posted
My LLMD said he wants me to take Roxithromycin but told me i cannot get it in the US. He also could not tell me where to get it freom, but said I should have no problem finding it online. Could you please send me a PM if you have ordered it online with the name of the site.
Thank you sooo much!
Posts: 27 | From Las Vegas | Registered: Mar 2007
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Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
I get mine from www.sundrugstore.com. The price seems very reasonable to me. The service is much faster if you pay the extra for expedited shipping. Otherwise it can take a LONG time to get to you. Also, the last time I ordered, I didn't get the full order, but after I emailed them, they sent the rest. Maybe they didn't have enough in stock the first time (i ordered 480 tabs). that was the first time I'd ever had any kind of problem getting the correct # of tabs from them, but they did come through in the end.
Posts: 975 | From California | Registered: Apr 2007
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CD57
Frequent Contributor (1K+ posts)
Member # 11749
posted
What is Roxy used in place of?
Posts: 3528 | From US | Registered: Apr 2007
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The initial studies which indicated that Roxy was not that effective were done on mice. But a later study on humans demonstrated that it behaved differently (better) than it had in mice.
Posts: 975 | From California | Registered: Apr 2007
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pamoisondelune
Frequent Contributor (1K+ posts)
Member # 11846
posted
What dosage are you taking?
Thanks
----Polly Polygonum
Posts: 1226 | From USA | Registered: May 2007
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TerryK
Frequent Contributor (5K+ posts)
Member # 8552
posted
August 2006
R. Gasser1, I. Wendelin2, E. Reisinger2, J. Bergloff3, B. Feigl3, I. Schafhalter1, B. Eber4, M. Grisold4 and W. Klein4
Summary Spirochaetal infections have been successfully treated with penicillin; more recently, erythromycin has been used in cases with known penicillin allergy. The discovery of the spirochaete Borrelia burgdorferi and the elaboration of a new generation of macrolides with properties that differ from older macrolides have led to new ways of treating spirochaetal disease with these compounds.
This paper presents data on thein vitro andin vivo efficacy of a combination of roxithromycin and co-trimoxazole against b. burgdorferi. In vitro (checkerboard technique;B. burgdorferi strain B31; modified BSK II medium) it was found that while roxithromycin showed excellent efficacy againstB. burgdoferi (MIC 0.031 mg/l), co-trimoxazole had no effect.
However, the combination of both chemotherapeutics led to a minor synergistic effect, decreasing the MIC for roxithromycin by one dilution step at concentrations of co-trimoxazole from 256 to 8 mg/l. In addition, a clearly reduced growth of microorganisms was seen at concentrations of roxithromycin as low as 0.015 mg/l in combination with 256 to 4 mg/l co-trimoxazole, when compared to the positive controls.
Most interestingly, however, the motility ofB. burgdorferi was markedly reduced even when the two drugs were combined at very low concentrations. In anin vivo, non-randomised, open, prospective pilot study it was found that of 17 patients, with confirmed late Lyme borreliosis (stage II/III), treated with combined roxithromycin (300 mg b.i.d.) and co-trimoxazole for 5 weeks, 13 (76%) recovered completely by the end of treatment, and four continued to have symptoms on follow-up at 6 and 12 months.
This success rate is similar to that seen with i.v. penicillin and ceftriaxone. It appears that the reduced motility ofB. burgdorferi makes the pathogen mor accessibile to the immune system.
Posts: 6286 | From Oregon | Registered: Jan 2006
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TerryK
Frequent Contributor (5K+ posts)
Member # 8552
Roxithromycin in Lyme borreliosis: discrepant results of an in vitro and in vivo animal susceptibility study and a clinical trial in patients with erythema migrans.
Hansen K, Hovmark A, Lebech AM, Lebech K, Olsson I, Halkier-S�rensen L, Olsson E, Asbrink E. Department of Infection-Immunology, Statens Seruminstitut, Copenhagen, Denmark.
