As one who suffers from serious esophageal problems, swallowing abx is a big deal for me.
I'm on mepron for babesia, and have been for some months, which was o.k. with my gastro system.
The original low dose of mepron wasn't working for the babs and I was eventally ramped up to the standard dose of two tsp. 2x daily and after two weeks took a baby dose of zithromax abx in liquid form, as per the doc's instructions
Right after I took the zith, my esophagus has gone wild. The doc told me to go back to half a dose of mepron, but my esophagus is really bad.
I'm gagging and wretching from it, and it feels like a stone . (I am on nexium for that but it doesn't seem to be working)
The doc is not there to talk to until Monday. The covering doc told me to take half a dose of mepron for a few days. But I don't think I can tolerate even that.
Does anyone know if I stop all meds for a few days to allow my esophagus to heal, would it really make the babs get much worse? Would I herx all over again?
I'm still on bicillin shots for the lyme. But obviously I can't tolerate the zith in any form and for other reasons cannot take artemesian neither.
I'm really worried about the babs, and I just got a bad cold on top of all that. (which might also be aggravating the esophagus problem)
I'm between a rock and a hard stone. Any advice from anyone?
Lymehead
-------------------- RI Posts: 440 | From New York | Registered: Sep 2005
| IP: Logged |
Vermont_Lymie
Frequent Contributor (1K+ posts)
Member # 9780
posted
Hi,
A number of lymenetters have mentioned that pine nut oil has helped with esophogael and acid reflux problems; do a search under this in Medical questions and you will find some information on it.
From an earlier email of kelmo's
"Someone posted on here that they were helped with their acid reflux and GI problems with a "pine nut oil". It was found here: www.siberiantigernaturals.com"
Hope that helps, though I do not know the answer to your mepron question! Worth asking your llmd as resistance is a problem in babs I understand.
Posts: 2557 | From home | Registered: Aug 2006
| IP: Logged |
CaliforniaLyme
Frequent Contributor (5K+ posts)
Member # 7136
posted
The answer is so individual- so I don't know!!
I wish you luck though- !!! Sounds like you have a good LLMD*)!!!! Best wishes, Sarah
-------------------- There is no wealth but life. -John Ruskin
All truth goes through 3 stages: first it is ridiculed: then it is violently opposed: finally it is accepted as self evident. - Schopenhauer Posts: 5639 | From Aptos CA USA | Registered: Apr 2005
| IP: Logged |
groovy2
Frequent Contributor (1K+ posts)
Member # 6304
posted
Hi Talk -- From my experance it is Not good to stop Babs meds even for short time--
The gagging symptom is somewhat common-- For most folks it only last a short amount of time-- day to weeks--
Threw treatment your symptoms will change -new ones will pop up- old one will go away--
I had the gagging thing also-- lasted about 1 month off and on--
Now gone--2 months-
I also had breathing problems pop up- never had them for 20 yrs- 3 yrs into treatment Bang-- Now after a month or so it is getting much better--Jay--
Posts: 2999 | From Austin tx USA | Registered: Oct 2004
| IP: Logged |
If it helps, know that Dr J in NC, a LLMD and infectious disease expert, wrote for me to do Mepron 750mg 2x/day for 3 weeks with Zith 500mg 2x/d, then off for one week before restarting another cycle.
Posts: 211 | From NC | Registered: Dec 2005
| IP: Logged |
beachcomber
Frequent Contributor (1K+ posts)
Member # 5320
posted
Lymehead:
I will share my experience with you. I am not suggesting you do what I did, it's just info to help you.
I did pretty well on Mepron. I ramped up to full dose. Though, it did eventually trash my gut. The package insert says 42% get diarrhea. So, I did have to take a few breaks or cut back. I would skip a dose or a day here and there with no setbacks whatsoever. I needed that to rest and heal.
However, the Zith was what really was hard for me. I also took the liquid form. It made me gag. I couldn't stand the flavors/sugars in it. Eventually, I stopped it alltogether. My MD showed me the stats on failure rates of those not doing a macrolide with Atovaquone (Mepron). It was like 20% (in hamsters). So, we ditched the Zith and just did Mepron and Bicillin. Guess what, I did not fall into the 20% failure group for Babs treatment.
You might want to try the protocol without the Zith and see how you do. I did so much better without it.
As for taking a break until you speak with your MD, I was always advised to cut back or take a break if the cure made me unable to function at any level and caused me stress. This has been invaluable wisdom for me. I have learned to listen to and respect my body. Mind you, I have been at this for 4+ years. It takes trial & error, lots of courage, and plenty of listening and learning.
Be kind to your body. It will thank you. Hope this helps a little.
I think I will have to do without the zith as it's hard on the gastro system, and my gastro system is for the birds.
Especially in the esophageal area.
I think a day or two off the mepron wouldn't be terrible for the babs-- and forget about taking the zith again.
I lost more treatment because of the zith than I gained!
But I don't know how long it will take for my esophagus heal, and if it takes a week or two-or longer- am I back to square one with the babs?
I have heard of a Dr. B. in PA who believes in pulsing mepron three weeks on and two weeks off. Does anyone know about pulsing mepron?
Maybe that would mean that it would not be so terrible if I wouldn't take mepron for a while.
Would starting mepron again after a week (or two?) mean starting another bad herx?
THe gagging is not from the babs, other co-infections or lyme. I always had this problem if I took any meds or even vitamins of any kind.
I am the perfect candidate to get Lyme and co-infections!
Lymehead
-------------------- RI Posts: 440 | From New York | Registered: Sep 2005
| IP: Logged |
caat
Frequent Contributor (1K+ posts)
Member # 2321
posted
the reason they say NOT to pulse mepron is because babesia can quickly build a resistance to it.
