Rifampin Generic? Name Brand?

[hollyanna]

Just wondering if rifampin has the same issues that minocyclin does with generic vs. name brand? I take the Watson lab version of minocycline and now need to pick up some rifampin. (I am going to MWF BID mino and rifampin).

[Maz]

@hollyanna wrote:

Just wondering if rifampin has the same issues that minocyclin does with generic vs. name brand? I take the Watson lab version of minocycline and now need to pick up some rifampin. (I am going to MWF BID mino and rifampin).

Hi Hollyanna,

Going after bartonella? I have to admit, I can’t recall if I used a generic or the brand when I was put on it (probably generic, though, as my carrier would have no doubt substituted). Everyone’s reactions to fillers, dyes, etc in both brands and generics will be unique. If your doc didn’t mention “brand only” on the script, then it should be okay to go ahead with a generic and see how you go. A lot of folk use Rifampin on the following site (Sriram and Stratton Protocols for chlamydias), so there may be some good info on this there or on LymeNet:

http://www.cpnhelp.org

http://flash.lymenet.org/scripts/ultimatebb.cgi

One thing rifampin does is to color bodily emissions a pretty flourescent tangerine color! Maybe your doc warned you about this already? Just thought to mention it in case it came as a shock. 😯

[hollyanna]

Ha – yes, he warned me about the orange urine. Today is the first day I haven’t taken antibiotics (since I am going to MWF). I was doing great all day until about 30 minutes ago when my shoulders suddenly filled up with fluid. These shoulders have been slowly but steadily losing their spongy swelling all month. It’s weird. Of course, my out of town doctor’s nurse said to “keep an eye on it” because it probably doesn’t have anything to do with the two missing doses of antibiotics today. I will – but I was liking my non-swollen shoulders a lot. I will go with the generic rifampin to start with.

[Maz]

@hollyanna wrote:

Ha – yes, he warned me about the orange urine. Today is the first day I haven’t taken antibiotics (since I am going to MWF). I was doing great all day until about 30 minutes ago when my shoulders suddenly filled up with fluid. These shoulders have been slowly but steadily losing their spongy swelling all month. It’s weird. Of course, my out of town doctor’s nurse said to “keep an eye on it” because it probably doesn’t have anything to do with the two missing doses of antibiotics today. I will – but I was liking my non-swollen shoulders a lot. I will go with the generic rifampin to start with.

Agh, so sorry to hear about this, Hollyanna…not fun. 😥 I think you came off your mtx and pred, didn’t you, in March, to start mino? You might be getting a bit of drug rebound now, if so, in addition to any herxing going on. Do what you can to keep yourself detoxing to keep that inflam at bay.

[hollyanna]

@Maz wrote:

Going after bartonella?

Maz, I am not sure what we are after with the Rifampin – I have an E. chaffeensis IgM blood test result of 20 which is the low end of “May or may not indicate active infection”. Perhaps my doc (Dr. B in NY- LLMD) thinks there is a pretty good possibility of either Human monocytotropic ehrlichiosis or bartonella (I have had a cat in my daily life since birth). All I know for sure is that yesterday, my second full day of Mino + Rifampin, I felt like there was a film of pain over my whole body and there was even a suggestion of the old fibromyalgia. This must have been a true Herx reaction. I am trying to figure out if this is good (body was definetly reacting to the antibiotics – esp. the rifampin, I think) or not.

I did stop the MTX cold turkey – but I now see that it had a negative impact on my blood count (my last MTX blood tests indicated a pretty severe anemia which has now improved significantly). I am hoping the antibiotics can now start taking care of their business.
Just so you know, this forum helps me (and my husband) so much. Since my doctor is in NY and I can only converse with him for a limited time on speaker (and not for free either 😕 ) It would be next to impossible for me to reasonably converse with him about chaffeensis and monocytotropic ehrlichiosis and bartonella on the telephone.

[Maz]

@hollyanna wrote:

@Maz wrote:

Going after bartonella?

Maz, I am not sure what we are after with the Rifampin – I have an E. chaffeensis IgM blood test result of 20 which is the low end of “May or may not indicate active infection”. Perhaps my doc (Dr. B in NY- LLMD) thinks there is a pretty good possibility of either Human monocytotropic ehrlichiosis or bartonella (I have had a cat in my daily life since birth). All I know for sure is that yesterday, my second full day of Mino + Rifampin, I felt like there was a film of pain over my whole body and there was even a suggestion of the old fibromyalgia. This must have been a true Herx reaction. I am trying to figure out if this is good (body was definetly reacting to the antibiotics – esp. the rifampin, I think) or not.
.

Hi Holly,

Well, the appropriate treatment for erhlichiosis would either be doxy (mino substituted?) and/or rifampin, so you’re on the right road to hit this coinfection and, if bartonellosis is also involved, it would be a two-hit shot with this combo.

The following Wiki link has info about symptoms/treatment of HME here:

http://en.wikipedia.org/wiki/Human_monocytic_ehrlichiosis

And another info link on the Medical Entomology website:

http://extension.entm.purdue.edu/publichealth/diseases/tick/monocytic.html

The LymeInfo.net site is a Lyme Literate website that also has some very good links you can scroll through to learn about various coinfections:

http://lymeinfo.net/coinfections.html

HME is transmitted by the Lone Star tick that is more often found down south (south east and south central regions of the US). This infection literally hijacks white blood cells, which are the body’s first line defense to fighting infections. With WBCs (monocyctes, granulocytes and macrophages) infected, this waylays immune function and will cause fibromyalgia-like symptoms.

The whole “past infection” thing doesn’t mean a great deal when one is chronically ill with Lyme, as many of these coinfections get holed up in our blood cells or in bio-films within the body, so when immune function is compromised, as with Lyme (which is so immune-suppressive) or commonly-used immune-suppressives, these coinfections rise to the surface to have their day in the sun.

It’s good to hear your anemia is improving as that can indicate another coinfection, babesiosis. Just keep a watch on that for a while, because sometimes the stronger coinfections play with us for a while and then the weaker ones make their way into the picture. This is why LLMDs will treat with a combination approach…so they can hit a few things at once (e.g. Lyme, bartonella and HME), but when symptoms resolve with that or progress plateaus, they then switch things up to hit a different part of suspected pathogen load. Labs can help a lot in this, so try to keep copies of all your labs as time goes on, just to watch your progress and so you can ask Dr. B questions as you go.

Two or three days in sounds like it could be herxing, especially if you’re experiencing an exacerbation of old symptoms. Sometimes some new symptoms might be experienced, too, like rashes or fevers. If anything becomes a concern for you while going through herxing, even if herxing becomes intolerable, that’s when to call Dr. B’s office.

In the meantime, while herxing (and just for general health), make sure to do what you can to detox to get rid of circulating toxins out of your body as swiftly as poss. There are lots of ways to do this…a simple one – drink lots of water and ensure regular bowel movements. FIR saunas are excellent for detoxing, but also epsoms/peroxide baths and the lemon/olive oil detox drink. These are all my own personal favorite ways to detox and perhaps others can chime in with theirs for you. There are a ton of old threads on detoxing you can read through, too, if you type in “detoxing” on the main page of the forum.

Herxing is no fun, Holly, I know…it’s hard for rheumatics and manifests differently for other AI diseases. People with neuro-borreliosis have a wretched time, too. It’s like one of those necessary evils, but LLMDs almost rub their hands together in glee when patients herx, as it means the patient is responding and the abx are hitting their targets.

Does that help any, Holly?

[hollyanna]

Maz, this helps tons. Thank you. 😀

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