Question regarding Minocycline/Doxycline

Hello all!

I'm hoping someone more antibiotic knowledgeable than I am can tell me if it would be normal for a doctor to prescribe minocycline and doxycline to be taken together?

I saw my LLMD about a month ago and asked if he could prescribe Rifampin to take along with the Doxycline that I have been on for the last 4-5 months. He agreed and took me off of the Biaxin I had been on. He told me to let him know how I do with the Rifampin in a month and if I was tolerating it ok he would refill my Rx and possibly up my Doxy dose (he still has me on what I think is too low of a dose of Doxy- 100mg 2x/day.) or change me over to Minocycline. I went into his office to have blood drawn a few days ago and told the nurse that I do feel crummy on the Rifampin, but I'm willing to continue on it since it's only been a month (I figured maybe the herx would subside at some point).

The nurse just called me and said the doctor told her he wants to take me off of the Rifampin and put me on Minocycline instead. I asked her if I would take this with the Doxy and she said yes. Does this sound right? I thought Mino and Doxy were in the same antibiotic family therefore a person would be on one or the other, but not both simultaneously. I told her I wanted to stay on the Rifampin a little longer and switch to the Mino since I have been on Doxy for 5 months now and am not feeling any improvement. She said she would speak to the doctor and get back to me.

Can anyone tell me if taking Doxycline with Minocycline sounds like a reasonable protocol? It doesn't to me but admittingly I don't know much about what antibotioc combinations most Lyme/Bartonella patients are on.

Any help would be greatly appreciated!

Ya just try it?

Does he mean 100 mg of mino and 100 mg doxy, but take each twice per day?

The 2 abx affect the bacteria in exactly the same manner but simply get into tissues differently. Mino is better for brain infection and passes blood brain barrier better and deeper tissues better. Doxy also passes into deeper tissues but stays in blood longer. Mino dissolves and penetrates bacteria better. But when these 2 are inside the bacteria, they affect them exactly the same.

Instead of doing 200 mg doxy twice a day, he is just staying do 100 mg 100 mg doxy twice a day, which I think in theory would be more effective?

Lyme_mama227 said...
Hello all!

I'm hoping someone more antibiotic knowledgeable than I am can tell me if it would be normal for a doctor to prescribe minocycline and doxycline to be taken together?

I saw my LLMD about a month ago and asked if he could prescribe Rifampin to take along with the Doxycline that I have been on for the last 4-5 months. He agreed and took me off of the Biaxin I had been on. He told me to let him know how I do with the Rifampin in a month and if I was tolerating it ok he would refill my Rx and possibly up my Doxy dose (he still has me on what I think is too low of a dose of Doxy- 100mg 2x/day.) or change me over to Minocycline. I went into his office to have blood drawn a few days ago and told the nurse that I do feel crummy on the Rifampin, but I'm willing to continue on it since it's only been a month (I figured maybe the herx would subside at some point).

The nurse just called me and said the doctor told her he wants to take me off of the Rifampin and put me on Minocycline instead. I asked her if I would take this with the Doxy and she said yes. Does this sound right? I thought Mino and Doxy were in the same antibiotic family therefore a person would be on one or the other, but not both simultaneously. I told her I wanted to stay on the Rifampin a little longer and switch to the Mino since I have been on Doxy for 5 months now and am not feeling any improvement. She said she would speak to the doctor and get back to me.

Can anyone tell me if taking Doxycline with Minocycline sounds like a reasonable protocol? It doesn't to me but admittingly I don't know much about what antibotioc combinations most Lyme/Bartonella patients are on.

Any help would be greatly appreciated!

Lyme Mama - I think it could be an error. (since you said you wanted to continue on the Rifampin.)

Your question: "I'm hoping someone more antibiotic knowledgeable than I am can tell me if it would be normal for a doctor to prescribe minocycline and doxycline to be taken together? "

No it's not normal...I haven't seen it yet. With the Rifampin you will be treating bartonella...but mino and doxy together - wouldn't be effective against bart IMO.

and I plugged them into the Drug Interaction checker:
Tetracycline-type antibiotics
Therapeutic duplication

Therapeutic duplication warnings
Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

The recommended maximum number of medicines in the 'tetracycline-type antibiotics' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'tetracycline-type antibiotics' categoryy:
Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

I would definitely double-check with the Dr. on this one.

Rifabutin is for bart...but not sure if it's less harsh. You could try it.

I don't know enough about it to comment.


You could try bactrim... don't know if that will be enough though....but maybe you could try it for awhile and then give rifampin a try again after.

When you say you felt crummy...were you herxing? If you can tolerate the Rifampin...I would try it again..maybe with the minocycline instead of doxy?

Okay - I thought maybe the prescription wasn't renewed and you were stopping it right away

i didn't take doxy right away i took it a year into treatment and boy did it kick my butt. it did hit my bart i'm pretty sure which i was surprised about.

i did rifampin for several months as well as rifabutin after that for several months. i didn't notice any appreciable change except my pee color ;)

do be careful with the rifampin and herxing. if you are getting your proverbial butt kicked too hard then see if you can back off on quantity/timing. some LLMD's will do 2 pills 1x/day other 1 pill 2x/day. i was doing rifabutin 1 pill 2x/day and decided to try both pills 1x/day and after 3 days it nearly put me in the ER.