posted
Well, after seeing an LLMD last week (my first visit) and getting put on abx (currently on day 4), I finally got around to reading Dr B's Treatment Guidelines and have some Q's I'm hoping some of you experts can help me with.
First, the LLMD put me on 400mg daily of doxycycline (a tetracycline) and 250mg daily of metronidazole (flagyl).
I found a sentence in Dr B's text that states: "Because there is laboratory evidence that tetracyclines may inhibit the effect of Flagyl, this class of medication should not be used in these two-drug regimens".
HUH??!! If what he states above is true, then why would my LLMD put me on this combo?? Makes me wonder just how Lyme Literate she is. Has anyone else been put on these two together?
Another Q, he talks about measuring blood levels of antibiotics to help in defining a person's regimen. The LLMD I saw said absolutely nothing about this. Do y'all's LLMDs do this??
Learning more daily....thanks! Susan
-------------------- Susan T. Posts: 28 | From Austin, TX | Registered: Oct 2006
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posted
That's the only place that you will find that info. There is no contraindication for doxy or Mino when used with Flagyl according to the makers of all 3 drugs. I am currently on Mino + Flagyl myself, and many others on the board have taken them together. See this thread for more info:
My Lyme specialist has never measured my blood levels. It sounds like a good idea, but I don't know how many doctors do this, and wonder if it is expensive/not covered by insurance.
Most Lyme specialists are forced to treat within cost constraints because insurance won't cover certain tests/drugs, patients are not able to afford them, or both.
I would recommend calling your doctor to ask why she has prescribed these two medications in combo when a leading LLMD has advised against it. She may have a reason, or she may not be aware of the interaction.
-------------------- Suzanne Shaps STAND UP FOR LYME Texas (www.standupforlyme.org) (Please email all correspondence related to protecting Texas LLMDs to [email protected] with copy to [email protected]) Posts: 977 | From Austin, TX, USA | Registered: May 2004
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robi
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-------------------- Now, since I put reality on the back burner, my days are jam-packed and fun-filled. ..........lily tomlin as 'trudy' Posts: 2503 | From here | Registered: Apr 2004
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posted
It's a little strange that Dr B's guidelines is the only place that you will find that "Possible" warning about Tetra and Flagyl. None of the manufacturers have any warning. You will not find a Pharmacyst that will tell you that you shouldn't use them together. Remember that he does specifically say Tetra. There is no reference to Mino or Doxy, and he only says "May".
I have also come to realize that Dr B does not have all the answers. He is a great Dr, but like everyone else he does make mistakes. Is there really an interaction, or is it a mistake that was never corrected. You'll have to decide for yourself with the help of your Dr.
I have used Flagyl with both Mino and Doxy. I have also used it with Biaxin and Zith, and I haven't noticed any difference in it's effectiveness. It would be interesting to see the results of a blood test that could verify or debunk this "Possible" warning once and for all.
-------------------- You're only a failure when you stop trying. Posts: 945 | From U.S | Registered: Oct 2004
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posted
Actually, there is a reference...Tetracyclines are a "class" of antibiotics..Doxycycline is in that class...so it's a tetracycline.
So when he says that flagyl shouldn't be used with tetracyclines, that includes doxycycline.
But I do agree that he says "May", and yes it would be interesting to see bloodwork that confirms or discounts once and for all.
I was reading his latest Guidelines - Sept 2005, so I don't think it's a matter of it not getting updated in the guidelines.
If a patient of his sees this, it would be great if you could ask him about it!
Also, anybody out their had there antibiotic levels measured via bloodwork?? Just curious since Dr B emphasizes this.
Thanks y'all! Susan
-------------------- Susan T. Posts: 28 | From Austin, TX | Registered: Oct 2006
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Health
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posted
Hello,
I dont see Dr B, but can say that for myself this was very true.
I tried the flagyl with the minocycline and actually used it for a month or so with minocycline.
I then was put on flagyl alone, to see how I would do. I could tolerate 1/2 flagyl. Anymore near killed me from the herxing.
While I was on Mincycline I was taking 4 flagyls a day, 2 twice a day with the minocycline.
I then went back on biaxin and flagyl, and could tolerate ONE flagyl, twice a day.
So, for myself I can say for sure, that Dr B's remark about this combo, is right on for myself.
I found flagyl mildly effective while on minocycline. Minocycline made the flagyl less effective for myself,
I am very sick, so I can tell the difference. BIG difference for myself. I was hoping it was not true, as I cannot take the plaquenil.
Dr B was RIGHT ON about this comment for myself. I wish he wasnt, but he was. Great to see that someone writes helpful info for us all. Try it to see if it applies to you, there is truth behind some of the info I can say, I have not done all he said to do though
as I cannot take some of the supps he recommends, they make me worse.
Have you seen the new info about wether the cyst may actually be the L-form? He said maybe, he was not sure, not his exact words but something to this degreee I write. In his 2005 guidlines.
Trish
Posts: 1250 | From Canada | Registered: Aug 2004
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posted
ALSO,
About the blood levels, this is very true as well.
I say this because when on Minocycline, I was taking this twice a day, and was MUCH better on this because the mino was active in the body for 1-2 days so I was continuously level.
On the biaxin, I was taking this twice a day, and noticed when I was VERY ill, that after 8 hours, I had symptoms return, Biaxin is only active in the blood about 12 hours.
If they dont measure blood levels, for yourself check out how long each antibiotics is active, I think? this would be the same.
I am very brain poor today, so am trying to get this across the best way.
Trish
Posts: 1250 | From Canada | Registered: Aug 2004
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posted
Very interesting Trish. I'd been told flagyl was rough and to start with 1/2 or 1/4 pill and work your way up. But I didn't, I started with the full 250mg.
It hasn't been a cakewalk, but I'm functioning (not fully though).
So, makes me wonder if I'm experiencing the same thing you did.
I went back and looked at what Dr B said about the L form...sounds like the jury is still out. Still controversy "whether the cyst is different from the l-form"
Thanks all.
-------------------- Susan T. Posts: 28 | From Austin, TX | Registered: Oct 2006
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posted
There are always differing opinions os subjects like this, and even when coming from a respected source they may not always be based on verifiable facts.
I've not been given these two at the same time, but I think the reason was that either one alone can be pretty rough to handle.
How they all work against Borrelia and which ones work together or against one another is still not well understood. Unfortunately none of them work that well, or we would all be cured long ago.
In general, if you are fortunate enough to have found a Dr. to treat you, trust his judgment.
Of course, if you have a problem or suspect a med error you should definitely ask questions.
Posts: 714 | From San Antonio TX | Registered: Oct 2004
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posted
I am on flagyl three days of the week, with Oxytetra all days of the week. I definitively can feel flagyl kick in. First day is ok, then the second and third I am herxing big time. When I am on just Oxytetra I feel better again.
My guess is that tetra will make spiro go cyst, and flagyl breaks the cyst = herx, and tetra will get a chance to kill off more bacteria.
Posts: 155 | From Norway | Registered: Jan 2006
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