Dapsone and Bactrim - similar?

As I approach the day that I'm supposed to start my persister regime...I am getting a bit apprehensive.....


Is Dapsone considered a sulfa drug?


Reason I ask...is I had a skin reaction on the Bactrim. A couple of blisters appeared. I stopped it for a week, then resumed and was fine for a couple more weeks, and then I got another blister...so i stopped permanently.


So...Dapsone - is it similar?

I can understand cold feet and worries. Of course you should trust your gut. But imo starting with low dose, 25mg, minimizes the risk. And you can stop immediately if you have issues. What you might want to consider doing is dosing that first day, and maybe waiting a day or two to assess response before taking your next dose. I know that is not conforming to how it is prescribed by your doc, but it might be a way to make it easier and safer for you given your apprehensions.

Another option is cutting the pill even smaller, to like 12.5mg and dosing at that level (I think the pills can be cut if I remember correctly). Imo doing anything that can minimize your worries while still giving the med a chance would be a good idea. There is a chance this therapy could really help your case, so it all depends on the potential risk/benefit you feel about this situation...

I've also heard some really good things about daraprim, some patients seem to do amazingly well with that drug.

Anyways, I think you should trust yourself. I merely throw ideas out there. Keeping my fingers crossed for you, I hope things work out and you can make lots of progress with whatever decisions you end up making! if you feel this isn't the right path back to health, I'm certain there will be other avenues to pursue that will help you.

Post Edited (sebreg) : 8/19/2018 9:58:27 AM (GMT-6)

sebreg said...
I can understand cold feet and worries. Of course you should trust your gut. But imo starting with low dose, 25mg, minimizes the risk. And you can stop immediately if you have issues. What you might want to consider doing is dosing that first day, and maybe waiting a day or two to assess response before taking your next dose. I know that is not conforming to how it is prescribed by your doc, but it might be a way to make it easier and safer for you given your apprehensions.

Another option is cutting the pill even smaller, to like 12.5mg and dosing at that level (I think the pills can be cut if I remember correctly). Imo doing anything that can minimize your worries while still giving the med a chance would be a good idea. There is a chance this therapy could really help your case, so it all depends on the potential risk/benefit you feel about this situation...

I've also heard some really good things about daraprim, some patients seem to do amazingly well with that drug.

Anyways, I think you should trust yourself. I merely throw ideas out there. Keeping my fingers crossed for you, I hope things work out and you can make lots of progress with whatever decisions you end up making! if you feel this isn't the right path back to health, I'm certain there will be other avenues to pursue that will help you.

My dose is 25 mg twice daily. problem is the tablets I got are 100 mg tablets and are scored....so I'm having to split them twice so the second splitting won't even be accurate. But, I figure as long as I take the 50mg total...per day...even if that second split isn't accurate..I should be okay.
But, I certainly can't split to 12.5 mg.

I'm not just worried about a rash...I've had plenty of those since treating....The issue I'm worried about - is Stevens Johnson syndrome. I had these strange blisters show up...hey had a center to them...and one of them actually scarred me.

If Dapsone is considered a Sulpha drug like Bactrim....then I'm going to be reconsidering this.

I don't even know - if you have a reaction to one sulpha drug...does that mean you can't take another one?

Dr. J knows about the bactrim experience...and noted not to prescribe it to me...so hopefully he knows what he's doing prescribing the Dapsone.

Sorry to be so wordy...just typing what my mind is thinking...and it's OVER thinking this one.

Well, based on a cursory google search it's not guaranteed that if you react to one sulfa drug that you will react to another. That said, I don't know the numbers behind that. You might want to contact your doctor's office for more info on the risks given your previous response to bactrim. (do they already know about this?)

