Azithromycin, Ethanbutol, & Rifampin Drug Therapy for MAC

Posted by cmi @cmi, Dec 11, 2020

I have just begun my drug therapy for MAC. Question, does anyone have any advice on how to take the cocktail of azithromycin, ethanbutol, & rifampin, and suffer the least discomfort. I am taking my meds at night 4 hrs PO after I go to bed (set alarm clock and wake up to take) 3 days a week. I was very discouraged by pharmacist and ID doctor on how brutal the meds are to the system.

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I don't understand why more research hasn't been done to kill this bacteria since it isn't so rare anymore !!!! Drs don't seem to care about the person it's affecting but are only treating a disease .My four Infectious disease Drs couldn't care less about my weight ,appetite or me as a human just about the disease .I'm at the end of my rope with pill after pill making me feel worse than ever !! They really should have waited for me to try to put some weight back on as I will die of cachexia not ntm !!!.

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Has anyone ever skipped a dose of anzithromicin to make it through the day to not feel sick for an appointment or to get something done .Like just forgetting a dose for a day ??? I'm only on 125 mg in the morning two ethanbutol at night .both aren't great but no problems taking the night dosage just the morning pill .I need to get to my Dr appointment and don't want to be sick it's an hours drive !!

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@marthamac

I don’t think my nausea /cramping response to the Nuzyra has changed at all after taking it for a year. If I premeditate with the Zofran half an hour before taking it I rarely have an issue though. At least that's my impression. I never skip the Zofran. But once in awhile it doesn’t work for some reason. Maybe I don’t get the timing just right, or my stomach is more or less empty than usual, or who knows. Then I’m in for at least an hour of incapacitating and miserable GI stuff.

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Thanks for your response. i will have to ask my Dr about Zofran. i have been lucky with the Azithromycin and Rifampin (on now for almost 2 years) but the Ethambutol I had to go off for eye problems, Then they put me on Arikayce for 8 months and the cough was terrible they took me off that as well. That's when they added Nuzyra. Hope with time the effects will get better.

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@nonamebrand

I was warned that this would not be fun and it certainly isn't .Drs said I might have had this for years and I never had any symptoms still don't but am now on two meds ..ethambutol and anzithromycin .and I feel terrible .I don't know how much more I can take ..only took them on advice that the cachexia I now have will go by doing the meds ..it took me a month of very low dose of ethambutol to start since I'm down to 80 lbs .and then bumped up to two pills per night ...took a month to get used to that ,now the anzithromicin is a half dose and my appetite is now totally gone !!! So back to not eating .Seeing Dr on Mon and hoping he has the good sense to put me on a three times a week schedule so I can take a day off now and then .This every day thing is killing me ..18 months of this ??? No way I nor my husband can handle this !!!😥

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My experience with azithromycin, ethambutol and rifampin was not good. Azithromycin caused hearing loss after 2 months of taking it. My ophthalmologist warned me that ethambutol could affect my vision.
My experience with clofazamine as a substitute was also bad, because it caused intestinal blockage.
I am not on any treatment now; only nebulizer for air clearance.
The antibiotics were not tolerable for me.

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@nonamebrand

I don't understand why more research hasn't been done to kill this bacteria since it isn't so rare anymore !!!! Drs don't seem to care about the person it's affecting but are only treating a disease .My four Infectious disease Drs couldn't care less about my weight ,appetite or me as a human just about the disease .I'm at the end of my rope with pill after pill making me feel worse than ever !! They really should have waited for me to try to put some weight back on as I will die of cachexia not ntm !!!.

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I agree. It is hard to believe that no treatment can be found that doesn’t make you sicker than the disease itself .
Perhaps there is not enough incentive for it since it mostly is appearing in the elderly .

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I was told many times that it's in our water system here in Florida ,years ago they used a substance in the system to kill another bacteria that was affecting many ,but they never put anything in for ntm bacteria which is now very prominent not only in Florida but Texas Hawaii and now other farming states .Our wonder government when was offered money by the President refused to take it to clear up our system !!! Talk about caring for your people !! In this country only the rich can stay healthy !! .Unless you can get to NJC or somewhere that specializes in ntm your stuck with whatever you can get !! It's very sad !! 😂

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@aprado31

I agree. It is hard to believe that no treatment can be found that doesn’t make you sicker than the disease itself .
Perhaps there is not enough incentive for it since it mostly is appearing in the elderly .

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I completely agree with you. For a disease that is up and coming in the elderly and those younger I would hope more drs would become knowledgeable in the disease and drugs would become more plentiful and cheaper.

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how are you doing now? finished with the Big 3? Did they work? Are you cured?

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@nonamebrand

I was warned that this would not be fun and it certainly isn't .Drs said I might have had this for years and I never had any symptoms still don't but am now on two meds ..ethambutol and anzithromycin .and I feel terrible .I don't know how much more I can take ..only took them on advice that the cachexia I now have will go by doing the meds ..it took me a month of very low dose of ethambutol to start since I'm down to 80 lbs .and then bumped up to two pills per night ...took a month to get used to that ,now the anzithromicin is a half dose and my appetite is now totally gone !!! So back to not eating .Seeing Dr on Mon and hoping he has the good sense to put me on a three times a week schedule so I can take a day off now and then .This every day thing is killing me ..18 months of this ??? No way I nor my husband can handle this !!!😥

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Couldn't you go on three times a week by yourself? The doctors know a great deal, but are also sorting all of these things out, and there is not perfect equation often.

Mokie

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@nonamebrand

I'm 73 perfectly healthy woman who started losing weight after being put on tramadol for chronic back pain .Went from 118lbs down to 90 the to 80 lbs in less than a year after two trips to the hospital and being diagnosed with severe depression just sent home with a bunch of antidepressants which I couldn't take finally the md there called in a scan pulmonary Dr said she knew immediately what it was ,this could have been diagnosed a few years ago and could have been easier to deal with if I had better Drs !! Bad doctoring is everywhere but Florida is the worst !!! Can't believe how much I'm suffering and it's just beginning ,I just want to feel normal just for one day !!! 😥

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It took my Dr over tons of tests for over two yrs, then I changed Drs to really great Mayo trained Internal med Dr and he fought insurance to be able to do a bronchoscope as I was finally coughing up blood . Results came back positive and had 60 days of IV Amikacin , Moxicycllin , daily with oral Clarithromycin twice daily and oral Ethambutol. I also, by that time needed monthly IVGG ( which I still get every six weeks) . During three years of misdiagnosising; everything tanked and many nodules developed . I tolerated the Ethambutol for a year but had optic nerve damage so my Eye Dr stopped it after MRI .I saw my eye Dr every two months while on Ethambutol . During the three years of suffering and finally getting a Dr to truly investigate, I yawned constantly , had to push into my lower left lobe just to get a breath and had chronic night sweats , and could only get a normal breath if I was totally flat . Extremely tired, severely depressed and lost all hope as when I went to ER they treated me like I just needed an inhaler and a psychiatrist. My CBC and other labs came back fine and I had no elevated temp. So , I know this is very long but I thank God every day for that Dr who saved me and I just want to share that if you do not have a Dr that can figure it out; keep searching and fighting for yourself with this silent destructive lung infection . I completed my antibiotic treatments in 2013 and I am doing fine now , still getting IVGG every six weeks , but just want to share my story to help others

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