I am now faced with waiting until Mondayt to have serotonin toxicity levels taken. Then Wed. for appointment with specialist to slowly wean her off Lexapro.

Anyone with a pharmacologhy background have any ides what 20 Mg of Lexapro will be elevated to by interaction with Biaxin???Lexapro levels increased when interacted with Biaxin.

. I cannot stop the Biaxin because this could cause my daughters lexapro level to drop steeply and cause serios side effects such as crying, bad temper, mania, insominia, headaches etc,

aunty

[This message has been edited by auntybiotic1499 (edited 16 January 2005).]

[This message has been edited by auntybiotic1499 (edited 16 January 2005).]

not sure this would work - what about the hospital - and say she is feeling sick - you think maybe she 'accidentally' took double her meds could they check her levels???

could atleast get them checked.

So you folks out there think about the Biaxin and evidently especially those who are on Lexapro. You dont want to go through what I did. I thought of the gun in my drawer and the medications in the cabinet for just a split moment. It was scary.
My heart was racing, i couldnt stop shaking, and crying and knew i needed some help.

I have checked with two online drug interaction guides and niether of them or my LLMD or family doc or psych had any problem with the combo.

What does it cause? Is it toxic or does it cause psych problems? I have been on the two together for almost two months.

I would venture to guess that it makes either one of the drugs more or less potent which is why Aunty is so worried.

Biaxin alone has been reported as causing psych. reactions, and if Lyme is stirred up by a new antibiotic, that could also cause psych. problem. We've experienced both of these (I think, hard to be sure) but it took awhile for the anx to buildup to the level that caused the problem. Auntybiotic's daughter and lemonhead both describe quick reactions after one dose- could this be an allergy?

In addition Lexapro, and all the SSRI's have seizures as a listed side effect, and also can activate mania. Personally, I think there's something unusual about Lyne patients' reactions to these drugs.

But lemonhead, you were doing fine on Lexapro until you did the Biaxin. Sunty, I had thought, personally, that you should cut the Lexapro and have her stay on the Biaxin. Maybe she could be on zithromax and cut the Lexapro...??

We have all had weird dreams, anxiety and heart palpitations on Biaxin. Nothing like that on zithromax.

Differeent SSRI's are metabolized in different percentages by the liver vs teh kidney, and I think abx are metabolized by the liver (correct me if I'm wrong, anyone). So maybe if you are a "slow metabolizer" are metabolized mainly through the liver, you can end up with elevated levels.

There is information on some of the sites devoted to info on SSRI's about this...there is a test for some liver enzyme (or lack thereof?)that will show you are a slow metabolizer. These sites say that MD's should be testing for this enzyme before prescribing SSRI's.

Most drug interactions with Biaxin that I have seen increase the level of Biaxin in the bloodstream, not the other drug (for instance, Diflucan- I got really sick on this combo-is listed as increasing Biaxin levels).

Like everything we deal with, there is just no way to get clear answers and we all just have to watch out for ourselves and our loved ones in the face of medical apathy or worse.

Aunty, I would see if the Biaxin could be switched to zithromax. Start gently until your daughter has stabilized, with maybe 250mg/day. Cut the Lexapro by 50% fairly quickly and then taper more slowly over 6 weeks, with a written plan that is flexible as you go along. That is just a suggestion. Would your LLMD agree?

I will relay what I have found out as best I can. Biaxin absorbtion uses serotonin receptors or something todo with that. I wrote everything down. When ANY marcolide is combined with any SSRI, potential for side effects do occur, The pharmacist says this is very reare because most people are on antibiotics with SSRI's for about 10 days at most, so no damage is done.

But the lyme paitent are on atibiotics for months to years and THIS is the reason that the this combination is nor recimmended.

In my daughters case, she was prescribed 20 mg of lexapro. Due to the Biaxin, the lexapro levels could be several times the highest recommened dose. This would result in drug toxicity which can cause mania, depression, physcosis and other symptoms in some users.

Now Cave take note, when lyme patients try to wean off SSRI's (Paxil for example)and go from 20 Mg to 15mg.,,,,,,,,,,,, a strong withdrawl occurs. This is do to the antibiotics, macrolides or Erthromycins making the 15 mg dose of Paxil really be a possible 60 Mg dose. You need to wean yourself very slow off of SSRI antidepressants or Mania, Depression,and shock like sensations can occur.

In lyme we think this is a worsening of our lyme symptoms and increase antibiotics dosages which increases the level of SSRI . Please, if you have lyme and are on ANY SSRI while taking antibiotics and have mania, severe depression or phycosis or seizures or shock like feelings in yur body.......WEAN OFF THE SSRI very slowly by consulting with a professional.

aunty

Just coming back after checking my daughter's med history: the three times she experienced these weird complex partial seizures was when she was on an SSRI and then went on Biaxin (the worst) or zithromax. Omigod! Please lt me now your source.

When your daughter is better and your stress is down, maybe we should talk about a class action suit! Just about everything we are dealing with now is from drugs, not the illness itself...

So far the information I found was from word of mouth thru many phone calls to pharmacists.

Biaxin and Lexapro are subtrates andinhibitors of the 3A isoform subfamily of the cytochrome P450 enzyme (CYP3A

coadministration of these two substances or anydrug primary mtabolized by CYP3A will be associated with elevations in drug concentrations that could increase or prolong the adverse affects of the concomitant

Serum concentrations of drugs metabolized by CYP3A should be mononitored closely. In the caseof SSRI's the level of lexapro will be raised.