I do agree Stevens-Johnson syndrome is frightening. You know who you might want to contact? Sheeks175, I think he has sulfa issues and ended up getting a very bad response (Stevens-Johnson actually) to dapsone. I'm not telling you this to scare you, but he is a smart guy and might be able to give you insights on his experience. He may have had previous issues with other sulfa drugs as well if I recall correctly...

sebreg said...
Well, based on a cursory google search it's not guaranteed that if you react to one sulfa drug that you will react to another. That said, I don't know the numbers behind that. You might want to contact your doctor's office for more info on the risks given your previous response to bactrim. (do they already know about this?)

I do agree Stevens-Johnson syndrome is frightening. You know who you might want to contact? Sheeks175, I think he has sulfa issues and ended up getting a very bad response (Stevens-Johnson actually) to dapsone. I'm not telling you this to scare you, but he is a smart guy and might be able to give you insights on his experience. He may have had previous issues with other sulfa drugs as well if I recall correctly...

Yes my LLMD does know about bactrim and said he wouldn’t prescribe it even though he didn’t know if my reaction to the bactrim was a SJS effect. He asked if I had any lesions in my mouth (I didn’t).

But he did prescribe the Dapsone.

Then when I got home I started to think about it and wondered if it also carried the SJS risk.

Interestingly there are some meds that are commonly used that have the SJS risk including Advil.
I believe amoxicillin does too. I was fine on that.

Maybe I’m making a mountain out of a molehill ....


Thanks - I have emailed Sheeks.

I hope georgia will see this and break it on down for us ....but they work by similar mechanism with folate depletion and paba something ...after what bactim did to me i filled script but let the dap sit on the shelf ....funny howi thought bee venom to bee safer...lol

A friend had some gains on it then another at 4 or 5 months had a bad reaction like red man syndrome...

bluelyme said...
I hope georgia will see this and break it on down for us ....but they work by similar mechanism with folate depletion and paba something ...after what bactim did to me i filled script but let the dap sit on the shelf ....funny howi thought bee venom to bee safer...lol

A friend had some gains on it then another at 4 or 5 months had a bad reaction like red man syndrome...

red man syndrome....gotta google it brb

xpeetzax said...
I think I saw a lecture earlier this year on youtube by Dr. H on the use of dapsone for persistent lyme and co-infections...he seemed to highlight it as a very promising abx. Will try to find that lecture/presentation.

Yes, Dr. H. has been prescribing it as well.

Girlie said...

sierraDon said...

Girlie said...

sierraDon said...
Good luck, I would go with your gut feeling and start slow if you have reservation.

I have been doing pretty well over here with Rifabutin, very pleased with how that has helped me. Will probably be doing another month of it, and see how things have progressed.

Did you try rifampin first...and this one is more effective so far?


I am wondering if I should have just tried the Rifabutin first...now that I've knocked babesia back, maybe bart will 'fall' easier with just Rifabutin.



signed....Worrywart.

Nope, i went straight to Rifabutin. Rifampin wasn't a good fit for me at the time due to interaction with betablocker. Rifabutin seemed to have less interactions. its been goin on 5 months now. Months 1 to 3 were easy, months 4 and 5 some ups and downs, but over all good.

with so many meds its hard to know what exactly is helping.

Interesting that months 4/5 were more difficult than the first few..

So you’re having some improvements now?

Yes, i am functioning pretty well. majority of my issues seem to be resolving or resolved. i have some lingering or transient or sporadic issues, i am not sure how to best describe them. but they come and go, its not clear to me if they are from damage done by the infections or from the antibiotics themselves, like tinnitis. i had that all along, but its different now. before it would come and go, and change frequency. now its fairly constant, azith has side effect as tinnitus.

i am functioning pretty well, riding about 40 or 50 miles a week on my bike, and working every day. my memory problems are far less problematic now too. out of about 30 original symptoms, i am probably down to about 5 or 6 that i think maybe something else, maybe side effects or just residual damage that needs to heal. another thing that makes feel like its side effects or residual damage, is that Ifeel most of it after my dose in the morning of antibiotics, and then it somewhat levels out or lessens 3 hours later after my milk thistle, NAC, and probiotics. that seems to 'pull me out of it'

i will keep treating a bit more though to be sure.