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How close should you take Rifampin with other Abx?

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Posted 4/6/2014 2:53 PM (GMT -5)
Forgot to ask my LLMD this at my most recent visit! I've read that Rifampin (for bart) without other antibiotics can cause bacterial resistance. Now I've taken doxy with all my Rifampin, but I usually take my two doses of Rifampin 2 hours, then 5 hours after my morning doxy dose. Is this okay?

I really appreciate all the answers I get from this site...i've posted at other lyme forums but this seems to be the best, and people seem to be a bit more positive, encouraging, so thank you all!
Posted 4/6/2014 4:33 PM (GMT -5)
Yes that should work okay . You are still taking both medications on a daily basis so that is the main thing to prevent the resistance. What they are referring is when a patient is only taking the rifampin by itself on a daily basis.

The issue with rifampin is that it raises liver enzymes that can also reduce blood levels of doxycycline. So your doxy levels might be reduced.

My suggestion you might want to consider or discuss with your LLMD, is take your 600 mg of rifampin, and take 400 mg doxy 12 hours later. So take one in the morning and one at night. Or all at the same time? High blood spikes of antibiotics seem to be most effective with kill kinetics according to LLMDs.
Posted 4/6/2014 5:48 PM (GMT -5)

LymePickle said...
Yes that should work okay . You are still taking both medications on a daily basis so that is the main thing to prevent the resistance. What they are referring is when a patient is only taking the rifampin by itself on a daily basis.

The issue with rifampin is that it raises liver enzymes that can also reduce blood levels of doxycycline. So your doxy levels might be reduced.

My suggestion you might want to consider or discuss with your LLMD, is take your 600 mg of rifampin, and take 400 mg doxy 12 hours later. So take one in the morning and one at night. Or all at the same time? High blood spikes of antibiotics seem to be most effective with kill kinetics according to LLMDs.

That's an interesting idea. I'm only taking 300mg currently of doxy so I should probably take more either way...thing is, I have to space the pills by half an hour each or it kills my stomach. Thanks for the advice
Posted 4/7/2014 5:59 AM (GMT -5)
Wilson,

I wanted to pass you an advice that my pharmacist gave me. If taking Doxy, take it with a large glass of water and sit up for at least an hour. One of the side effects is irritation of the oesophagus. Taking it this way can prevent more issues with your digestive tract.

Doxy is less absorbed when taking it with Rif. I had to take Rif on an empty stomach (if possible, my sister couldn't handle it), half an hour before breakfast. You can take the Doxy with or just after your evening meal, then it'll still be possible to sit up for a while.

MarieLS

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