lymebytes
Frequent Contributor (1K+ posts)
Member # 11830
posted
I am currently staying on Biaxin (having trouble getting off LLMD says not uncommon) so he said just add Rifampin. I told LLMd of interactions listed, he didn't seem too moved by it.
I talked to pharmacist - he said Rifampin will likely wipe out the usefullness of Biaxin or vice versa and recommended against it.
I know others are on this combo.
However all drug ineraction checkers say that it is not a good combo and to avoid "rifampin and baxin" together.
FYI even though a macrolide - Zith and Rifampin show no interactions.
Anyone on Biaxin/Rif having any interaction problems?
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Here is what the interactions reads:
rifampin and Biaxin (clarithromycin) (Moderate Drug-Drug)
GENERALLY AVOID: The coadministration of clarithromycin and rifabutin at normally recommended dosages has been reported to have resulted in significantly altered pharmacokinetics for both drugs. In a study of 34 clinically stable subjects with advanced HIV infection (CD4 less than 200 cells/mm3), the addition of rifabutin in patients stabilized on clarithromycin therapy slowly decreased the clarithromycin area under the plasma concentration-time curve (AUC) and C(max) up to an average of 44% and 41%, respectively, at the end of 4 weeks of combination therapy. In patients stabilized on rifabutin therapy, the addition of clarithromycin significantly increased rifabutin AUC and C(max) after the first dose. After 4 weeks, average increases of 99% and 69%, respectively, were reported. This bidirectional interaction is consistent with rifabutin's cumulative inducing effect over time on the CYP450 enzymatic pathway as well as clarithromycin's immediate inhibiting effect on the pathway. In the study, the combination was tolerated by more than 90% of the patients. However, 66% of them experienced gastrointestinal problems including nausea, vomiting and diarrhea. An increased incidence of uveitis (An inflammation of part or all of the uvea, the middle (vascular) tunic of the eye) has also been reported with this combination. In addition, the combination of clarithromycin and rifampin 600 mg/day (with multiple other drugs) decreased clarithromycin serum levels by approximately 90%. Other macrolide antibiotics may interact in a similar manner with rifamycins.
MANAGEMENT: Some experts recommend that this combination be avoided since it may result in decreased efficacy of the macrolide and increased rifamycin toxicity (e.g, neutropenia (decrase in white blood cells and uveitis).
dmc
Frequent Contributor (1K+ posts)
Member # 5102
posted
I took them together for months. My llmd is a past president of ILADS and super cautious. Didn't have problem nor any "cancelling" out of the Rifampin.
Maybe more will give their experiences and opinions.
Posts: 2675 | From ct, usa | Registered: Jan 2004
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lymebytes
Frequent Contributor (1K+ posts)
Member # 11830
posted
Dmc - thanks good to know. Did it help you?
hcconn22 - Rifampin and the Tetra's are fairly common. Interestingly, Rifampin/Doxy shows an interaction similar to Rifampin/Biaxin, yet LLMD's prescribe it. But Rif/Mino has no ineractions.
Weird how a drug from the same class can interact and another doesn't.
Yeah, very familiar with bicillin. I have been on Bicillin about 4 months this round, 2 months last fall with Biaxin. Didn't seem to do much for me, except cause a lot of emotional instability. Amoxi actually did way more for me.
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