Rifampin for Bartonella

My experience with Rifampin.

Most docs combine rifampin with another med like minocycline, doxycycline, azithromycin, biaxin, erythromycin.

It took me awhile to get up to 600 mg daily (300mg bid).

1200 mg daily, to start, sounds awful. If it is giving you psych issues, try backing down the dose and ramp into it.

My experience was like yours and my anxiety was horrible, especially in the middle of the night/early, early morning hours. I didn't realize that it could've been a herx since it was also horrible before I went on Rifampin (and azithromycin). My dosage is the same as carlnpa but my llmd didn't work up to that level. I was on doxycycline for a really bad ear infection, then switched to azithro for the same ear infection, got the bartonella diagnosis and went on Rifampin full force while staying on the azithro. Maybe it wasn't the best way to go and it never occurred to me that my llmd or I should've or could've slowed the process down... I hope you're able to get some comfort in knowing you're not alone because the loneliness can be really awful.

Sunflower1920 said...
I tested positive for Bartonella. My LLMD put me on Rifampin ( oral). Unfortunately, I've heard many not so good stories about that drug. I am on day 4 of it and my anxiety is so bad, worrying so much. In the middle of the night it's a lot worse. I guess I have legitimate worry ( who doesn't in the Lyme community right? Living with a chronic illness is not easy)

The body pain was really bad earlier with bad fatigue. Not sure if I can call this a herx or not since all these symptoms are Bartonella anyway.

When taking Rifampin how soon did anyone( if anything) find relief??? I'm such a mess now and so scared this won't cure me. I'm on 2 pills (300mg each) 2x a day.

It is a difficult drug to tolerate, but if you can, it is the first choice drug because it is bactericidal (kills pathogen when high enough concentration hits it) vs. bacteriostatic (kills pathogen by inhibiting it’s ability to replicate) and crosses the BBB.

It is combined with a tetracycline or a macrolide (if your symptoms are neuro you may want to consider minocycline since that crosses the BBB whereas macrolides don’t).

I went from deathly ill to feeling much better in about 4-6 weeks. I was able to tolerate rifampin for 8 weeks. Generally you want to take it for at least 3 months. Anxiety was my biggest symptom and taking clonzepam (I had been on it before I got sick for existing anxiety issues) helped tremendously. You don’t have to go that route, just detox well, rest, and soon you’ll be feeling better. I herxed about a week into it and could feel the inflammation throughout my body. Towards the end of my treatment I would feel worse about 1-2 hours after taking Rif (it has a short half life and reaches peak concentrations soon after taking it) and knew I had to stop it. The symptoms of intolerance were different from what I had experienced with Bart - felt very weak, tired, and like I was going to faint at times.

It got rid of my Bart, though! The other combos of drugs that attack Bart (Tetracyclines, macrolides, tindamax) did nothing but keep it in check. Rifampin eliminated it.

Nope, each pill is 300 mg, 2 pills in the morning and 2 at night. I even double checked the print on the bottle too last night because even I questioned this.

I just emailed my lyme doc to double check dosage to be on the safe side.

ChristianWithLyme said...
I think Dr. MR also has this dose as a possibility in his recent bart protocols.

Yes, I read that recently.

Girlie, I had been on Rifampin back in March on 1 x twice daily; w/azith but was only this for a month because thought my balance issue was more from Babesia so I treated babs for last 8 mo, but now LLMD is hitting bart hard hoping to take care of my ongoing neuro & balance issues. He just put me back on Rifampin but at double dose of 2 x twice daily and Azith and also added Liposomal Oregano oil. My herx has been lots of neuro and worse balance but I am desperate to find my way out of this long nightmare, barely able to walk. Most anxiety feelings have been from the recent Full Blue Moon on Halloween though, and the US election!!

Solaris719 said, "Towards the end of my treatment I would feel worse about 1-2 hours after taking Rif (it has a short half life and reaches peak concentrations soon after taking it) and knew I had to stop it. The symptoms of intolerance were different from what I had experienced with Bart - felt very weak, tired, and like I was going to faint at times."

Sunflower1920, I'm on Rifabutin 300mg/day, for two 1-week pulses for Lyme/Bart (Dr. J's protocol). . . . Rifabutin along with SeptraDS & Amoxicillin in the 1st week, and along with Azithromycin & Amoxicillin in the 2nd week. Rifabutin, I believe, is very similar to Rifampin (maybe more effective?). And because of the similarities I suspect Rifampin will kill Lyme Borrelia also, along with Bart. Some of your Herx symptoms could be Borrelia die-off. I had (about a week ago) the symptoms that Solaris719 mentioned: exhaustion, feeling faint, and air-hunger. I actually DID pass out, and hit the floor hard (a face-plant!). I think that a lot of that Herx was deep Borrelia, and some of it CNS die-off (Rifabutin crossing Blood-Brain barrier).

Post Edited (BlueRidgeDave) : 11/9/2020 11:11:56 AM (GMT-7)

Rif seems like a very good drug against all sets of chronic microbiome, not just one co-infection like bart, since it targets RNA - so no wonder almost all protocols include it. I've also heard its the most difficult to tolerate.

ref: https://www.mdpi.com/2079-6382/8/2/54/htm

Both of them. They are used against cpn too as well as mycobacteria.

I'am not sure they are targeting bart directly though. Yes, i know its a common story among llmds but
endless times repeated theory does not automatically convert itself into the fact.

Hi all!
I’m on rifampin too. I just started it a lights less then two weeks ago. I’m ok 300 mg twice daily. I also take doxy 100 mg twice daily. I will be starting dapsone tomorrow. This is dr h’s protocol.
I don’t think I have herxed but it’s hard to tell. I feel pretty horrible everyday.
I don’t know what to expect when I start the dapsone.
The big issue I had was very bad nausea. My dr told me to go off the doxy for a few days. I did and the nausea seems a little better. The thing is that I had nausea before I even started the protocol. Maybe the doxy just made it worse. When I go back on I guess I will find out.

Had anyone her orange urine and stool from the rifampin?

sdarrah said...
Yes the red/orange is normal on Rifampin. I began Zhang’s latest protocol for Persister Bart used by Dr MR; Rifampin 2x300 mg twice day (1200 mg), Azithrimycin 1x day, Oregano Oil 75mg twice day.

No nausea but strong Neurological Herx symptoms, might be hitting possible mold toxicity; pending mycotoxin test results but hope this works told will take a few months to see any improvement.

How did you make out on 1200mg a day of rifampin?