Question about prostatitis treatment….

[mj47]

Hey everyone,
Well, things have been going really well for my husband with regards to mino & his psoriatic arthritis. It seemed to be working & he felt pretty good until the day after Halloween. At that point he had a flare up of prostatitis. We figured it was that because he’d suffered from it 6 or 7 years prior & the symptoms were the same…at that time he went to a specialist who didn’t find anything other than a slightly enlarged prostate & prescribed antibiotics which didn’t seem to help. Don’t remember what was prescribed.
This time the symptoms were extreme discomfort, some difficulty urinating, but mostly it was irritation & a feeling of needing to urinate. It went on for a week or so before he decided to up his mino by 50mg to see if it would help the prostate symptoms (we had read that mino & doxy are often prescribed for this). Eventually things seemed to calm down (he did herx a tiny bit with his arthritis, but that also seemed to correspond with the horrible snowstorms we’ve been having). He had about a week or so of feeling ok, but then Christmas came up (accompanied by the stress of the holidays & lousy eating habits – lots of sugar) and on the day before Christmas eve, his prostate started flaring again and hasn’t stopped. He’s really having a hard time dealing with the constant symptoms & has been recommended to take trimethoprim-sulfamethoxazole (TMP-SMZ) at 80-400 mg given twice a day or fluoroquinolone antibiotics (eg, ciprofloxacin at 500 mg or ofloxacin at 400 mg) twice a day or gatifloxacin/moxifloxacin at 400 mg daily. I don’t know anything about these antibiotics & was hoping someone could chime in with advice.
My big questions are these:
Can you take these other antibiotics concurrently with mino?
Have any of you guys out there had to deal with prostatitis while on AP?
Any advice, input, suggestions or info would be greatly appreciated.
I know this is a forum for AP, but I know how knowledgeable so many of you are that you’re my first line of defense when medical issues arise! 😉
Thanks in advance,
mj

[jims]

Hello mj, I have had similar issues a couple of times in the last couple of years. Last time I took Saw Palmetto and that helped allot. So much that after a couple of weeks I was able to quit the Saw Palmetto and am ok. Saw Palmetto is like everything else you need to research its contraindications. My Gp off the record agreed Saw Palmetto is a good treatment, after she checked my Psa. I can’t speak on the antibiotic combinations. jims

[mj47]

Thanks for your input jims.
My husband did take a supplement that had a large percentage of saw palmetto last month, but he didn’t feel like it helped at all. I wonder if pure saw palmetto would be different.
He’s been doing sitz baths & some other ancillary treatments as well.
I guess I’m really curious about the addition of the antibiotic trimethoprim-sulfamethoxazole (TMP-SMZ) at 80-400 mg given twice a day. That’s the one that was called in for him. He’s apprehensive about taking it.
Does anyone have experience with this drug?

Again, thanks for your input jims & I’m so glad for you that it cleared up! It looks like it’s difficult to endure.
~mj

[PhilC]

@mj47 wrote:

I guess I’m really curious about the addition of the antibiotic trimethoprim-sulfamethoxazole (TMP-SMZ) at 80-400 mg given twice a day. That’s the one that was called in for him. He’s apprehensive about taking it.
Does anyone have experience with this drug?

Hi mj,

I took that antibiotic for over three months about two years ago. I did not herx at all while I was on it. I took it again in September 2010 for a few days, but had to stop due an allergic reaction. It appears that I developed an allergy to sulfamethoxazole.

I believe the doctor who prescribed that medication for your husband may have made a mistake. That dose is only half the recommended dose, which is TMP-SMX 160/800 mg, twice a day, for at least four weeks (assuming it’s effective).

See:
http://www.aafp.org/afp/20000515/3015.html
http://www.acpmedicine.com/bcdecker/newrxdx/rxdx/dxrx0723.htm
http://www.medical-library.org/journals2a/prostatitis.htm

Phil

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

[mj47]

hey phil,

thanks for your response. if you don’t mind, could you tell me if you were taking tmp-smx for prostatitis as well? and, is the 160/800 dosage what your doctor prescribed for you?
my husband’s doc said that he rx’d the lower dosage bcz he thought it was possibly chronic bacterial prostatitis vs acute…but once i showed him the link that you provided from medical library journals (which gives that dosage for chronic), he said he had no problem with the higher dose.
thanks for your input on this.
mj

[PhilC]

@mj47 wrote:

hey phil,

thanks for your response. if you don’t mind, could you tell me if you were taking tmp-smx for prostatitis as well? and, is the 160/800 dosage what your doctor prescribed for you?

Hi mj,

Yes, that’s essentially correct.

Phil

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

[mj47]

Hey Phil (hopefully you’ll still get a notification on this thread),

My husband upped his TMP-SMX to 160/800 & did well for about 8 days then started having a low grade fever & feeling just terrible (nausea, chills). We suspected the antibiotic & he stopped because he was unable to get any sleep. In 48 hours he felt much improved.
Do you think that one can herx from prostatitis & taking TMP-SMX? Or do you think he was herxing from his Psoriatic arthritis & the med?
We were also wondering if he’d developed an allergy to it. May I ask what your allergy to the med was like?

Since then, he’s reintroduced it at a lower rate to see if he reacts & he hasn’t had a problem. He wants to continue taking the med because he felt like it was helping the prostatitis (even at the lower dose)…he just couldn’t stomach the higher dose. Weird, huh?
If you (or anyone else) has any thoughts on this, bring ’em thisaway please!
Thanks,
mj

[PhilC]

Hi mj,

Although those are considered severe side effects, it does not sound like an allergic reaction. If it were an allergic reaction, it is highly unlikely that cutting the dose in half would be enough to make it go away.

My main symptom of allergic reaction to sulfamethoxazole was an itchy rash accompanied by some swelling or puffiness. The last time I took TMP-SMX (160 mg / 800 mg), I took half a tablet. About 90 minutes later I felt hot, my face was red, and my eyes felt scratchy.

Phil

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

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