posted
My LLMD wants me to try CoArtem (known as Riamet in Europe) for babesia.
Has anyone taken this? I'm really scared of the possible side effects. He is putting me on it for 7 days.
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janet thomas
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posted
Coartem is a 3 day dosing protocol. You will probably not herx but feel much better quickly. To prevent relapse you also need to treat the sequestered forms with primaquine. You may herx from that.
I used chloroquine (coartem probably works just as well) for 3 days followed by 14 days of primaquine 30mg/day. I still relapsed.
So the treatment was repeated but I am taking 30 mg once a week now to prevent relapse.
I am now treating Lyme with much better success.
A new drug, tafenoquine, which is 10 times as potent as primaquine will be available soon.
Informative links follow, I suggest you read them all:
Artemether and lumefantrine combination is active against the blood stages of P. vivax, but is not active against hypnozoites. Therefore, an 8- amino-quinoline derivative such as primaquine should be given sequentially after the combination in cases of mixed infections of P. falciparum and P. vivax to achieve hypnozoites eradication.
[ 08-01-2010, 03:41 PM: Message edited by: janet thomas ]
-------------------- I am not a doctor and this is not medical advice but only my personal experience and opinion. Posts: 2001 | From NJ | Registered: Mar 2005
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Sammi
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I have done two three-day courses of Coartem spaced several months apart.
It did stir up Babs symptoms, but I did not have any side effects from the drug that I am aware of. It did help a little but did not eradicate Babesiosis for me.
Is your doctor having you stop other meds while taking it?
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posted
Yes, I will be stopping other meds and herbs except for two homeopathic things.
I wonder why I'm getting a 7 day course when it is for 3 days?
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janet thomas
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I did stop all other drugs while doing this tx.
Lyme came back big time after this Babs tx.
I'm now back to ketek, 800mg daily 4 days a week, IM bicillin twice a week and flagyl daily. I take my weekly dose of primaquine on the second day off ketek.
I have high hopes of beating Lyme now that babs is not messing with my immune function.
Then it's on to Bart tx.
-------------------- I am not a doctor and this is not medical advice but only my personal experience and opinion. Posts: 2001 | From NJ | Registered: Mar 2005
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posted
I was prescribed this for 3 days as well and have to stop all other abx. I will start it in a few days.
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Sammi
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opus2828, I would ask your doctor about the length of time you will be taking it.
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posted
I did three seperate 3 day pulses with this drug. I had no side effects. I was very worried and the time but I tolerated it very well without much side effects at all.
I didn't have much of a herx. Not sure what the overall effect was. I have treated with so many drugs for babesia over time. I am much better since treating though.
posted
No side effects and not much of a herx - sounds good to me. Thanks.
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janet thomas
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Babesia and malaria rapidly develop resistance to drugs. Riamet only clears the blood forms but it will come back because it sequesters in bone marrow.
Repeated courses of Riamet is inviting resistance.
But, don't panic, there's still chloroquine. But I wouldn't use it as a monotherapy.
I sure hope I can get some tafenoquine soon.
-------------------- I am not a doctor and this is not medical advice but only my personal experience and opinion. Posts: 2001 | From NJ | Registered: Mar 2005
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posted
I am having trouble finding a drug store that has Coartem. Did you guys have to go to a special pharmacy to get it?
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posted
txgirl, The pharmacy I used initially said they could not get the Coartem from the distributor when they requested it through their usual computer method.
The pharmacist finally called and spoke to a person at the distributor who said yes, could be sent out the next day. I've not had a problem obtaining refills since.
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Sammi
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txgirl09, I was able to get at Walgreens but they had to order it.
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posted
my CVS called the distributor who said they could not get it, and I've tried Walgreens and many other pharmacies!
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posted
I am taking my prescription to the pharmacy tomorrow. Will let you know what happens. Don't know which one to try.
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Sammi
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Maybe you can call the pharmacy managers. It doesn't make sense that Walgreens here can order it but not the one where you are.
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sammy
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I was told today that Coartem is on "indefinate backorder". This is awful. It seems to be the only thing that works to reduce my Babesia symptoms.