A new semisynthetic macrolide roxithromycin was evaluated for its potential use in the treatment of Lyme borreliosis.
Using a macro-dilution broth technique, Borrelia burgdorferi was shown to be susceptible to roxithromycin with a minimal bactericidal concentration (MBC) of 0.06-0.25 microgram/ml.
A systemic B. burgdorferi infection was established in gerbils; a dosage of greater than or equal to 25 mg/kg/day roxithromycin for 10 days eliminated the infection.
A single blind, randomized multicenter study was performed to evaluate the efficacy of roxithromycin 150 mg b.i.d. versus phenoxymethyl-penicillin 1 g b.i.d. for 10 days in patients with uncomplicated erythema migrans.
The study was interrupted when 19 patients had enrolled because of five treatment failures. All 5 patients had received roxithromycin; three patients had persisting or recurrent erythema migrans, one developed a secondary erythema migrans-like lesion and severe arthralgia and one developed neuroborreliosis.
B. burgdorferi was isolated from skin biopsies after roxithromycin therapy from two patients with persistent erythema migrans and both isolates were still highly susceptible to roxithromycin (MBC = 0.03 microgram/ml).
No treatment failures were seen in 10 patients treated with phenoxymethyl-penicillin. Roxithromycin is thus not recommended for treatment of Lyme borreliosis.
PMID: 1357894 [PubMed - indexed for MEDLINE]
Posts: 6286 | From Oregon | Registered: Jan 2006
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CD57
Frequent Contributor (1K+ posts)
Member # 11749
posted
So Roxy would also be in place of Biaxin?
Posts: 3528 | From US | Registered: Apr 2007
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posted
BTW, I just read the literature above which noted the treatment failures w/Roxy, but see that they were using 150mg BID. I started on that dose and didn't do well either, but began to improve when I increased the dose to 300mg BID.
Roxy WAS effective in the gerbil study at 25mg/kg/day. If you consider that the average weight of an adult is 70+kg, that should indicate a dose of at least 1750mg/day. That would mean that 150mg BiD (300mg) is probably way underdosing the therapeutic levels needed to be effective.
I have even considered increasing my dose to 900mg/day, but haven't done that yet.
Posts: 975 | From California | Registered: Apr 2007
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posted
My perception of effectiveness of roxy was based on first paper TerryK quoted- it is using human patients, with chronic lyme and is pretty recent 2006. It also notes use of co-trmoxazole (bactrim) - I believe it is great synergistic abx as it does not work very well on its own, but works much better with other abx
The 1992 study uses patients with recent infections, for which anti spirochetal drugs are much more effective(since it is not disseminated yet into tissues),using low dose and for 10 days only! Antibacterial action of macrolides is based on inhibition of protein synthesis(made by 50s ribosomal subunit). -It will take sometime before inability of synthesize those proteins will affect BB (since its long living bacteria with long division cycles)
There is big difference between treating early lyme and late one. Many drugs which are needed for chronic lyme do not work very well vs early one
Posts: 856 | From MA | Registered: Jul 2009
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posted
If you consider that many patients are taking doses of Biaxin (clarithromycin) and Zithromax (azithromyin) at up to 2000mg/day for chronic Lyme according to some threads on this board, then higher doses of roxithromycin isn't a stretch for the imagination.
Of course there is less experience and fewer studies probably done w/roxy, but that may be because of inadequate dosing in the initial studies to start with, i.e. the 300mg/day dosing of the one study.
The highest dose of roxy that I had come across somewhere online (anecdotal) before I increased my dose to 600mg/day was 900mg/day.
Posts: 975 | From California | Registered: Apr 2007
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MariaA
Frequent Contributor (1K+ posts)
Member # 9128
posted
I want to bump this because a few people were talking up Bactrim (ie co-trimoxazole, or Septra) recently and one of the studies discussed in this thread sounds like Bactrim plus roxithromycin are effective.
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