Rumigirl
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I may switch from IV rocephin to IV clindamycin in 2 weeks in order to get Babesia, as well as Lyme. I have a few questions:
What is the usual dose?
Is it given once per day?
It's also good for Lyme, right? Is there any thought that it is not as good for Lyme as rocephin?
Is it usually paired with Malerone or Mepron? (I'm on rifampin, so probably Malerone).
Is it ever pulsed the way rocephin is, ie, twice a day for 4 days, then 3 days off?
The last question is especially because during the summer, I would like to have a long weekend here and there where I can have my port de-accessed (no needle in), so I can go away and go swimming!
If it isn't usually given this way (never heard of it), does it sound like a bad idea? It will all depend on what my LLMD will rx, of course, and on what my body can handle. I just want to be prepared about what is possible, and what I would like to ask for.
It would be truly sad for me not to be able to swim for a few days here and there. I've got nothing to enjoy much now as it is. Thank you, guys!
Posts: 3771 | From around | Registered: Mar 2008
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I don't know anything about a port or if you can go swimming, but I hope you can.
My Clindamycin IV was not prescribed by an LLMD, so I don't know what dose is normally recommended. However, I was on 1200 mg IV Clindamycin seven days every month for two years, and it was a big help. I have lyme babesia, and was also on Mepron, Zith Tindamax and Lariam. Aside from Mepron, it has been the best medication for me. I recently stopped the IV's, because two years is a long time, but I can feel the difference without Clindamycin.
I just looked at my notes from a lyme conference two years ago, and the clindamycin dose recommended by Dr. H. in CA was 300mg. to 600mg three times a day. I don't see why it has to be split up and would do the IV all at once. It's usually combined with quinine for babesia, and I tried that, but couldn't tolerate quinine.
Clindamycin treats both lyme and babesia (although it is not a complete babesia solution without other drugs in combination). It's just a great drug that is well tolerated.
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Rumigirl
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The dose that you mentioned 3 times a day sounds like it was for oral clindamycin.
Any other responses---even if you can answer just one part of my (many!) questions? Thank you.
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Haley
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I was doing 600 mg a day 7 days a week. I would sometimes take weekends off (don't tell my doctor). I think its fine to take the weekends off. Actually, most of his patients get infusions in the office and take the weekends off.
Everyone I know that has done this medicine feels great on it, but they also start to feel lousy when they stop it. I think the key is having the right combination like bailypup said.
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posted
IV clindamycin dose for most infections is 300-600 mg every 6-8 hours or 900 mg every 8 hours, but you can take as much as 4.8 g a day.
The doses need to be spaced every 8 hours (3 times a day), instead of infusing all at one time once a day like you can with Rocephin, because the half life of clindamycin is shorter.
Clindamycin does not significantly cross the blood-brain-barrier, whereas Rocephin does, but it is effective against babesia.
Posts: 962 | From Charleston | Registered: Jan 2002
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posted
Hubby does IV Clindamycin 900mg twice a day. 7 days a week. it is not pulsed. He also takes Malerone. He has a Picc line so will not be swimming. Posts: 305 | From United States | Registered: Nov 2011
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Rumigirl
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Maryland Mom, thank you! The fact that it doesn't cross the blood-brain barrier is significant! I need that. Is it sometimes given along with rocephin for that reason??
Every 6-8 hours, hmmm, that sounds quite challenging. Then, if I had to add on rocephin (if that is done), that would mean 4 IV's per day, in addition to doing IV nutrients---whew! Well, I just may do it anyway.
Haley, the fact that people feel lousy when they stop the clindamycin makes me think that they are not eliminating the Babesia, just getting the load down. It's so darned complicated and difficult (what else is new!).
Keep the responses coming, this is helping to get a sense of what is what with IV clindamycin. I presume that I would pair it with Malarone, while on rifampin, correct?
Posts: 3771 | From around | Registered: Mar 2008
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posted
I took clindy with quinine for babesia. Be sure to take plenty of Florastor and watch your diet. It's really bad about causing c.diff.
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96222 | From Texas | Registered: Feb 2001
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Rumigirl
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Lymetoo, yes, I know that about clindy; it's a concern. I presume that if you are really good about the probiotics, hopefully that will protect you. To get c diff would be horrible!! Is it known to do that even if you are good with the probiotics and Saccharomyces Boulardii?
Lymetoo, how long did you have to take the two? I'm not sure that I could take quinine, as I have had bad reactions to 2 meds in that class. But I'd be willing to try, if my LLMD is willing to rx it.
Anyone else on the issue of skipping 2-3 days a few times during the summer, so I can have the needle out of my port and go swimming? It doesn't sound like the best idea, but not sure.
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Rumigirl
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up.
Posts: 3771 | From around | Registered: Mar 2008
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Rumigirl
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up.
