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Rifampicin (Rifampin) Herx or adverse reaction.

xrunner

Senior Member
Messages
843
Location
Surrey
How can we really tell if it is an adverse drug reaction or a herx?
Hi @justy,
generally speaking one can be sure of a herx only after the end of the course if and when there's been some improvement compared to before. As a rule of thumb herx reactions can take a few days to kick in. Burrascano in his Lyme guidelines says (if I remember this right) of at least three days of continuous bacterial killing. In my case when it happened it would happen from around day four or five. If you had such a quick reaction I would consider it a hypersensitivity reaction.
It's a shame Rifampin is a very effective abx which I took for some time (together with Minocycline and at some point zithromax) as it can act simultaneously against CPn, Bartonella and Lyme and many other often resistant infections. But there are good alternatives such as those your dr has come up with and as treatment progresses and recovery starts, we can also overcome sensitivities . Best wishes.
 

justy

Donate Advocate Demonstrate
Messages
5,524
Location
U.K
Thanks @xrunner - useful information. Do you know if Burrascano has a good book worth reading? I saw him interviewed in Under our skin and thought he came a cross very well.
 

xrunner

Senior Member
Messages
843
Location
Surrey
I only read his guidelines but I think he wrote a book which I haven't read it so I wouldn't know if it's good book. Sorry, I'm not up to date as this past year I haven't been as much in touch with the Lyme community as I used to be.
 

Sushi

Moderation Resource Albuquerque
Messages
19,935
Location
Albuquerque
Just to let you all know that I couldn't get through to the clinic by phone so sent an e mail marked urgent treatment question and they replied within 3 hours! I'm pretty impressed.

My doctor said to definitely not take any more Rifampicin and to start 500mg clarithromycin 1 x daily and then after to weeks add 200mg 1 x daily Doxycycline.

I hope this will be a better combo - and perhaps with a few weeks off of all drugs I will fieel a bit stronger and ready to go again.

Great justy! I hope this works better for you. We are all so different in our response to meds. It is impossible to predict what drug might wipe us out! So glad you got a quick response.

Sushi
 

barbc56

Senior Member
Messages
3,657
@justy

I think what @xrunner said makes a lot of sense whether you are having a herx or adverse reaction. That had to be scary.

Is your doctor having you take a short break to get the medication out of your system and give you a chance to rest or is that counterproductive?

These things happen and sometimes its next to impossible to predict when they will.

Treat yourself kindly, rest up and hopefully you will feel better soon.

Barb
 

Hanna

Senior Member
Messages
717
Location
Jerusalem, Israel
@justy

I think what @xrunner said makes a lot of sense whether you are having a herx or adverse reaction. That had to be scary.

Is your doctor having you take a short break to get the medication out of your system and give you a chance to rest or is that counterproductive?

These things happen and sometimes its next to impossible to predict when they will.

Treat yourself kindly, rest up and hopefully you will feel better soon.

Barb
My Doc advised me to take a four days break before beginning a new ABX after a bad reaction. (That was to amoxycillin) I felt it was not enough and took a whole week...
 
Messages
41
How can we really tell if it is an adverse drug reaction or a herx?

I started this antibiotic to treat Bartonella. I also have chlamydia pneumonia chronic and possible Lyme.

My reaction was that within an hour of taking 300mg I felt extremely confused, agitated, weepy and slightly short of breath with facial flushing and heat. The confusion and feelings of paranoia, alongside a type of dizziness wore off as the drug left my system over the course of the day - approx. 8-10 hours later I felt almost back to my normal.

Next day same thing, but added to this was an upper left sharp stabbing pain. The third day I was too afraid to take it, but aware that I am supposed to push through a herx I took a lower dose - despite the dose being lower the effect was exactly the same, and also wore off.

So I stopped it after this and felt fine - in fact I then had two really good days and I haven't had a single good day in many months.

The internet is awash with peoples experiences of taking Rif for Bart - and many people talk about horrific herxes, or side effects. But how can we tell which it is.

I went to see my regular GP and she suggested I stop - she wasn't sure if it was an adverse reaction, but felt certain that I should stop when I told her that I had been feeling so much more ill than normal for so many months now that the effects of the drug where pushing me over the edge emotionally and psychologically and that I was having some suicidal ideation (now I am back off it that seems weird).

