Time of day to take big 3

I take azithromycin in the morning after breakfast and rifampin and ethambutol 3 hours after dinner (on an empty stomach) at bedtime.

Thanks for the reply! How are you tolerating the meds? Any side effects?

Hello,
I started the big three in November. I can’t take them at empty stomach because it’s juts to hard on my stomach and I get nauseous. I usually get up at 7:30 do my ACT and have breakfast. At 11 I take all of them with a glass of water and about three crackers. Then I have lunch at 12. This works for me and I check with my ID doctor at NJH and she said that is good. I also have GERD so I don’t eat or drink after dinner.
I hope this helps.

I have been on the big 3 for 17 months. It was a little challenging in the beginning but now I am not having any problems.

I started the big 3 yesterday morning. I took a probiotic an hour before taking rifampin on an empty stomach. I waited an hour and took azithromycin and ethambutol with breakfast. I didn't have any side effects except my urine was bright orange from the rifampin! I'm on the MWF schedule and hoping that I don't feel sick as time goes on.

Thanks for the reply. I wish you lots of luck as you also start on this treatment journey. I have been postponing starting thee meds for a couple of weeks but need to start them. Im very nervous for side effects

Thanks for the reply. Do you take them daily? And what do you mean by challenging? Did you feel ill or was it difficult to get into a routine of taking them?

I also take the big 3 three times a week and I do take probiotics and Kafir first thing in the morning.
I did postpone them for 6 months because I really do not have any symptoms from NTM and BE but my CT of the chest it’s not improving with just ACT. So I’m hoping this will work in addition to the other precautions.

Sorry, I should have elaborated. I take the pills Monday, Wednesday and Friday. For the first few months I had a lot of nausea and some diarrhea. I was very sick with MAC and pseudomonas at the time so it’s hard to tell how much of my problem was the illness and how much was the medication. The doctor prescribed ondansetron for the nausea and it really helped. I tested negative for MAC in April and am still negative as of now. I hope to be off the antibiotics by April 2025. I occasionally still have diarrhea but it is not severe and usually ends quickly. It is important to take a probiotic while you are on this regimen. I take Align every day after lunch which is several hours after my morning antibiotic and many hours before my nighttime antibiotics. One other problem I had was some pretty severe heartburn which my doctor said was caused by the azithromycin. Regular antacids didn’t help so my doctor prescribed sucralfate oral suspension. I take it one hour before dinner on the days I take my pills. It is important to take it several hours before you take your antibiotics as it coats your stomach and may prevent the absorption of the antibiotics. There is so much to learn with this treatment and I will be happy to answer any more questions you might have.

Mary Jane Childs

Mary Jane, Are you on any medications for the pseudomonas? If yes will you share what medications and how you take them and how often?