Posts: 3771 | From around | Registered: Mar 2008
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Rumigirl, you take Clindamysin in place of Rocephan. Not both of them. Hubbys is paired with malarone. One yesterday. Not seeing much for improvement yet other than neck pain has definitely improved and arm tremors not quite as much. He had plateaued on the Roephan. thats why they changed the meds
Posts: 305 | From United States | Registered: Nov 2011
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Hubby started with the IV clindamycin and quinine to try to treat his babesia. He was also taking 4 - 6 malarone per day.
Yes, the clindy needs to be given every 8 hours.
But what we did was to pulse the quinine -- 10 days on and 10 days off. Did that for 4 cycles and then 21 days on and 10 days off for 2 cycles.
On the 10 days off of quinine we usually just did 1 or 2 clindy IV's -- not 3. Hubby needed a break from the frequent infusions.
The combo above was very helpful. During this 3 or 4 month period was when hubby had 2 or 3 of his 5 high fevers with hospitalizations. 1 or 2 of those were diagnosed as serratia infections. So he was also on oral cipro or levaquin for several 10 or 30 day cycles while on the quinine/clindy/malarone.
Before starting on the quinine/clindy hubby's LLMD had him do 30 days of diflucan with no other meds to try to balance out his G.I. bacteria. Hubby took his good bacteria and s.boularrdia and had no G.I. problems or c.diff or significant yeast issues while on all these meds.
The plan was to add IV flagyl to the mix, but that never got off the ground as hubby started running fevers with every dose of the IV flagyl. We ended up pulsing the last 14 doses on 2 or 3 days per week to use it up.
The original plan was to go for up to 10 rounds of quinine/clindy. If hubby had been able to do that with the IV flagyl added I think we might have actually gotten the babs. But none of the docs we saw at that time would continue the clindy or the flagyl and then after the next doc moved to IV doxy and hubby had the 5th fever with the first dose and sepsis that put an end to the picc line and IV meds.
I am still very much up in the air as to whether to seek out yet another doc to give hubby more IV meds. Kind of waiting to see if his low grade fevers will resolve (it has been 5 weeks again).
Testing has not given us any additional insight into which infections are really active so we are just plugging along in the dark as usual.
The quinine did bother hubby's hearing while he was taking it -- he said it sounded like he was in the bottom of a barrel. But within 2 or 3 days of stopping each round of quinine his hearing went back to normal.
I seem to remember reading or hearing somewhere that clindy was considered the number 3 med for lyme -- with rocephin as number 1 and right now I can;t remember what was the number 2 choice.
Good luck if you end up on the IV clindy.
This is not medical advice, just my opinion based on hubby's experiences.
Bea Seibert
P.S. If I knew then what I know now, then I would suggest adding sida acuta and ivermectin to the med list at some point and maybe that med cocktail could really nail some of these infections.
Not sure if you saw my recent post that included a pubmed abstract which indicated that cipro and rifampin may actually kill babesia. If you stay on the rifampin and add in malarone plus clindamycin that could be a different babs combo.
Pretty sure that the next step with hubby is to try again to add back rifampin to his current med combo -- he definitely gets some sort of reaction to that med. We thought it was just lowering the malarone dose, but now are leaning more towards it being a herx.
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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posted
Bea, your experiences with your hubby provide good opportunities for others to learn from. I hope his treatment is going well.
Rumigirl, as Bea said, clindy is usually paired with quinine.
I think the approach of dosing with diflucan for 30 days before starting clindy is also a good idea--knock down the yeast to reduce chances of developing c diff overgrowth. And of course, a candida diet and probiotics to further hedge your bets.
Posts: 962 | From Charleston | Registered: Jan 2002
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nonna05
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will the pill form of Clindamycin work well also?/
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Sammi
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Oral Clindamycin is one of the best meds for me, but I have a pretty bad case of Babesiosis. I take it twice a day. I have never done IV Clindamycin.
If it is being used for Babesiosis, I don't know if it is as effective being pulsed.
I agree with Lymetoo about the C-Diff. I use both VSL #3 Double-Strength packets and Nystatin daily, and I have not had any problems.
I have had a port in the past that was not accessed on the weekends. Personally, I would not risk swimming with one, but you need to do what is best for you. Talk to your doctor and home-health agency to see what they think.
Good luck with your new protocol!
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nonna05
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Lymetoo was yours oral? The Clindamycin
Maybe to ask about a switch
Have VSL #3....I also use 3 or different kinds with it ,to catch as many strains as I can.. Keep some in my room that don't need to keep cold.
So I pop a couple here and there
Posts: 2563 | From Denver,CO | Registered: Aug 2011
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Rumigirl
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Hmm. I didn't think about oral clindamycin! I'd have to take quinine or something with it, right? What about malarone? I know that I had horrible reactions to two other meds in a similar class to quinine---Atabrine (now off the market), and Plaquinil. Maybe they are not close enough to be a problem.
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nonna05
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What about tonic water instead>>????with it
Posts: 2563 | From Denver,CO | Registered: Aug 2011
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You can take Clindamycin orally, if you can tolerate it, and it doesn't need to be taken with quinine. It's just a good drug by itself.
That said, a complete babesia treatment would include Quinine.
