Artemisinin - how to take it?

The bottle says before meals.

How were you prescribed it?

I am doing this on my own...so not sure what a LL Dr. says.

I have herxed on it both with or without food. I hear it is best absorbed with fat. So take it with a spoonful of peanut butter.

Have you started on it yet? I bumped my dosage up a little and didn't notice much difference. Took a break for about 3 days and took the increased dosage again and have felt pretty lousy, but it also still takes care of the neck pain.

I get that research shows you have to take a longer break to avoid resistance, but I have just never run into that with Art. I have been taking it since Easter with only a few 2-3 day breaks, and it still takes care of my neck pain and I have also started herxing on it (flu-like achiness and mild irritability). Weird.

I don't dispute what research has found so far, but more needs to be done.

There haven't been enough studies on metabolized Art in a broad spectrum of populations with gene variations.


"In conclusion, while the candidate genes involved in their production of several metabolites of artemisinins have been identified, further study is needed to explore the impact of genomic variation on these drugs particularly in the context of multiple drug treatments"

https://www.pharmgkb.org/pathway/PA165378192



"Various studies have been carried out on molecular mechanisms for resistance in malaria chemotherapy . However limited efforts have been made to determine genetic polymorphisms in cytochrome P450 enzymes, which may be associated with treatment failure (in extensive metabolizers) as a result of subtherapeutic drug concentrations"

"The increasing use of artemisinin-based combinations as an effective treatment of resistant malaria demands determination of genetic polymorphisms in the metabolism of these drugs and its influence on pharmacokinetic profiles between individuals, adverse drug reactions and clinical outcome.

Polymorphisms in gene encoding for drug- metabolizing enzymes and transporters are associated with individual variation in drug response . The frequency of variant alleles encoding for CYP families varies among populations according to race and ethnic background ."

https://malariajournal.biomedcentral.com/articles/10.1186/1475-2875-13-420




At the end of the day, if I feel that I continue to make progress with Artemisinin without long breaks, despite what the research suggests, I will continue with it - provided my liver enzymes are still in good shape.

Thanks everyone.

This will be my second round of it.

I did 4 days of it and took a 10 day break. I did 200 mg twice daily, then 300 mg twice daily, and then the last two days 400 mg twice daily.

Today - first day of round two - I started at 300 mg twice daily, will do two days of 400 mg twice daily and the last day will bump to 500 mg twice daily.

Then will take 10 days break.

I think the third round I will start at 500 mg twice daily. I'm thinking that's as high as I will go...but not sure?

Remember - there are two different 'things' going on - one is resistance. The other one is the intestines developing an enzyme that kills the Artemisinin.

Tillybear - what do you consider the top dosage?

I herxed on day three of the first round.

Dr. MR says to go up to 5 caps 3X daily but that seems high.

Rikky - do you know the difference between Artemisinin and Zhang's artimisiae?

I took my artemisinin with meals. 500mg at breakfast and 500mg at dinner.

Are you herxing? It's some potent stuff.

Bump ,girlie how are you fairing ?...rikky how was alinia?

Girlie said...
I did herx on the first round on Day 3. Woke up in the night shivering...and very emotional...an emotional herx...i guess.

On Day 2 of the second round...we'll see what happens in the next few days.


Thanks, Jackie. I will take mine just before eating breakfast and dinner.

This is IDENTICAL to my experience on artemisinin.
Day 3. The emotional herx was definitely weird. At first I thought it was just in my head, until it happened every weekend like clockwork for the last month.

Girlie, which brand are you using?
Are you not taking your Rifampin/Biaxin/Ceftin while you'r doing the artemisinin?

As for dosage, here's a quote from Buhner:

"Chinese dosage runs from 500-1600mg for three days repeated in two weeks (to treat newly hatched parasites). I do think there is some evidential support for 800-1200mg for five to seven days, repeated for another five to seven days in two weeks". (pg387, Healing Lyme Second Edition).

So I think you're on the right track here. 1500mg was an upper limit I have read elsewhere, so it seems we're in the ballpark.

I take the same brand, but the 200mg capsules.
Ya it's tough to say if biaxin would add any help against resistance. Maybe some herbs like csa?

Ya I'm going to say at least 4 months. Heck, I've been on malarone for 6 months and haven't really noticed much change.

Also, do you have Bart symptoms and does the rifampin help at all? Would like to do rifampin in the future if I decide to stop malarone.

Girlie said...
I am taking Crypto, sida, and am gradually adding in the CSA - and will discontinue the crypto and sida.

I do have bart symptoms. I am blaming my nerve pain on bart. (radiculopathy - upper left side of back/shoulder blade/arm/hand) - Imaging showed no pinched nerve root in neck.

Also blaming my foot pain and rib pain on bart...and perhaps my 'shivers'.

I have had some improvement while on the rifampin. My rib pain is much better...and I don't have the pressure in my head behind my eyes anymore - not sure if that can be attributed to bart though.
Oh...and my pulsatile tinnitus is greatly improved. That could be a nervous system issue...so maybe bart.

How long were you on rifampin for?
EDIT: just read your signature.

A note about "shivers". I never had shivers or chills until I started Malarone. I then felt freezing cold pretty much 24/7. I would literally sleep with a t-shirt + a sweater + a hoodie + long underwear + sweat pants + a down duvet blanket + an extra blanket on top of that. I'd still be cold at night. Occasionally, on top of all of that, I would add an electric blanket and that would help.

If I stopped Malarone, the chills disappeared. When I re-started, they returned.

However, the chills have really subsided after 6 months of Malarone. Actually by month #5 it finally improved. Now I only get chills when I herx really bad from artemisinin.

So the shivers could be Babesia rather than bart.
But it's different in everyone so it might not be.

Post Edited (mustardseed2) : 5/24/2016 4:33:05 PM (GMT-6)

Girlie - what finally cleared your babesia? I know you are still around... so thought I'd ask since I am working on that.

blueberrymuffin said...
I take Artemisia, my LLMD prescribed me, however, I do not have Babesia symptoms.
I wonder why he gave me it, when I don't have Babesia? Is it good for other bacteria as well?

Two things come to mind with your LLMD's recommendation:

Artemisia can treat Lyme and...

It's not uncommon for healthy people to have asymptomatic Babesia infections. Even the CDC acknowledges this on their website:

www.cdc.gov/parasites/babesiosis/

"Although many people who are infected with Babesia do not have symptoms, for those who do effective treatment is available."

Your LLMD seems knowledgeable...and thorough.

I'm still doing 'rounds' of the Artemisinin - I've done six rounds so far.
I don't take my other meds with Art because of the cytochrome P450 interaction.

I think these are all on the list:

Artemisinin
Rifampin
biaxin


I am taking CSA on T/Th/S/S - because on M/W/F i take Rifampin and biaxin.
Someone posted the Cryptolepis shouldn't be taken with Rifampin or biaxin.

(I think for a different reason than the P450 issues)

It's confusing.