Rifampin. Dosing and protection strategy.

So I'm going to start rifampin therapy for bartonella come February 1st.

A couple things.

Is it better to dose rifampin 300 mg twice daily, or 600 mg once daily? I ask because I am not sure, rifampin had a shorter half life of 4 hours and as we all know puts the liver into overdrive. But lots of other lyme docs prescribe it 300 mg twice daily. I think mine thinks the 600 mg gives a better spike of the drug into the tissues.

Also what are the best herbs to be on to protect the liver and cells? I'm going to do curcumin, vitamin C, vitamin E, ALA, milk thistle, and NAC. Rifampin I know can create a lot of oxidation inside cells so I want some protection strategies.

You should not take milk thistle when you are on rifampin.

LP - I looked it up...and Milk Thistle shouldn't be taken with Rifampin or Erythromycin.

I was just given Rifampin, 2-300mg at night. Wonder if better to split it up. Then I throw in Zithromax 500 mg, twice a day, in a few weeks, then toward end of anx cycle Tindamax for 3 days. I have a few symptoms starting back up.

Let us know how you do on it LP.

Must avoid alcohol while taking Rafampin, not that I drink often.

When I took Rifampin the info sheet that came from the pharmacy said Milk thistle should not be taken at the same time.

I found this on a quick search:
www.liversupport.com/wordpress/2011/04/does-milk-thistle-have-contraindications/

LP let me know what your doc tells you about Milk thistle and rifampin. With what achievinggrace posted it sounds like it will be ok.

What is MST, is that milk seed thistle? Ya I will ask. I think the mino is preferred because it is found to be more effective against bart by many LLMDs, and rifampin can reduce levels of doxy in the blood whereas mino is not affected. I was also told mino gets into the nerve better where bart likes to hide.

I'm up to 300mg rifampin daily, 250mg azithromycin daily, and nystatin twice daily - been doing this about a month now. I still have to add in plaquenil and get to rifampin and azith twice daily. Every morning, as soon as I take the meds, I get brain foggy (maybe 15-30 minutes after taking them) and it lasts most of the morning. I'm terrible about detoxing, though, so I need to make detox a part of my routine. I haven't noticed much improvement in symptoms yet so I know I have to press on. Just chiming in that it doesn't seem that the lower doses are very effective for much other than causing a herx. Keep pressing on with your regimens! I know I have to!

Any suggestions on how you made detoxing a part of your day? My problem is that I'm at work when I feel the worst so I'm always reminded about castor oil and H2O2/salt soaks when I'm at a place where it doesn't seem feasible. It's probably just part of my evening routine that I need to get more proactive about.

Girlie, Rifampin puts the liver into overdrive as it is such a difficult compound for the body to break down and metabolise.  Because of that all kinds of liver enzymes are elevated, and this is what causes some drugs that are combined with rifampin to have reduced blood levels as they too are metabolized faster.  Rifampin induced elevated liver enzymes may do that for tinidazole too, but I don't know for sure.

Some people had elevated liver enzymes when combining the two.  The combo just causes too much oxidation and can be permanently damaging.  It is not a good idea to combine the two, however there are doctors that will combine them.  I think it's good to consider the risk though. 

Bump, hoping chapelle gives her knowledge about it.

I'm going to say it is fine to take milk thistle with the rifampin. (However please don't take it without asking your doctor).

I'm going to be taking milk thistle with my rifampin treatment as I see a double benefit in doing so. It makes it attain higher blood levels, and it also slows the metabolism down. Hence you get more bang for your ammo against Bart. In addition to that it keeps the liver enzymes down. If your liver enzymes get high and for too long it could cause permanent liver damage, it would be in the form of small scars, which could be lifelong damage. Having your liver enzymes elevated just seems too risky to not take the milk thistle. But an important note is the oxidation inside cells from the rifampin itself. I am going to be taking both NAC and ALA (R-form), to make more intracellular glutathione. Also going to probably order the liposomal tri-fortify orange to help as well. I will need a form of vitamin C (not sure what to take for that yet but will decide soon) and vitamin E. it is important to take anti-oxidants on a rifampin treatment.

I was going to take my first dose tonight but decided to delay it. I took Zithromax for the first time this evening so I wanted to see how my body would react to that. May introduce the Rifampin tomorrow though.

Thanks CD. I'm hoping to be able to get rid of this once and for all! Darn bart.