Just started big 3 for MAC: Questions about dosing and more

@poodledoc Thank you. I actually just purchased some from Pure Encapsulations. I will definitely try them as well. irene5

Sorry so late in replying to your post. I don’t get time to check regularly sometimes. For what it’s worth, I’ve been on the “three” daily for 6 months. Think my year is just starting as just had first negative sputum. I was worried about GI effects and started taking Kyolic (there is a lot of research on aged garlic extract and the gut biome) two (600 mg) twice a day along with 600 mg NAC (Lung support as it’s a precursor to glutathione) twice a day as well. My gut has been fine and it even got rid of food allergies I have suffered with for years. I also take a probiotic when I think about it at night. I take Kyolic when I get up in the morning, then antibiotics and NAC with my blend of hot cocoa, coffee and collagen. I had a little nausea at first, and took something for that, but never not one day of cramping or diarrhea. Gas yes, but I’m not complaining. I started to feel better in general after about 6-8 weeks on the antibiotics. I hope this helps. It’s good to have a variety in info available. Don’t give up, it will get better!

sam33, you take kyolic and NAC with the antibiotic? How often do you take the meds? Just wondering if taking antibiotic is ok with NAC. I’m also taking the antibiotic 3x week. Thanks Cila

Hi Cila. I take daily. Morning I take 2 Kyolic when I get up. Only wait on NAC so I have a little something in my stomach so I take at same time as antibiotics. Then in the evening when I eat, I take both again with food. ID Doc knows and simply doesn’t care one way or another. He’s 100% pharm and believes little concerning supplements, but that’s ok. We are all entitled to our own opinion (at least we used to be! Not sure of anything anymore!). All my bloodwork has been fine and GI is great. That’s all i need to know😊

I am starting the Big 3 today after a long Covid delay. My Dr. is introducing them one at a time, but I am wondering what time of day you take your drugs? With or without food? I am requesting clarification from the physician but curious to know what the schedule looks like for others. Thank you! Nancy

My pharmacist was very helpful in scheduling my Big 3. I take every Monday, Wednesday and Friday - 2 Rifampin first thing in the morning ( no food ), then 3 1/2 Ethambutol at lunch and then 1 Azithramycin at dinner. Hope this helps and I absolutely hope you can tolerate your meds. Best of luck to you !

@n4seth The schedule for taking the Big 3 has to be what is best for you and how you can tolerate them. What Toni1132 said is probably quite good. The only thing I would add is if you need a probiotic you should probably take that first in the morning on an empty stomach. Rifampin can be one hour before or two hours after a meal with a full glass of water. Ethambutol and azithromycin can be taken after breakfast with a full glass of water eight hours before or four hours after your daily multivitamin. Your vitamins and probiotics should be separated from the antibiotics by at least four hours. NOW foods probiotic-10 or Ultra Jarro- Dophilus (50 billion per capsule) are good ones. I follow a schedule a former mentor used during her MAC journey. irene5

Everyone has great suggestions. Welcome to this group. You will find a lot of support here. I learned about nebulizing 7% sodium chloride here and it has really helped. I take Rifampin first thing and I split up the other two. Ethambutol at noon with lunch and Azithromycin at dinner. Taking more than 3 pills at a time can really upset your stomach. But, everyone is different. Welcome and hang in there!

Thank you to everyone who has replied. Day 1 went well.....tomorrow I add the ethambutol. Keeping my fingers crossed!

Finishing up on 15 months of the Big 3 at the end of May. At least I hope so. CT of Chest coming up soon so I will know if I can quit altogether. IDC doc had already reduced the azithromycin to one/day as I was showing signs of clearing. I have taken a good probiotic and ClearLungs by Ridgecrest every night. Rifampin before breakfast, azithromycin 1 hr after and ethambutol 2 hrs. after. Luckily, no side affects other than a bit of hearing loss - but I guess to be expected at 73! One thing I've done which might help you is I was able to considerably reduce the cost of the drugs. I had my dr. request approval of a Tier Exception by my insurance carrier Humana. They agreed to reduce to a Tier 1 copay which lowered my copay considerably. Best of luck with the antibiotics - get plenty of exercise and fresh air - breathe deeply!!