Taking All 3 At The Same Time Every Day?

Hello Group, I looked and didn't see anything about taking the 3 meds every day together. I was splitting them up morning and night but my doctor didn't like that. This is my second go around and the MAC is super stubborn. I started to take them again every morning at 6:00 AM and my stomach just doesn't like it. I am wondering if there is any info on the efficacy of the meds when divided vs altogether.
Thank you!

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I take all mine about an hour before bed. My doctor is fine with that.

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I looked into this a while back as had heard that some docs advised taking all together and couldn’t find any evidence that time of day or taking at same time makes a difference- azithromycin definitely needs to be taken with food, ethambutol with or without and rifampin on an empty stomach
I mostly took rifampin on waking and then others with food an hour later, mostly for convenience to be done for the day. Given how slowly the bugs divide/ grow, it seems improbable that you are going to hit them with any particular medication timing so do what is best for your stomach !

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@dulwich

I looked into this a while back as had heard that some docs advised taking all together and couldn’t find any evidence that time of day or taking at same time makes a difference- azithromycin definitely needs to be taken with food, ethambutol with or without and rifampin on an empty stomach
I mostly took rifampin on waking and then others with food an hour later, mostly for convenience to be done for the day. Given how slowly the bugs divide/ grow, it seems improbable that you are going to hit them with any particular medication timing so do what is best for your stomach !

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Thanks! I am going to stick with azithromycin and ethambutol in the morning and rifampin before bed. Taking them altogether really messes with my guts and, at this point, I am more into quality over quantity. If I have to live with this for the rest of my life then I will find the best way to manage my drug intake. Thanks for the thumbs up and the info. You all are so very helpful.

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When my MAC drug regime was introduced in 2018, I nearly quit after the first 2 weeks because the side effects were a testament to "the cure is worse than the disease." Even though I was very sick and totally fatigued from MAC and coughing, the medication side effects of nausea, headache, body aches, etc were even worse. I talked to my pulmonologist's wonderful nurse, and she convinced me to keep trying for 2 months. She recommended taking all the meds 1 hour before bed, with a small, starchy snack. It worked - I was able to sleep (even if restlessly) through the worst nausea and headache. By late morning, I was even able to eat a little. I spent 12 months on 3 x weekly meds, and 6 months on daily meds. Now, 27 months layer, I am able to maintain with mucus thinning meds, 7% saline & airway clearance.
Her statement was "taking the meds on a schedule that works for you, even if not ideal, is better than quitting." My ID doc and second that opinion. I urge anyone who must take the Big 3 to seek a schedule that works for you.
Sue

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Thanks Sue. I went back to my old regimen that works.

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Hi, I took mine with saltiness at bedtime. I would eat about 6 crackers take a few then crackers and so on. I hope it helps.

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When I began the Big 3 in August 2021, I took all three one hour before breakfast. The side effects was diarrhea and loose stool and I was housebound until noon on those days because one can't control when either will happen. My new MAC specialist suggested I take Azithromycin before breakfast, Ethambutol on empty stomach before or after lunch, and Rifampin before going to bed (also on empty stomach). It worked! No more loose stool and diarrhea! I am no longer housebound on those days I take my drugs.
lora jo

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@ljfoo

When I began the Big 3 in August 2021, I took all three one hour before breakfast. The side effects was diarrhea and loose stool and I was housebound until noon on those days because one can't control when either will happen. My new MAC specialist suggested I take Azithromycin before breakfast, Ethambutol on empty stomach before or after lunch, and Rifampin before going to bed (also on empty stomach). It worked! No more loose stool and diarrhea! I am no longer housebound on those days I take my drugs.
lora jo

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Thank you!

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