@mad1max wrote:

Also, I know that the recommendation for Doxy is to take it on an empty stomach for better absorbtion- but my daughter wants to take it with food – do you think there is any problem with that – or maybe up the dosage from the current 2BID MWF? Just looking for some thoughts.

Hi Max,

Did your daughter’s doxy come with a pharmacy print-out with a list of instructions? It’s my understanding that different generics will have varying absorption rates when taken with food and there are usually some instructions given at the time of pick-up that will outline what is needed in terms of dos and don’ts and what time is needed between taking the dose and eating.

It’s accepted that some effectiveness in absorption will occur when anything is eaten or supplements used that contain minerals within a two to three-hour time-frame of the dose, such as dairy products, or foods high in mineral content, like spinach or bananas…or even calcium-fortified orange juice (one needs to be a label-reader in these instances). If she needs to eat something to quell stomach issues, then something like a few gluten-free crackers or a pot of apple sauce will usually do it. Minerals that interfere with absorption in a big way are anything containing magnesium, calcium, iron, zinc, etc.

Interestingly, I’ve read that minocycline was developed with teenagers in mind (for acne) and so while the same restrictions on minerals apply, less absorption is lost with this abx than with other tetras.

I use Watson brand doxycycline hyclate and the instructions say:

“Take this medicine with or without food. If stomach upset occurs, take with food to reduce stomach irritation.Certain medicines may bind with doxycycline, preventing its full absorption. To avoid this problem, take doxycycline 2 to 3 hours before or after taking any medicines containing magnesium, aluminum, calcium, iron, or zinc. Some examples include, quinapril, didanosine, vitamins/minerals, antacids, sucralfate and bismuth subsalicylate.”

There are other important instructions about how to take it with a full glass of water (to ensure cap goes down to prevent esophageal burning) and not to lie down for at least 30 mins or more after to prevent reflux. My daughter took doxy a few years ago for her cystic acne and one night she woke up with very severe esophageal pain due to a capsule she took right before bed. This was so bad she could barely swallow her own saliva and was unable to eat properly for a couple weeks until it healed, so this really should be stressed, if possible. 😉 Teens tend to think we’re being over-protective, but “hindsight is a fine thing” in these sorts of instances. My daughter is a nurse now and still uses mino for her acne (thank goodness, as she’s going on a camping trip this weekend here in CT – peak season for Lyme – and I’m freaking out about ticks!), but I think she learned her lesson about that one and will never do that again.

@mad1max wrote:

so besides feeling “crummy” for one day this week, and a worsing of lab results, she is doing pretty well.

Maz, I’m sure your daughter will have a great time on her camping trip and everything will turn out just fine – but if your like me, you will probably worry yourself silly until she’s safely home again – thats part of being a good parent.

Max, that’s really good to hear…so glad she’s doing okay. 🙂 It’s still really early days, but young ones seem to do really well at turning things around a lot faster than older adults.

Thanks for your kind words about my daughter….I guess even when she’s in her 60s and I’m in my 80s, I will still be worrying about her. 😆

Just sending a quick PM to you with some info you might find useful.

@mad1max wrote:

Just when you think things are getting better….you come back to reality. My daughter drove with her mom to New Mexico to visit family and took a dramamine because she always gets car sick. Became nauseous during the trip and was up most of the night crying because of severity of nausea. A little better today, but not that much. Any ideas if this could be a here – is nausea a primary herx symptom.

Also, should she still be taking ABX and celebrex while feeling this way – has not had anything to eat and I’m afraid to give her her medications when her stomach is so upset and she’s feeling this badly, Your thought/experiences would be much appreciated…best…Max

Max, I just checked Drugs.com and there don’t seem to be any interactions between Dramamine, Doxy or Celebrex. However, one of the serious side-effects of Celebrex can be nausea and other gastrointestinal issues:

http://www.drugs.com/sfx/celebrex-side-effects.html

Nausea can be a side-effect of doxy (helped by taking with something to eat to settle stomach) and this may have been worsened if she was reclining in the car on a long journey and had a bit of reflux.

Your hunch to give her a break for a few days until she can tolerate foods again is a good one. Would also check with doc about the celebrex, as this could be an issue, too. In situations where I’ve had to back off something, I usually reintroduce one thing at a time to gauge what might be exacerbating things.

While this could be a herx (herxes can erupt in any part of the body where bugs are hiding and in cycles due to life cycle of bugs), personally, I always think it’s wise to err on the side of caution and rule out side-effects, first, and to mention anything of concern to one’s doctor.

Interestingly, I remember when my first doc mentioned that some pain relievers work by oxidation or cause oxidative stress on the body. Celebrex works in this way:

http://www.arthritis.co.za/celebrex_package.html

“Celecoxib is metabolised in the liver by hydroxylation, oxidation and some glucuronidation and in vitro and in vivo studies indicate that metabolism is mainly by cytochrome P450 CYP2C9.”

Therefore, it’s possible that using anti-oxidative strategies may help to avert the nasty side-effects of this type of metabolic process. The P450 cytochrome in the liver is a major detox pathway and so drugs, like Celebrex, probably have some effect in creating oxidative stress on the body.

Not saying if this is the issue, but it’s worth considering and discussing with the prescribing doc.

Hope this is just a passing bug or something that can be helped with temporarily stepping back meds, Max. Let us know how she gets on.

Max
Ginger is listed a possibly having an interaction with celebrex (there are lots of things listed BTW!). So worth checking with doc or pharmacist before combining the two.

http://bodyandhealth.canada.com/drug_in … &page_no=2