have symptoms left but many are improved or gone).
I was on the Rifampin (along with Zithro, Plaq.)for over 6 months when I added the Mepron in. The combo was great and I have been on that for about 2 1/2 months. I do think that even if they are not combined--- each alone with other abx are good for Babs and Bart. Either one with Zithro is a good combo IMO. My LLMD wanted me to start the Bicillan with it too, so that we would be hitting Babs/Bart and Lyme aggessively but I am getting switched now to a new protocol as I have said.
Got a call back from the office after I ask 2 x's for Mino or something and to stay on the Mepron and it is onto Malarone for me. Hope it works as well as the Mepron does! I will be coming off the Rifampin too so we will see? Fingers and toes crossed.