I had Biliary sludging (and subsequent colorless stools and high free bilirubin in my blood) from just 4 days on Zith. I think I'm the only person I know that can't take Zith.

67% of Rocephin is excreted in the urine - the rest is excreted thru Bile.
Zith is mostly excreted thru biliary elimination

Did your Doc say why you got this reaction so fast on rocephin?

And have you ever taken Zith?

Thanks,
Barb

Referenced post:
Were you on IV Rocephin? I was while eating a stick of butter a day on the advice of a DDS Dr. H. After only eight days my gallbladder was hurting. Biliary sludging.
Is your pain inn the lower right quadrant of your body?
Dandelion tea is what resolved my pain.

C. diff is a worry. While waiting for tests or treatments I'd load up on beneficial bacteria.

Good luck.

trevor/oliver

I found the same 67% biliary excretion figure in a search I just did on rocephin. I thought it was higher than 67%, however, even one percent of a seriously hepatotoxic compund eliminated via the biliary route can cause liver disease.

My understanding is that what's important is HOW rocephin behaves during elimination more than HOW MUCH leaves via what route.

"This reaction is the result of the formation of a ceftriaxone-calcium complex."

from: http://pedsccm.wustl.edu/All-Net/english/pharmpage/antibx/ceftriax.html

or
http://www.healthsystem.virginia.edu/internet/pediatrics/pharma-news/FEB97.PDF

Interestingly, the above links claim 60-70% RENAL elimination as unchanged drug.

Dr. B. related to me when I saw him that he's had his gallbladder removed due to rocephin. Rocephin is a life-saver, fantastic for huge numbers, however, the cost/benefit calculus entailed by ALL of it's effects ought to be included in any decision made by any patient considering it.

I posted over a year ago on the importance of keeping your gallbladder when many people were discussing rocephin and their upcomming gallbladder resections.

I have tried Zith a few times. It has caused symptoms that have led to discontinuation, but at other times it's been ok, not super, but fine.

Zith takes longer than many other meds to be excreted I've read. But I also think most other meds take much longer to excrete than what is generally stated in the literature.

Dr. K informed me of this longer duration to elimination and I've been on several homeopathic remedies to remove what's been left, even from meds I've taken over two years prior.

I'm unclear on the exact significance of this lingering, but the impression I've gotten is that it's not good. Anyhow, I believe Zith takes longer than many others.

The doc who prescribed the rocephin was Dr. H. He was aware of my stick of butter a day diet before he prescribed it and I expressed reluctance and concern to him. He went ahead anyway and for over a year afterward I experiened pain.

After my eighth dose of IV rocephin I discussed the pain with Dr. H. He expressed amazement and stated that he had never seen it happen so quickly.

How's your gallbladder doing currently?

Thankyou for the detailed reply.

My gall badder and liver are fine, but I should add (other than high dose amoxicillin
this fall for chest cold) I have not been on any Lyme abx for a year.

I have a complication in that I was born withinout a spleen (DOcs think a genetic anomolie). A 2001 ringCTscan also shows a abnormally shaped pancreas - with 'maybe' a tiny auxillary spleen attached to that..

So anatomically, I know I'm not the same as everyone else - so I have to take what I read
and consider everything carefully when applying it to my spleenless body.

Are you saying that you experienced either liver or gall bladder pain for a year after stopping rocephin?

And what was your adverse reaction with Zith?

Yes, I experienced intermittent gall bladder pain for about a year after rocephin. It finally subsided with dandelion tea. No liver pain really, I was just using hepatotoxicity and liver disease as an example.

So you're spleenless with an abnormally shaped pancreas. How curious!

If it's any consolation, my grandmother has a liver on the opposite side of her body and other of her organs are abnormally placed.

I also suspect her unusual organ placement was genetically orchestrated. And I'm not someone who ascribes blame to genes alone in many cases at all.

My grandma and her rearranged organs just turned 88, she's sharp and healthy as a horse. Maybe her genetic abnormalities have been advantageous. Evolution is funny, natural selection might be gradual, but, mutations can elicit more abrupt jumps in fitness among some populations.

Though not via mutation, it's been argued that the human frontal lobes developed as a result of serious viral encephalopathy a long time ago.

So, abnormality, even apparent pathology, does not always equal inferior survival ability.

-trevor/oliver

Mixed TBDs, long time sufferer, treated for 5 years, mainly neuro/brain symptoms, very tired most of the time

Thanks

This is the info I have form the class notes
on liver function:

Heptocellular enzymes are:
Serume aspartate aminotransferase (AST)
Serum alanine aminotransferase (ALT)
Serum lactate dehydrogenase (LDH)

Hepatocyte function:
Serum albumin (decreased in liver disease)
Prothombin time (clotting increased in disease)
Serum amonia

Biliary excrteory function:
Serum Bilirubin ( conjugated & unconjugated)
and direct (conjugated)
serum alkaline phosphatase
Serum gamma glutamyl transpepitase (GGTP)

Conjugated bilirubin is watre soluable, and non toxic and doesn't build up to toxic levels.
Free unconjugated bilirubin can rise to toxic levels ( and can be cause by certain protein binding drugs that displace bilirubin from albumin).

So it looks like your husbands out of range number have to do with biliary excretion.
And it can be a 'intra' or 'extra' impairment of bile flow.

Here is an excellent site: http://www.postgradmed.com/issues/2000/02_00/gopal.htm

Hope this helps.
Barb

Is your husband taking any medications?

I forgot to answer one of your questions.

The adverse symptoms I experienced on the Zith were, from what I can remember, poorly enunciated speech and the others I can't recall, but I do remember people around me saying that I seemed more "off".

Cheers!

Looks like it was not a metabolism side effect for you.

I think I'll need to be carefull with drugs that are eliminated thru the biliary excretion.. Zith was the first of that class I took - no problems with other drugs metabolised thru the P450 enzyme pathways.