Today I saw the respiratory nurse at my local hospital - she was shocked that I had been given Rifampicin - she said it was a hard drug and not given much.

I am concerned tjhat perhaps what people think of as herxes are just adverse reactions. I have spent a lot of money on testing and travelling to see an M.E specialist and so much want to follow their plan and get better, but I feel like I have failed at the first hurdle. I am not feeling brave at all. I don't want and cant risk making myself worse right now.

What experiences/knowledge do others on here have with this drug or with herxing and bacterial infections?

I have the exact symptoms on many natural anti-microbials as well as prescription medication (antibiotics,anti-fungal,anti-virals)

It's hard to tell if it's a drug reaction or a herxheimer reaction, the way I see things is that it's most likely a 'herx', even though all of the symptoms you describe are listed as adverse effects on many antimicrobials.

Believe it or not I have felt extremely confused as if I didn't connect to anything, severely agitated, anxious, weepy and slightly short of breath with facial flushing and heat and burning all over... could add 10 more symptoms .... from natural products such as cats claw, japanese knotweed, GSE and coconut oil, colloidal silver gives me similar reactions...

Though my worst reactions have been on acyclovir and fluconazole... (Diflucan) .... something that gave me a lot to think about. I am LOADED with yeast (I have oral trush, esophagus trush and lately went down al the way into my digestive tract) and herpes type viruses as well as HPV and EBV. I've also been tested positive for mycoplasma, borrelia afzelii, garini and burgdorferi.
 

justy

Donate Advocate Demonstrate
Messages
5,524
Location
U.K
I have the exact symptoms on many natural anti-microbials as well as prescription medication (antibiotics,anti-fungal,anti-virals)

It's hard to tell if it's a drug reaction or a herxheimer reaction, the way I see things is that it's most likely a 'herx', even though all of the symptoms you describe are listed as adverse effects on many antimicrobials.

Believe it or not I have felt extremely confused as if I didn't connect to anything, severely agitated, anxious, weepy and slightly short of breath with facial flushing and heat and burning all over... could add 10 more symptoms .... from natural products such as cats claw, japanese knotweed, GSE and coconut oil, colloidal silver gives me similar reactions...

Though my worst reactions have been on acyclovir and fluconazole... (Diflucan) .... something that gave me a lot to think about. I am LOADED with yeast (I have oral trush, esophagus trush and lately went down al the way into my digestive tract) and herpes type viruses as well as HPV and EBV. I've also been tested positive for mycoplasma, borrelia afzelii, garini and burgdorferi.

So sorry to hear of all of your problems. I went on to try the antibiotic Doxycycline - all over intense body itching after two hours of taking a single dose. This was considered an allergic reaction so I am now on clarithromycin and so far after two days low dose, ok - some worn out dizzy feeling after a couple of hours and today some slight itching, but I don't think I am allergic to this one.

someone on another forum suggested I try and get some proper testing to find out if I really do have an allergy to these antibiotics, and I am currently trying, with little success to find one in the UK - it can be done on the NHS, but could take many many months before I see anyone.
 
Messages
41
So sorry to hear of all of your problems. I went on to try the antibiotic Doxycycline - all over intense body itching after two hours of taking a single dose. This was considered an allergic reaction so I am now on clarithromycin and so far after two days low dose, ok - some worn out dizzy feeling after a couple of hours and today some slight itching, but I don't think I am allergic to this one.

someone on another forum suggested I try and get some proper testing to find out if I really do have an allergy to these antibiotics, and I am currently trying, with little success to find one in the UK - it can be done on the NHS, but could take many many months before I see anyone.

Hey - May I suggest something?

I have systemic yeast infection, tested positive for C. Albicans, endoscopy showed my esophagus coated with candida and it's down all the way in my digestive tract.

If you have the possibility to do an upper and lower endoscopy and candida shows up in colonies - then forget lyme, forget antibiotics for good. Candida is the culprit in most cases where people think it's lyme.

Antibiotics fuel candida and will only make you more ill.

PM me if you want to discuss more on the subject.

God bless