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.

@ellenn

Thank you for your reply, Sue.
Where do you buy the 7% hypertonic saline?
Have you done the nebulizer with the aerobica attached? Do you need the 7% ?
Ellen

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I get my 7% saline with a prescription for less than half what it costs without. I use the higher strength because I still have MAC but cannot tolerate the antibiotics anymore. With my pulmonologist's blessing I neb once a day with the saline. If I am having an asthma exacerbation I neb first with Levalbuterol then saline. If I am congested or coughing a lot I use saline twice a day. Usually I only neb about 3/4 of the solution.

This has been working for me since last December.
Sue

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@tinaesims

I split mine up. I am also on synthroid so when I wake up, I take it. I wait 2 hours and take my first dose of ethambutol and my only dose of azithomycin. Before I go to bed I take my other dose of ethambutol and rifampin. I have not had gut issues and I've been on for a year. I do have ringing in my ears and it wouldn't matter what time of day I took my drugs for that. I am on 3 times a week too but they are talking about going to daily. If someone has a better regimen I'd like to hear it too. The rifampin was interfering with my synthroid. It seems to be working giving a 2 hour split.

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Do you take only one dose of rifampin three times a week?

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@erikas

@cmi Welcome to Mayo Clinic Connect, a place to give and get support. You will notice that I changed your conversation to, "Azithromycin, Ethanbutol, & Rifampin Drug Therapy for MAC."

I did this so you could connect more quickly with active members of the MAC groups like, @thumperguy @windwalker @heathert @brigby @poodledoc more quickly.

You are looking for ways to better tolerate the medication trio. May I ask what your provider has offered as an alternative to the medication trio?

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@erikas I have been following Mayo NTM for about a year. Just a note, not every good at following sometimes. Recently someone mentioned a few podcasts. I picked up on NTMtalk. It has been very helpful for me to see the big picture. As a moderator, I thought maybe you could mention this to the group. Thank you.

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@crepass

@erikas I have been following Mayo NTM for about a year. Just a note, not every good at following sometimes. Recently someone mentioned a few podcasts. I picked up on NTMtalk. It has been very helpful for me to see the big picture. As a moderator, I thought maybe you could mention this to the group. Thank you.

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Thanks! By mentioning it here, you have mentioned it to the group. Here is the link if anyone wants to take a look – https://ntmtalk.com/ This is brought to us by a pair of doctors highly experienced in treating Bronchiectasis and NTM (non-tubercular mycobacteria or MAC). We can always use another reliable source of information.
Sue

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