if you've done Rifampin, how was your experience?

go for it... I've had many rounds of Rifampin with various abx combo protocols and don't think I've had any damaging side effects. I just can beat down Bart entirely and it keeps coming back. Once you get use to seeing your pee glowing orange you should be fine.

I had to fire my Rheumy years ago.... she never bought into my Lyme diagnosis and treatment. But never could find another cause or treatment plan for my sx.

Sometimes its Bart alone that's messing with your liver enzymes. I had to stop my Rif, Zith, Doxy protocol after 6 weeks of my first round due to elevated AST/ALT levels. After that one time stopping abx, each time after that AST/ALT got elevated, I would just blast through it.

I'd heard about the orange pee, but I hadn't heard that it can stain your teeth. Yikes! I know I'm being silly and vain, but I'm not sure I can take orange teeth on top of everything else that's happening.

tickbite666 said...
Sometimes its Bart alone that's messing with your liver enzymes. I had to stop my Rif, Zith, Doxy protocol after 6 weeks of my first round due to elevated AST/ALT levels. After that one time stopping abx, each time after that AST/ALT got elevated, I would just blast through it.

My AST/ALT was fine. Rifampin elevates CYP3A4, which destroys cortisol. This is what causes the adrenal stress. It also lowered my vitamin D.

Notime4lyme said...
I stopped it because after being on azithromycin, penicillin, rifampin, doxy and mino (but not at the same time), my gut was really messed up (yeast infection). I also didn't really notice any kind of herxing or change in my symptoms from taking the rifampin, except that it seemed to be killing something in my gut. I had much less stomach pain after taking it.

Bart herx (from minocycline and bactrim) caused me stomach pain. Bartonella generates a lot of toxic stuff and made my poop smell. Be careful with bactrim if you have adrenal problems as it caused sodium loss.

tickbite666 said...
Sometimes its Bart alone that's messing with your liver enzymes. I had to stop my Rif, Zith, Doxy protocol after 6 weeks of my first round due to elevated AST/ALT levels. After that one time stopping abx, each time after that AST/ALT got elevated, I would just blast through it.

Yes, tickbite666!

After several months on lyme only treatment, my liver enzymes went up....so my LLND had me stop treatment for a couple months...and they returned to normal.
Then I went on Rifampin plus mino for bart...and they never rose again.

so possibly treating lyme, allowed bart to come to the forefront...hence hitting my liver....then treating it...beat it back down again...not sure tho.

LilyPanda said...
I'd heard about the orange pee, but I hadn't heard that it can stain your teeth. Yikes! I know I'm being silly and vain, but I'm not sure I can take orange teeth on top of everything else that's happening.

It didn't stain my teeth. So far, the only meds that have stained my teeth: minocycline - a blue/gray color
I wasn't on doxy long enough for the brownish stains to form.

Doxy stains usually come off with dental cleaning. But the minocycline - I believe is not on the surface...it's deeper..and cleaning didn't help.
Mino can also stain the thyroid....ugh...wonder if that causes something....down the road.

I tolerated 7 antibiotics just fine with no side effects... Except Rifampin. It induces CYP3A4 enzymes that process other drugs. It can basically cause some drugs to double their strength and half life and others to be totally inactivated. I experienced the latter and had to stop Rifampin.

I probably would have been fine if I hadn't been on a medication that was metabolized by the P450 CYP3A4 pathway.

