Taking Atovaquone with Rifampin

i don't see a significant problem if you are aware of the interaction and mitigate risks that may be associated

my guess is the LLMD is trying to combine well known combinations for babesia ( atovaquone with a macrolide) together with well known combinations for bartonella ( a macrolide and rifampicin )

since they both impact liver metabolism - safety blood work done monthly would probably be prudent

one potential risk is that the rifampicin lowers the atovaquone sufficiently to hamper the Babesia treatment
it might be possible to increase the mepron dose to try to counter the lowering effect

its also worth noting the half life of azithromycin is very long - 68hrs on average
this means that its blood concentration will typically only have reduced to half its maximal value after 3 days -
and more like 10 for most of it to come out of the system
this makes it a little difficult to understand the dosing schedule

i hope its of some help

skippy0349 said...
Hi everyone, hoping I can get some insight on the medications that I'm currently starting to treat diagnosed Babesia and Bartonella. I am currently seeing a LLMD. I will be starting off by taking these three prescriptions for ~3 months.

My treatment for Babesia is:
-Atovaquone 750mg/5ml, 2x/day with food
-Azithromycin 500mg, 1 pill per day 4 days on, 3 days off

My treatment for Bartonella is:
-Rifampin 150mg (starting with 1 pill 2x/day and then increasing to 2 pills 2x/day)

I'm aware that taking Rifampin along with Atovaquone can potentially cause the Atovaquone to be less effective and also enhance the effects of the Rifampin.

I am just hoping to get some insight from the community to see if anyone else has taken these two drugs together (Rifampin and Atovaquone) and what your experience has been and if there is anything I should be aware of.

Will I be okay taking the Rifampin and Atovaquone together for ~3 months?

Thank you.

I haven't taken Rifampin or Rifabutin along with Mepron based on advice from my doctor. If the Rifampin cancels out a lot of Mepron effectiveness, it wouldn't be too good especially if you're paying out of pocket for the Mepron (expensive). I think I've heard of people taking them together though they may have taken higher dose of Mepron to counter the interaction with Rifampin. I've recently been using Alinia. It can be taken fine with Rifampin/Rifabutin.

Just realized I'm just repeating some of what Garzie said.😀

Post Edited (JMF84) : 6/6/2024 9:28:07 AM (GMT-8)