another antibiotic.

[mkay]

Hi All~

I have a sinus infection and my doctor rx’d amoxicillin 875mg twice a day. My question is do I continue the mino which I take M-W-F with this? I’m sure Maz might know the answer! Thanks in advance!

[mkay]

I did just speak to the pharmacy and she said they can be taken together or I could go off of the mino until the amoxicillin is finished. What do you normally do? I was afraid by adding 875mg of another antibiotic it would throw me into major pain– which I do not want…any ideas?

[Maz]

@mkay wrote:

I did just speak to the pharmacy and she said they can be taken together or I could go off of the mino until the amoxicillin is finished. What do you normally do? I was afraid by adding 875mg of another antibiotic it would throw me into major pain– which I do not want…any ideas?

Hi Mkay,

I was able to attend an online conference chat with Dr. S, one of the experienced AP physicians down in GA/TN a couple weeks ago, and he confirmed that it was fine for amoxy to be taken with low dose mino (or other tetras).

I, myself, took high doses of Moxatag (775mg BID) for 8 months last year while also taking 150mg doxy MWF and Diflucan 100mg BID. Moxatag is an extended release amoxicillin that only needs to be taken twice a day instead of 3 times per day and I was taking it for Lyme. Yes, it did throw me into a 5 week-long herx that began on day 3…but the benefits over time of this abx were astonishing. Every month, my anti-CCP came down by 40 points!

So, you may experience worsening (herxing) while taking the amoxy, but if you do, then you know it is also working on your RA. In fact, it might also provide a clue that you have other cell-walled bugs that need addressing. Brown often used penicillins for his rheumatic patients, too, to lower strep titers, so it’s not an unusual abx to be on. All in all, it’s not a bad thing to have to use other abx at intervals for acute infections, as sometimes they work on infections we didn’t know were in our mix and could provide clues on what might be of benefit to add to our protocol. We hear it so many times when people arrive to RBF that they discovered AP when they have had to treat an acute infection and it caused their RA or other rheumatic disease to feel temporarily better.

All this said, the two abx are not exactly compatible and some efficacy of the amoxy might be lost while on a tetra, which you may not want while trying to get rid of the acute infection. Stopping AP for short intervals isn’t unusual and Brown would often taken patients off their abx when hypersensitivity became a problem in order to do a week’s washout and then to re-start then protocol. So, the logical assumption (purely surmise on my part) is that stopping mino during a short-course of treatment with another class of antibiotic isn’t very likely to do much to alter longterm outcome. I’ve had to take a month-long break from tetras in the past and it didn’t change much, all in all, aside from a little herxing when re-starting. Currently, I’m doing looooonnnggg pulses…3 weeks on and 3 weeks off to trick the Lyme bugs out of hiding. It’s working!!!!

http://www.drugs.com/drug-interactions/amoxicillin-with-minocycline-1636-0-187-0.html

[mkay]

Thank you Maz. The thing I’am trying to avoid is extreme pain! Also if you do take them on the same day how exactly do you do it…I know with the mino I always leave the 2 hour window clear from food or any supplements. Thanks!

[Maz]

@mkay wrote:

Thank you Maz. The thing I’am trying to avoid is extreme pain! Also if you do take them on the same day how exactly do you do it…I know with the mino I always leave the 2 hour window clear from food or any supplements. Thanks!

I wish I could tell you that by taking the amoxy that you could avoid the pain of herxing, but the thing about penicillin for acute infections is that it needs to be taken in quite high, regular doses. It’s not a good idea to mess around with lowering the doses to minimize herxing, in other words. I know…bummer, eh? I guess you’re just not going to know how you will react to the amoxy until it happens, if it happens.

Yes, when I was on both Moxatag and doxy, I took the Moxatag at 12 hour intervals and was able to take my doxy mid-afternoon, 6 hours after my morning and evening Moxatag doses. I’m guessing you’re likely needing to take the amoxy 3 times a day at 8 hour intervals? If so, then keeping the two abx spaced apart as far as possible, as you suggest, makes good sense so that the two interfere as little as poss with one another.

[nord]

Amoxicillin was previously used together with Doxycyline in the cpn CAP, so that interaction seems not too strong. In cpn CAP Amoxicillin to eliminate the infectious form of C Pneumoniae, the Elemantary Bodies. It can cause reactions in various locations if Cpn is a problem. What infection was found to be the culprit in the sinus issues?

As a side-note: Piperine (black pepper) enhances the uptake of Amoxillicin (as well as several other substances, Norfloxacin, Ampicillin, CoQ10, Turmeric are a few that can be of interest here).

[Author]

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