I took it along with a complete babesia treatment that included Mepron/Zith/Tinda, but no quinine, because I couldn't tolerate quinine.
Posts: 964 | From san diego | Registered: Oct 2009
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I took oral clindamycin, 150mg 2x/day for five years, then it stopped working. But I think five years was a pretty good track run!
It stopped fibro pain and joint swelling, and may have been responsible for a prolactin count drop.
Posts: 13116 | From San Francisco | Registered: May 2006
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nonna05
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sounds like one of the more difficult ABX...But Works, I'm talking pill form... If you pulse it ,that would give gut better chance, but maybe not kill Babs???????
Robin did it do anything to help your day to day functioning??////
Fatigue?? or was that a big issue for you??
How are you now?/ So you fought with it for 5 and then what???
Thank you
Posts: 2563 | From Denver,CO | Registered: Aug 2011
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nonna05
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Up for more input please
Posts: 2563 | From Denver,CO | Registered: Aug 2011
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According to my LLMD the oral dose of Clindaymycin is 300 mg twice a day. I believe this is one of the cheap drugs to take. Some LLMD's treat more aggressively than others.
The IV version for me is 900 mg a day. Oral Clindamycin would work fine if you don't have malabsorption issues or a lot of neuro issues.
My LLMD doesn't pulse Clindamycin. The only thing that gets pulsed is Flagyl and Arteminisin. All other orals are everyday. My IV is 5 days a week with the weekends off. That allows me to get into my sauna for detox.
-------------------- Faithful
Just sharing my experience, I am not a doctor. Posts: 2682 | From Colorado | Registered: Oct 2009
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If you are treating babesia with clindamycin the standard IDSA dose is 600 mg IV 3 times per day. That is the dose hubby tried for his babesia. Was helpful but did not get rid of babesia.
If I remember correctly the Dr B used to consider clindamycin his 3rd choice as the best lyme drug -- think rocephin was #1 and then maybe doxy but not 100% sure on #2.
Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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I am sure I am going to hear it for saying this, but many LLMD's that are experimenting with IV drugs are finding that other things besides the 2008 guidelines from Dr. B are working better for many of their patients. There is no cookie cutter approach as all have different combinations of things going on.
I am also seeing a lot of people posting with relapses from Rocephin. That happened to me too.
Right now, what I am hearing from two of the LLMD's in the DC area is that Clindamycin is working better than Rocephin but the dose is individualized based on symptoms and coinfections.
I don't know if anyone is actually following anything the IDSA says about treatment. Babesia is a bear to get rid of no matter what you are taking.
-------------------- Faithful
Just sharing my experience, I am not a doctor. Posts: 2682 | From Colorado | Registered: Oct 2009
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CD57
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I don't get what the point is of taking clindamycin if you feel great on it, but relapse when off? that says it doesn't really kill anything, just suppress, right?
As far as the BBB thing, we all have leaky/inflamed ones so likely some does get across.
what about this combo: Tindamax, Ivermectin, clindamycin, sida acuta?
Posts: 3528 | From US | Registered: Apr 2007
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lymewreck36
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I like the Buhner Herbs. Arteminisin or Crytolepsis or both for Babesia.
I am going to add sida acuta to the mix I am on with crytolepsis to the arteminisin I am already on AFTER my vacation in three weeks. I can't start this before then but I hear from my LLMD I should go SLOW. These herbs will boost abx and cause a good herx.
Google Buhner herbs and you should will find Woodland Essence, 1st Chinese Herbs and others that carry the herbs.
-------------------- Faithful
Just sharing my experience, I am not a doctor. Posts: 2682 | From Colorado | Registered: Oct 2009
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CD57
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up
Posts: 3528 | From US | Registered: Apr 2007
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[QUOTE]Originally posted by nonna05: [QB] sounds like one of the more difficult ABX...But Works, I'm talking pill form... If you pulse it ,that would give gut better chance, but maybe not kill Babs???????
Robin did it do anything to help your day to day functioning??////
Fatigue?? or was that a big issue for you??
How are you now?/ So you fought with it for 5 and then what???
Nonna, I have Lyme only, no babesia. I had a slow-growing fibromyalgia strain from 1981.
Within a week of starting oral clindamycin, 150mg, which I took around the clock every 6 hours just like I had been told to do for a recent finger infection, all fibro pain went to zero and I had my energy back!
I was also flabbergasted, as I put myself on the remainder of the finger abx since I knew I wasn't allergic to it, and it worked! After 25 years of nonstoppable pain. Yes!!
I herxed after a month, then dropped to 150mg clindamycin 2x/day for 5 years. It stopped fibro pain and joint swelling. Then it stopped working.
So now I keep those symptoms pretty much at bay by taking turmeric powder and teasel root tincture drops on a daily basis. I do well with food anti-inflams, and the teasel root is a Buhner herb that works well for me.
We're all different in what we respond to. Btw, I never got C diff while taking it. But I got C diff once from a course of erythromycin for an ear problem. Go figure.
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