My CVS pharmacist is incredibly caring and helpful. They can usually find and order any rare drug or medical product for me and have it ready for pick up by noon the next day! So it is not good news if they cannot get the Coartem my doctor prescribed.
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seekhelp
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Oh crap Sammy. I need to get it. You gotta be kidding.
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posted
I spoke to someone at CVS tonight who said ordering it would not be a problem. I guess we'll see.
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There is also an indian pharma that do it for dirt cheap if you want to PM me.
-------------------- Pos BB and Bart(Q & H IGG pos) Began treat 1 year after start of illness. Diagnosed Feb 2007. Posts: 648 | From Ireland | Registered: Jan 2007
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seekhelp
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Is the Indian pharmacy reliable? Is the drug expensive in the U.S. for a 3-day supply?
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posted
I am in GA and just picked up my prescription yesterday at Publix and all they had to do was order it and it was in the next day. They did say however, i was the very first person to ever order this medication from them. They had never had it in their symptom. I know it is very new to the US.
I have yet to start it....I will do so today. I am also on it for 7 days on off for 2 weeks and then back on for 7 days. We will see! Then following that up with Mepron and Zithromax for 3 months. Babesia is one of the hardest ones for me to kick as well as Bart.
Glad to hear that the side effects are not to terribly bad.
Best of luck to everyone!
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sammy
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I talked to my pharmacist again today. He called the company (not CVS warehouse), while I was there, to check the backorder status of Coartem. They said that they earliest they might be able to get it out would be Aug 16th. That is much better than what I was last told.
onmyway, you were lucky to be able to get it from Publix. They must have been able to order it for you before the backorder.
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posted
You guys are lucky! I still have not manged to find any pharmacy down here who can order it!
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posted
I will ask the pharmacist next time I see her and see if there was a backorder on it. The manufacture on my bottle is Novartis. Not sure if that may be of any help.
I hate to hear there is a problem getting this for some of you. You may want to try a specialty pharmacy. I am not sure but just a thought.
I guess I am lucky mine came in so fast I had no idea there was a problem with the stock on this drug.
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Sammi
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Has anyone tried calling the manufacturer to see if they can recommend a pharmacy in their area?
posted
Mine is in and I am picking it up today.
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seekhelp
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No one answered my cost question six posts earlier. Posts: 7545 | From The 5th Dimension - The Twilight Zone | Registered: Mar 2008
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Sammi
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posted
I believe I paid a $25.00 co-pay.
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posted
Mine was a $50.00 copay but I am on for 7 days 4 pills a day off two weeks and then on 7 more days so a total of 56 pills. Hence why it was probably a little more.
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posted
I went to get the coartem from CVS and they now say it is backordered until Aug. 16th.
However, they couldn't guarantee they would be able to get it then. And Walgreens orders from the same manufacturer and they told me 3 months!
So, I went to a small, family owned drugstore in town and they actually had some in their store.
That was kind of strange but I told then I'd take it.
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janet thomas
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Riamet (coartem) is a combination of lumefantrine and artemether. It is used to treat chloroquine resistant Plasmodiun falciparum, one of the 4 malarial species that causes disease in humans.
P. falciparum is the most deadly of the malarias but it does not relapse. So riamet rapidly clears the blood of P. falciparum, and seemingly Babesia. You feel better. It does not treat sequestered forms because that is not a concern with falciparum malaria.
The course of treatment is 3 days. If anyone uses seven days and does not relapse within 6 weeks I would love to hear about it. I personally know someone who used Riamet for several weeks. It no longer had any effect, resistance had developed.
Plasmodium vivax, although not as deadly, does have dormant forms and is the most difficult of malarias to treat. Chloroquine (again a 3 day course of treatment) clears the blood but primaquine is essential to eradicate the dormant forms. Many strains of P. vivax are becoming primaquine resistant and higher doses and longer treatment is recommended (by the CDC among others). The US military has been researching decades to find a more effective drug than primaquine. Tafenoquine may be the answer. Your tax dollars at work.