The reason zith is added is to prevent resistance to the mepron. Both mepron and zith have long half lives- 2 days or more, but mepron is hard to absorb so the absorbtion rate is figured into the every day thing. Make sense? I hope so, don't know another way to put it.
I occasionally skip a zith dose or 2 but NEVER a mepron dose.
Posts: 1436 | From Humboldt county ca usa | Registered: Mar 2002
| IP: Logged |
david1097
Frequent Contributor (1K+ posts)
Member # 3662
posted
Hi, I can't give a definative answer but I can give you an idea of some of the factors involved. Based on these I dont think there is a big risk in stopping for a few days but you will have to decide that on your own. Here's what is known:
Zithromax has a half life of about 4 days. Meprom has a similar half life (about 3 days). What this means is the drug takes 3 to 4 days for 1/2 of it to be removed from your body. In other words even after 3 days, there is still 1/2 the peak drug level in your blood. At 8 days this is down to 1/4. At 12 days it is down to `1/8th.
So from a drug level perspective, zith and mepron are good candidates for short term stopping with not much effect. Still there is more to consider.
With the longer half life (many drugs are much shorter). it takes a few days for the peak concentration to build up. Lets look at zith as an example. If you start wit one pill (or some fixed dose) per day. The first dose does not "wear off" (ie get reduced due to half life) for a few days. This means that the next pill will add to the pill from yesterday. Then the next day adds to the pills fromthe last 2 days etc. This additive effect continues for up to about 12 days, after which the original contribution from the first pill is now negligable.
This effect is chracteristic of all long half life drugs. It is imoportant since it is one of the reasojns why long half life drugs are not typically "pulsed". basically, all pulsing does is reduce the averge dose level in the blood. (there are other factors related to brain penetration which might prompt the use of pulsing with high doses, but I think for babs this is not the issue).
So what does this mean?
If you stop taking the drug fro a few days AFTER having taken it for a few days, the days off the drug will have the same effect on the few days off as it did on the days that you where on it as it was building up. If you did not stop, the drug levels would increase a bit more but depending on how many days on vs days off, the increase may not be that much.
There are a couple of variables here that I have not mentiond yet. These are the "saturating dose" or the maximum level of drug in your blood that your blood can support after whcih any additional drug is discarded as waste by the body and the second is the minimum level of drug needed to enact effective treatment.
The first one "saturating dose" is perhaps the easiest to quantify as it is published in the drug pharmokinetics monologue for the drug. For mepron it is said to be reached with a 750mg single dose. For babesia this dose is often repeated 2 to 3 times per day depedning on body weight. Since it is a long half life and there appears to be a clinically proven need for multiple daily doses, I would guess that the 750 mg might only apply to the abilty to absorb a dose over a few hours. If this is true then one would assume that the effective satuarion level is somewhere above this 750 mg limit. If this is true then there is no real effect on the discussion about stopping for a few days above so we can ignore the efefct of saturation.
As far as the actual dose needed to be effective for treatment, this is a bit harder to figure out. I don't think anyone really knows the answer to this one as it likely depends on teh strain of babesia, perhaps how long you have had it (and corresponsindgly how dug in it is in the resoirvor portions of the body, ie liver or where ever else it stays in hiding). All I can infer is that the Dr that prescribed the mepron selected a dose based on his/her experience as to what actually works and there there is some extra margin in this. How much margin is hard to tell.
I summary, in this case, gven the log half life of the drug, the best effect would be to stay on the drug for more days than you are off. You could IN THEORY (you Must check this with your Dr) make up for the sag in blood levels during the days off by increasing the dose dueing the days on. This would work FROM A CHEMISITRY PERSPECTIVE, but there is more involved in this than just chemistry so this is why you need to check with the Dr.
If it was me, especially if the drug was causing severe irritation trying to swallow it, I woudl not be too concerned about a break of a few days but this being said you have to make up your own mind and/or talk to your own Dr. There ae no absolute answers here just some basic science and a lot of unknowns.
I hope this explains some of the factors involved.
PS. I have stopped mepron for several days with no apparent ill effect. If I stop for a few weeks the babesia has relapsed, this was only apparent after about a month.
Posts: 1184 | From north america | Registered: Feb 2003
| IP: Logged |
caat
Frequent Contributor (1K+ posts)
Member # 2321
posted
what Dave said except... maybe...
>>>"The first one "saturating dose" is perhaps the easiest to quantify as it is published in the drug pharmokinetics monologue for the drug. For mepron it is said to be reached with a 750mg single dose. For babesia this dose is often repeated 2 to 3 times per day depedning on body weight. Since it is a long half life and there appears to be a clinically proven need for multiple daily doses, I would guess that the 750 mg might only apply to the abilty to absorb a dose over a few hours. If this is true then one would assume that the effective satuarion level is somewhere above this 750 mg limit. If this is true then there is no real effect on the discussion about stopping for a few days above so we can ignore the efefct of saturation."
I think what they mean is the saturation amount for absorbing as much as practically possible in one dose. Above 750mg the amount actually absorbed doesn't increase much. I think it's a different saturation amount than what can be absorbed in a day or several days. I think it has more to do with how much can be digested at one time than effective amount absorbed.
I hope that makes sense. I'm having a hard time here, loopy as heck from artemisinin.
Posts: 1436 | From Humboldt county ca usa | Registered: Mar 2002
| IP: Logged |
The Lyme Disease Network is a non-profit organization funded by individual donations. If you would like to support the Network and the LymeNet system of Web services, please send your donations to:
The
Lyme Disease Network of New Jersey 907 Pebble Creek Court,
Pennington,
NJ08534USA http://www.lymenet.org/
UBBFriend: Email this page to someone!
Printer-friendly view of this topic