Brinsupri experience after 3+ months

Posted by scoop @scoop, Jan 2 10:34am

Brinsupri may take 3–6 months to reach full effect.
Please use this thread to share first-hand experiences only if you have been on Brinsupri for 3 months or longer.

To keep this discussion useful and focused, let’s limit comments to actual outcomes, side effects, or changes you’ve observed after at least 3 months of use.

General questions, early impressions (< 3 months), speculation, or unrelated discussions please post in a separate thread.

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

Profile picture for blm1007blm1007 @blm1007blm1007

@irenea8 The other day I wasn't sleeping well and dizzy at times.
Due to my past experience I felt it was that I had wrongly cut back on the amount of D I was taking and was therefore not taking enough Vitamin D. I went back to my regular routine of the amount and slept better and dizzy/vertigo spell stopped.
I found, for me, that when I am on certain types of medication it affects my D level and it goes lower.
I know you do the D but thought I would tell you of my experience and findings for myself.
Barbara

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@blm1007blm1007
True vertigo is not the same as dizzy. Severe vertigo is very frightening and awful to experience. I am taking plenty of D and even if it was a bit low it could not cause those extreme symptoms. I mostly suspect it was reaction to Brinsupri.

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Profile picture for scoop @scoop

@irenea8 are you thinking to stop it? I’m almost at the six month mark and starting to see quality of life benefits.

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@scoop, Glad to hear that Brisupri works for you. When youy say that you start seeing quality of life benefits, could you elaborate a bit? I imagine it is due to lessen the mucus production?
I am also close to six months old. I don't know if it works for me because when I started I had shortness of breath and fast heart beats. Shortly after taking Brisdupri, the symptoms were gone, but not long after they came back. After seeing my pulmonologist, he said that I had a flare-up. 5 days of prednisone cleared everything. Now my pulmonologist thinks that my symptoms were related to elevated eosinophil. It is so hard to sort things out, everything murky and blended together.

Hope you are continuing doing well.

Ling

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Profile picture for irenea8 @irenea8

@blm1007blm1007
True vertigo is not the same as dizzy. Severe vertigo is very frightening and awful to experience. I am taking plenty of D and even if it was a bit low it could not cause those extreme symptoms. I mostly suspect it was reaction to Brinsupri.

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@irenea8, so sorry to hear about your experiences with the drug. Hope you get better soon.

Ling

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Profile picture for @ling @wangling

@scoop, Glad to hear that Brisupri works for you. When youy say that you start seeing quality of life benefits, could you elaborate a bit? I imagine it is due to lessen the mucus production?
I am also close to six months old. I don't know if it works for me because when I started I had shortness of breath and fast heart beats. Shortly after taking Brisdupri, the symptoms were gone, but not long after they came back. After seeing my pulmonologist, he said that I had a flare-up. 5 days of prednisone cleared everything. Now my pulmonologist thinks that my symptoms were related to elevated eosinophil. It is so hard to sort things out, everything murky and blended together.

Hope you are continuing doing well.

Ling

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@wangling Like I say, I'd like more time with Brinsupri before declaring success. In terms of QoL issues, it really gets down to the decreased mucus as of now. That could change as I recently had Covid, recovered well with a course of paxlovid but needed rescue abx (as I was traveling). Much to my surprise I recovered quickly and well. Daily mucus might increase again over time, I just don't know. My hope, of course, is that it stays diminished. Time with tell...

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I believe the clinical trial showed that the 25 mg dose reduced the decline of lung function. In Europe they only approved the 25 mg dose and this was one of the reasons why.

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Profile picture for sweethighland @sweethighland

@sueinmn Sue, are you taking 10mg too?

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@sweethighland I am not taking Brinsupri at this point. My pulmonologists (I have a team) and I discussed it at length. One specializes in MAC & Bronchiectasis, the other in Asthma & Allergies.

