Suggestions on taking the Big 3
I was diagnosed with MAC early 2025 and will be starting my Big 3 treatment this week. I am very nervous because I have many digestive issues and am concerned about how my system will react to the different antibiotics. How do people take their pills? All at once? Spread them out to get the best results from avoiding nausea and other digestive issues.
Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.
Welcome to the group. I'm sorry you need to be here, but think you'll find it a helpful group. Tell us a bit more about your situation. How are you feeling now? Are you being seen by someone who sees a lot of patients with MAC? It's not common and some pulmonologist rarely treat it.
There have been other post with same concerns. Here's one.
https://connect.mayoclinic.org/discussion/started-big-3/
I'll post another and I believe others members will chime in.
Here's a group of very helpful links on ABC's.
https://connect.mayoclinic.org/discussion/resources-for-the-abcs-on-bronchiectasis-and-mac-ntm/
Thank you for your reply. I was diagnosed by my pulmonologist and he sent me to an ID. I still see my pulmonologist every four months to check my breathing. My ID doctor came highly recommended by my pulmonologist, the jury is out on if he and I are compatible. I nebulize four times a day using sodium chloride and albuterol. That has helped a great deal. My pulmonologist prescribed Trelegy once a day, but not sure that helps.
I use to be very active, play golf, volunteer and walk, but I can hardly get out of be most days. My kids and my pulmonologist tell me I should at least try the Big 3. I'm 77 and not ready to give in to this disease, but scared of the side effects.
@shirleyrr0 Sorry to hear you're feeling so poorly. When I was initially prescribed the Big 3, I was put on a 3 day regimen. Did your doctor prescribe the meds for 3 day per week or every day? That would make a big difference. I also have a sensitive digestive tract so the way I did it was azithromycin on Monday after dinner in which I limited vegetables because I found that created more of an intestinal problem for me. With no veg, I would sometimes get a bit gassy a couple hours later but not too bad and it would go away. The next day, I would take the rifampin on an empty stomach and not eat for 2 hours after, then I would have lunch. No problem with rifampin. I would take the ethambutol that evening after dinner, no problems with vegetables. No nausea with any of it. That schedule seemed to work pretty well for me. It was every other day in that manner, with no meds on Sunday. Best of luck with everything. This site is invaluable for advice and support!
@shirleyrr0 Azithromycin & Ethambutol can be taken with or without food. I take both in the morning after breakfast. Rifampin should be taken at least 1 hr before or 2 hrs after a meal, for best absorption, so I take that before I go to bed. A probiotic is recommended and should be taken 4 to 5 hours before/after any antibiotic so I take mine around 12 noon. We all react differently to the antibiotics. I will pray you can tolerate them with little discomfort.
Thank you for your input. I was thinking along the same lines to spread out each dose. I have to take them everyday. I also take a probiotic. Thank you for your prayers.