Rifampin and Klonopin

[soxfan]

I have been having 3 weeks of hell trying to sleep. I either can't fall asleep until 1 or 2am or else I fall asleep and wake every one or two hours.

I started on Rifampin/Levaquin on March 4th. I am wondering if anyone knows if these drugs interact with Klonopin and somehow make it less effective.

I had been sleeping great on only 0.25mg of Klonopin until this month. Now even if I take a whole tablet which is 0.50 mg I can't sleep. I hope I am writing these correctly. I take half a milligram which was working well.

I have read online from other people that there is an interaction with Rifampin and Benzos but can't seem to find that same information from the drug sights.

I am not sure how much longer I can deal with either no sleep or terrible interrupted sleep......

 

[minkeygirl]

I don't know about interactions but Maybe you're having tolerance issues?

I rotate between several benzos and z drugs to help avoid that and add different otc stuff.

What works for me, and my sleep regiment of trazodone and suntheanine stopped working overnight, is layering several things to out me to sleep and keep me to sleep.

I've been having good luck with kava too although I swear it gives me the munchies.

 

[soxfan]

It just seems like such a coincidence that as soon as I start the antibiotics the sleep meds don't work any longer. I am going to do some more researching and if my sleep doesn't improve then I will talk to my Lyme doctor.

The thing is even upping the dose isn't helping....I used to take Kavinace but that stopped working.

 

[Ema]

Levaquin works on the GABAa receptor as do benzos.

See here:

http://www.pharmacologyweekly.com/a...oxacin-levofloxacin-moxifloxacin-gemifloxacin

It's not recommended to my knowledge to take the fluoroquinolones with benzos. I know they can exacerbate withdrawal symptoms from benzos.

Rifampin is a big time inducer of the CYP 450 3a4 pathway which metabolizes benzos (as well as many other drugs). This generally leads to a decrease in effectiveness of the benzo as well.

This is a tricky combination in my opinion. I'd check with your doctor.

 

[Ema]

Also:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2435654/

 

[Sushi]

@soxfan I take Rifampin and Klonopin. They do interact in that Rifampin will block some of the action of Klonopin, as it does with many medications. You have to time your doses far apart. I take Rifampin twice a day but take my last dose about 7 hours before bed. But each person may metabolize at a different rate. This has worked for me.

 

[minkeygirl]

@soxfan Even if it isn't tolerance, you might want to think about finding a few things to alternate. I was on klonopin for 7 yrs so I understand how great it can be. But I found relying on only one thing is not so good.

 

[soxfan]

@Sushi....Thanks for the info. I will take my second dose of Rifampin earlier in the day. I was taking at dinner which is only about 4 hours before my bedtime.
I actually checked with the pharmacist and he looked it up and for certain it does speed up the metabolism of Klonopin.

My LLMD called in Ativan yesterday and I took one last night and actually slept 6 hours straight before waking and then falling back to sleep. I know it isn't a great solution but after 3 weeks of basically NO sleep I needed to. I will try the Rifampin earlier in the day and see how it goes.

@minkeygirl...I have been on a quarter milligram of Klonopin for 2.5 years and it is the only thing that has ever worked for me to fall asleep and not leave me hungover the rest of the day. I will take it until I know it isn't working anymore because I have had 10 years of horrendous sleep including a 6 year nightmare on lunesta or ambien.
Believe me when I say I have tried just about everything there is for sleep and either it didn't work...I had to take too much and be a zombie the next day...Klonopin for now is my miracle sleep med. Thanks for your post!

@Ema...I actually have to take Levaquin as it is the only thing that worked on my Bartonella 7 years ago. I have been on many different combos and this is the one that seems to be working. I haven't had a Bart rash in 3 weeks. I have been sick 10 years with 2 Tick bites so I do what I have to in order to live the best life I can. I do appreciate the info you provided though. I always like to keep myself informed.

 

[minkeygirl]

@soxfan I was like you, until my standby of trazodone stopped working. I had nothing for sleep for weeks. That was a nightmare.

All I'm saying is start trying to find stuff now while you still have something to help in case they don't work. I take a minimum of 5 things (to start). I hated having to do that but without anything I won't sleep at all.

 

[soxfan]

I have been taking the Rifampin earlier in the afternoon and it seems to have helped. I did have to up my dose of Klonopin to half milligram from a quarter milligram. Sometimes I also take half milligram of Ativan to keep me sleeping.

My doctor gave me a 30 day of Ativan in case it is needed as well...

 

[bmoberg337]

I have been taking the Rifampin earlier in the afternoon and it seems to have helped. I ...

Not sure if your doctor would agree to this, but my LLMD has me taking both doses of Rifampin in the morning. There is some research that suggests higher blood concentrations (rather than sustained levels) have better bactericidal activity.