Here are some concerns if you are taking any:
some immunosuppressants
ciclosporin (cyclosporin)[35][37]
tacrolimus[35][37]
sirolimus[35][37]
many chemotherapeutics
docetaxel[35][37]
tamoxifen[35][37]
pa***axel[35][37]
cyclophosphamide[37]
doxorubicin[37]
erlotinib[38]
etoposide[37]
ifosfamide[37]
teniposide[37]
vinblastine[37]
vincristine[35]
vindesine[37]
imatinib[35]
irinotecan[35]
sorafenib[35]
sunitinib[35]
vemurafenib[35]
temsirolimus[35]
anastrozole
gefitinib
azole antifungals
ketoconazole[37]
itraconazole[37]
macrolides
clarithromycin[35][37]
erythromycin[35]
telithromycin[35]
(not azithromycin)[35]
dapsone[35] (in leprosy)
tricyclic antidepressants
amitriptyline[37]
clomipramine[37]
imipramine[37]
cyclobenzaprine[39]
SSRIs
citalopram[37]
norfluoxetine[37]
sertraline[37]
some other antidepressants
mirtazapine[37] (NaSSA)
nefazodone[37]
reboxetine[37]
venlafaxine[37] (SNRI)
trazodone[35] (SARI)
vilazodone[37]
buspirone[35][37] (anxiolytic)
antipsychotics
haloperidol[35][37]
aripiprazole[35]
risperidone[35]
ziprasidone[35]
pimozide[37]
quetiapine[35]
opioids (mainly analgesics)
alfentanil[35][37]
buprenorphine[40] (analgesic, addiction maintenance treatment)
codeine[35] (analgesic, antitussive, antidiarrheal)
fentanyl[35]
hydrocodone (partial involvement, not the bioactivation factor)[41]
methadone[35] (analgesic, addiction maintenance treatment)
levacetylmethadol[35]
tramadol (to inactive metabolites, do not confuse with metabolism via CYP2D6)
benzodiazepines
alprazolam[35][37]
midazolam[35][37]
triazolam[35][37]
diazepam[35] (bioactivation to desmethyldiazepam)
clonazepam[42]
some hypnotics
zopiclone[37]
zaleplon[35]
zolpidem[35]
donepezil[37] (acetylcholinesterase inhibitor)
statins
atorvastatin[35][37]
lovastatin[35][37]
simvastatin[37]
cerivastatin[35]
(not pravastatin)[35]
(not rosuvastatin)[35]
calcium channel blockers
diltiazem[35][37](sensitive substrate[43])
felodipine[35][37](sensitive substrate[44][45][46][47])
nifedipine[35][37](sensitive substrate[48][49][50][51])
verapamil[35][37](sensitive substrate[52][53][54][55][56][57][58])
amlodipine[35](sensitive substrate[59])
lercanidipine[35]
nitrendipine[35]
nisoldipine[35]
amiodarone[37] (class III antiarrhythmic)
dronedarone[37] (class III antiarrhythmic)
quinidine[35] (class I antiarrhythmic)
PDE5 inhibitors
sildenafil[35][37]
tadalafil[60]
kinins[37] (vasodilators, smooth muscle contractors)
sex hormones agonists and antagonists
finasteride[35][37] (antiandrogen)
estradiol[35] (estrogen)
progesterone[35]
ethinylestradiol[37] (hormonal contraceptive)
testosterone[35] (androgen)
toremifene[37] (SERM)
bicalutamide[61]
H1-receptor antagonists
terfenadine[35][37]
astemizole[35][62]
chlorphenamine[35]
protease inhibitors
indinavir[35][37]
ritonavir[35][37]
saquinavir[35][37]
nelfinavir[35][37]
non-nucleoside reverse transcriptase inhibitors
nevirapine[37]
some glucocorticoids
budesonide[37]
hydrocortisone[35]
dexamethasone[35]
albendazole[63][64] (antihelminthic)
cisapride[35][37] (5-HT4 receptor agonist)
aprepitant[35] (antiemetic)
caffeine[35] (stimulant)
cocaine[35] (stimulant)
cilostazol[35] (phosphodiesterase inhibitor)
dextromethorphan[35] (antitussive)
domperidone[35] (antidopaminergic)
eplerenone[35] (aldosterone antagonist)
lidocaine[35] (local anesthetic, antiarrhythmic)
ondansetron[35] (5-HT3 antagonist)
propranolol[35] (beta blocker)
salmeterol[35] (beta agonist)
warfarin[65] (anticoagulant)
clopidogrel, becoming bioactivated[66] (antiplatelet)
omeprazole[37] (proton pump inhibitor)
nateglinide[35] (antidiabetic)
methoxetamine[67]
montelukast (leukotriene receptor antagonist)
vilaprisan (selective progesterone receptor modulator)
Angiotensin II receptor blocker
Losartan (sensitive substrates)[68]

Blood tests usually just detect ALP/AST/ALT, which won't tell you if you've got elevated CYP3A4. The effects of CYP3A4 are more indirect, such as increased drug metabolism and clearance, low vitamin D, low cortisol and aldosterone, sodium loss, or signs of adrenal stress, such as loss of vitamin C, B6 and B12.

HeartsinPain said...
ok thank you Quin. Do you think Cowden’s Adrenal tincture would be a good idea?

Cowden recommends about a dozen different things, so I'm not sure. I took hydrocortisone, plus what the blood tests showed was deficient (eg vitamin C, B12). Be a little careful with vitamin D as that can itself induce CYP3A4 if you take too much. And, try to avoid this problem by using antibiotics that are less likely to induce CYP3A4.

HeartsinPain said...
Thanks again Quin! I’m on month six of antibiotics and just added in Rifampin last week. I’ll be on it for three months but if it starts to cause me issues I’ll bd sure to get off of it ASAP!

Expect to feel effects on the Rifampin - as it will be hitting bart - so you most likely won’t feel great on it. Discuss anything concerning with your LLMD.

I don’t know many - if any people feel “good” taking Rifampin - especially during the first several weeks

You should be getting monthly lab work while on Rifampin (and all antibiotics)

Liver and kidney function tests plus hematology