Their criteria for prescribing is to have at least three of these issues:
3 or more exacerbations in a year, unstable or worsening Bronchiectasis as seen on a CT scan, worsening FEV (forced expiratory volume) in a lung function test, evidence of mucus plugs, excessive mucus production, worsening cough, worsening shortness of breath (SOB).

I don't meet the criteria, and I have asthma which must be controlled with Symbicort, containing an inhaled corticosteroid, so they feel the need to be extra careful. I also have allergies, essential tremor, coronary artery disease and rheumatoid arthritis, and they do not feel there is enough information about how Brinsupri might interact with those medications. Both docs are very into research and are watching carefully to see what the future information shows as the drug prescribed in the "real world."

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@phoenixrises I saw your post about thinning hair on a previous Brinsupri thread. You might wish to read through this thread here as I know it's been talked about. There are things you can do for thinning hair. I believe you need to speak with a dermatologist. Hair thinning is not one of the hallmark side effects of Brinsupri but I guess it can happen. Older age can bring it on too along with genetics.

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Profile picture for clynnp @clynnp

I started taking Brinsupri 25mg on October 1, 2025. I have bronchiectasis with MAC. At the time, I was being treated for pneumonia/infection. I had been diagnosed with the pneumonia in June 2025, and it had never cleared. I was back to the ER in September and twice in November. I don't think the antibiotics that were prescribed were right - included a lot of Doxycycline, with Augmentin added in September. I can't tolerate Levaquin. In November, I was prescribed two rounds of Azithromycin and Augmentin. Although I felt extra sick and developed a bad rash from the Azithromycin, it helped. Early this month, I developed acute bronchitis and was prescribed prednisone 40 mg for 5 days, and am now on Augmentin for 14 days. My last CT was 1/8, and the infection has still not cleared in my lower left lobe.

During all of this, I continued taking the Brinsupri. I have developed a lot of skin problems. I feel like I have been living in a dehydrator machine. The worst of it started in my 3rd month of taking the medicine. My lips have been terribly chapped, and my skin is very dry. I have developed hyperkeratosis on the soles of my feet and palms of my hands. The soles of my feet and palms of my hands burn and itch constantly. I also developed two odd looking sores that didn't heal, one on each leg. My pre-cancers on my hands were treated in November 2025, and they already need to be treated again. Last week, the dermatologist froze the leg sores, prescribed a super-strength corticosteroid to use for 2 weeks on the soles of my feet and palms of my hands, and scheduled PDT blue light treatment for the top of my hands.

I have also lost a considerable amount of hair. I noticed that it was getting dry and brittle on the ends, and then it just started falling out. I see my hair stylist every month, and she confirmed that my hair is much thinner. I can't style it as usual, so am just pulling it back in a banana clip.

I don't think I've developed any dental issues, but am scheduled to see the dentist in February. I also have bloodwork scheduled in February to check liver enzymes.

The positive things noted while on Brinsupri: My sputum was thinner, I had fewer coughing attacks (except for the recent bronchitis episode), I was sleeping better and I have not had hemoptysis since mid-November.

I met with my pulmonologist this week on Wednesday. I have decided to stop the Brinsupri for now, hoping my skin and hair problems resolve. If I do resume use, it will be at the 10 mg dose. I am concerned about side effects from stopping the drug. Hopefully, those will be minimal.

I hope that most of you don't experience these difficult side effects, as they are supposed to be rare. Good luck to all!

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@clynnp I had three flareups in the last 4 months and were treated with two rounds Azithromycin and Augmentin. Then my sputum tested Staphy (MSAA) which is gram positive bacteria. Both my Stanford ID and Sutter Hill suggested me to switch to 10-14 days of Linezolid. It worked magic after just 4 days on it. I also heard MSAA is rare for Linezolid resistant and I can use it again frequently in the future.

I am starting Brensupri 25mg next week for my BE. I was last tested positive MAC not one time out of 7 culture tests.

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