All babesia species (over 100) seem to sequester in the bone marrow and possibly elsewhere. Riamet will make you feel better for a short time but relapse is certain because Riamet (coartem) does not treat dormant forms.
Some lymenetters have had success using primaquine for extended periods.
Afer 5 yrs of fighting Babs, Lyme and who knows what else, in my opinion Babs needs to be treated first and then, perhaps, successful Lyme treatment is possible.
As an aside, when IM Bicillin LA was in short supply and CVS could not get it a small locally owned pharmacy had it for me the next day.
-------------------- I am not a doctor and this is not medical advice but only my personal experience and opinion. Posts: 2001 | From NJ | Registered: Mar 2005
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posted
I now dropped my script off at a small local pharmacy (since CVS and Walgreens could not get it) and they said they can order it. We will see....
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posted
Janet Thomas- Interesting reading your post. You are very educated. It is nice to hear all the nitty gritty about a medication. My LLMD has me on 7 days of Coartem then off 2 weeks then on 7 more days. Then after that he has me starting Zithromax and Mepron for 3 months. So maybe that is why since you are saying that it will more than likely come back if only treated by Coartem. I am looking forward to seeing how this goes.
Opus2828- we probably have the same Dr. I am really sorry to hear you had a hard time finding the medication. However, I am glad you finally found it.
Hope everyone is hanging in there. Have a nice weekend.
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janet thomas
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posted
onmyway
Here's something I posted on August 4th
Author Topic: Relapses in dogs treated with Mepron/zith janet thomas Frequent Contributor (1K+ posts) Member # 7122
Possible Emergence of Drug-Resistant Variants of Babesia gibsoni in Clinical Cases Treated with Atovaquone and Azithromycin M. Sakuma 1 , A. Setoguchi 1 , and Y. Endo 1 1 Laboratory of Veterinary Internal Medicine, Faculty of Agriculture, Kagoshima University, Kagoshima, Japan. Corresponding author: Yasuyuki Endo, Laboratory of Veterinary Internal Medicine, Faculty of Agriculture, Kagoshima University, 1-21-24 Korimoto, Kagoshima 890-0065, Japan; e-mail: [email protected]. Results of this study were presented at the ACVIM Forum, San Antonio, TX, 2008.
Copyright � 2009 American College of Veterinary Internal Medicine KEYWORDS Clinical pharmacology * Hematology * Nucleic acid sequencing * Therapeutics ABSTRACT Background: There is no well-established treatment strategy for Babesia gibsoni infection. A new therapeutic protocol using atovaquone (ATV) and azithromycin (AZM) has been proposed, but there is concern about the possible induction of relapse and the emergence of ATV-resistant variants after treatment.
Objective: To evaluate the clinical use of combination therapy with ATV and AZM as a first-line treatment of clinical B. gibsoni infection in dogs, and to investigate the emergence of ATV-resistant variants.
Animals: Eight B. gibsoni naturally infected dogs showing signs of acute onset of disease.
Methods: Retrospective case study. Eight clinical cases received combination therapy with ATV and AZM at Kagoshima University Veterinary Teaching Hospital during 2007-2008, and their clinical courses and clinicopathological parameters were evaluated. In addition, alterations in the cytochrome b (CYTb) gene of B. gibsoni were analyzed by polymerase chain reaction and DNA sequencing techniques.
Results: All of the dogs responded well to the treatment, with rapid improvement in their clinical condition and hematological parameters. However, 5 of the 8 dogs relapsed after treatment. Analysis of the CYTb gene strongly suggested the emergence of ATV-resistant variants after treatment.
Conclusions and Clinical Importance: The combination of ATV and AZM can be used as a first-line treatment for dogs with babesiosis, but relapses occur. Attention should be paid to the possible in vivo selection of drug-resistant variants.
Submitted November 10, 2008; Revised February 10, 2009; Accepted February 10, 2009
-------------------- I am not a doctor and this is not medical advice but only my personal experience and opinion.
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-------------------- I am not a doctor and this is not medical advice but only my personal experience and opinion. Posts: 2001 | From NJ | Registered: Mar 2005
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I need to get it. You gotta be kidding.
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