So...I was on Minocycline at 100mg 2x / day (I originally did 200mg 2x / day but we dropped the dose due to side effects.) I know that Mino has excellent CNS penetration...better than Doxy.
I felt pretty good on this. My brain was the clearest it had been in a LONG time. As in zero brain fog / mental issues. But..I didn't like that I was at a lower dose (200mg / day).
So...this week we stopped the Mino and I went back on 400mg / day of Doxy. I've been on Doxy before (it was my first drug) and have been on it for a while, previously (6 months.)
It is my 4th day of doxy and I feel worse. My brain is more foggy. Not bad..but more foggy in general. I've also noticed more twitching and other symptoms (TMJ stiff, left side of face feels weird.)
I hope it is a herx from restarting the high-dose doxy. But I worry it is a relapse. SInce mino has excellent CNS penetration, could it also be that the Doxy isn't working as well on my brain and that the brain fog / congitive stuff is returning with the Doxy?
Or...is it just a flare? I guess time will tell.
So frustrated. I'm still on all the other meds too. Malarone (high dose..6 pills / day), Zith (500mg / day), Nystatin, LDN. Will be adding Rifabutin in a few weeks after I do a round of Coartem.
Thanks.
Posted by joalo (Member # 12752) on :
Up.
Posted by nefferdun (Member # 20157) on :
That is frustrating! I would wonder too and don't have an answer.
But I don't think you should take Rifabutin. Read this:
"GENERALLY AVOID: Coadministration with a rifamycin may decrease the plasma concentrations of atovaquone. The exact mechanism is unknown but may be related to the enzyme-inducing effects of rifamycins. In 13 HIV-infected volunteers, administration of atovaquone suspension (750 mg orally every 12 hours) 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. Similarly, concomitant administration of rifabutin has been shown to reduce atovaquone plasma concentrations by approximately 34%."
As less than half of atovaquone is absorbed, reducing it by another 34% does not sound like a good idea. When you consider how much it costs - what a waste!
Bactrim DS can be taken with malarone and it was very effective for me against the bartonella.
Posted by bcb1200 (Member # 25745) on :
Thanks Neff.
I'm not worried about the Rifabutin with Malarone. First, the Rifabutin effect on Atovaquone isn't as bad as with Rifampin. Second...the Atovaquone isn't likely doing much for my Duncani anyway. I take Malarone for the Proguanil...and that isn't effected by Rifabutin.
I had another thread where I think I found out what is going on. Herx. I think the Minocycline that I have been on since April just hasn't been working for me. Dr. B says he never found any benefit from it. So, when restarting Doxy earlier this week I had a big flare.