Rifampin and Clonazepam unsafe for those with Porphyria?

I just had a porphyriai attack tonight. Had the warning signs. I have begun exercising again and was delighted to find I could go on the treadmill 5 days last week for 30 mins without fatigue afterwards. I have been swimming daily, working out with weights (starting slowly) and under alot of stress with work. I had a date this weekend (the first in ages) and suddenly started feeling badly: run down, cold body temperature (haven't had for a while), severe episodes of nausea, flu like feeling today. Tonight I was feeling jittery and suddenly felt dizzy, my BP and heart rate shot up, felt weak, sweaty, flushing, heart attack like symptoms. After 10 mins it calmed down and I took some b-12 and half a clonazepam (stopped taking this long ago but remember it helped before when I had attacks). I was looking at Porphyria symptoms online and stumbled upon the list of drugs that were considered unsafe for those with Porphyria. Drugs considered unsafe and safe in acute porphyriasi Acute porphyrias include acute intermittent porphyria, hereditary coproporphyria, variegate porphyria and ALAD porphyria. Drugs are not listed if the available information is not sufficient to classify them as clearly unsafe or safe. Unsafe Alcohol Anti-epilepsy drugs Phenytoin1 Barbiturates1 Birth control pills Calcium channel blockers4 Nifedipine Carbamazepine1 Carisoprodol1 Clonazepam* Danazol1 Diclofenac1 Diones Trimethadione Paramethadione Ergots Ethchlorvynol1 Felbamate Glutethimide1 Griseofulvin1 Mephenytoin Meprobamate1 Methyprylon Metoclopramide1 Primidone1 Progesterone1 Progestins/Synthetic Pyrazinamide1 Pyrazolones Aminopyrine Antipyrine Rifampin* Sedatives Succinimides Ethosuximide Methsuximide Sulfonamide-antibiotics1 Tranquilizers Valproic acid1 Noticed that Rifampin and Clonazepam are BOTH on there. I am about to go on Rifampin and just took the Klonopin. Did anyone out there know this? What about the patients here on Rifampin. Seems like it might pose a problem for me. Any ideas? Thanks! Chris

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CAPii since 11/06 for Cpnii, Lyme, Bartonella, Myco P, CMV, HHV-6 infectionsii. Doxyii 200mg daily, Zithromax 250mg MWF. NACi 2250mg daily. All other supplementsii.

Chris.

Chris.

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CAPi since 11/06 for Cpni, Lyme, Bartonella, Myco P, CMV, HHV-6 infectionsi. Doxyi 200mg daily, Zithromax 250mg MWF. NACi 2250mg daily. All other supplementsi.

I would have the question

I would have the question that is it possible that i have the same sort of attacks always after flagyli pulse? I feel good while on flagyl, i feel good a few days after too and then about 5 days later i am sweating like a horse, air hunger during nights. Why always a few days after pulses?

Azith250,doxy200,NAC2400,Flagyl (5 days) 

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doxy200, azith250, NACi 2400, Metroi 1250(once a month), supplementsi, vitaminsi.

Chris, secondary porphyriai

Chris, secondary porphyriai is not the same thing as any of the other, largely genetically inherited porphyrias.  Why else would Stratton have rifampicin among his pharmacopoeia?  He is far from stupid..................Sarah

An Itinerary in Light and Shadow

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Completed Stratton/Wheldon regime for aggressive secondary progressive MSi in June 2007, after nearly four years, three of which intermittent.   Still slowly improving and no exacerbation since starting. EDSSi was 7, now 2, less on a good day.

Chris- it is, of course,

Chris- it is, of course, possible these will worsen porphyriai because they increase liver load, especially rifampin. Rifampin can also increase this because of bacterial kill and dump of sequestered porphyrins. So if porphyria is a problem you should be cautious and keep the moppers and glucose up. Glucose especially will help limit the hemei production in the liver and thus lower the porphyrins.

veressv- what you report is common here, and is likely due to that dump of intracellulari porphyrins when cells undergo apoptosisi and lyse releasing their contents, combined with the inflammatory immunei clean up processes that also tend to have a delayed effect.

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CAPi for Cpni 11/04. Dx: 25yrs CFSi & FMSi. Currently: 150mg BID Roxithromycin, Doxycycline 100mg BID, Tinii 1000mg/day pulses; Vit D2000 units, T4 & T3

thanks Jim for this. I am

thanks Jim for this. I am wondering how i can decide what is really the difference between the apoptosisi reaction and secondary porphyriai . How can I know which one is what? i take supplementsi to work on the proph. and die off reaction. But still i have this same feeling after pulses, but not really while taking flagyli, maybe the anti-inflamatory effect of flagyl helps to cover up more the die off and later the die off itself causing my problem?

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doxy200, azith250, NACi 2400, Metroi 1250(once a month), supplementsi, vitaminsi.

Chris - My husband has had

Chris -

My husband has had some severe bouts of porphyriai AND he's been on several known porphyria inducing drugs including Rifampin, Bactrim DS, etc... While not pleasant by any stretch, these medications have been important to his recovery.

Sorry to say that exercise for patients on a CAPi can be a potent inducer of porphyria.  Dr. Stratton reports on this in his patent.

To use the necessary medications to treat my husband's illness, he has had to back off some on exercise.  This is a bummer to him but it has helped the severity of the porphyria.

When he does exercise, I try to give him a 1 to 2 of the 4 gram glucose tab every 15 to 20 minutes of exercise which helps immensely.

Best of luck

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Daisy - Husband on CAPi 5/07.  "When Going Thru Hell, Just Keep Going", Winston Churchill

I can't find where Dr.

I can't find where Dr. Stratton mentions this about exercise promoting secondary porphyriai in his patent???

Wherever it is, I need to find it and e-mail it to my doctor, immediately.

 

We are in the middle of deciding whether or not I need to keep my home PT case open. It has been a nightmare, so far! Must remain mobile to rid myself of edema, but had to fire the PT (long story but doctor is on my side with it, even though she reported me as being non-compliant). Have requested another PT, but am now wondering if I am making the right decision.Undecided

 

Am also wondering how I will possibly be able to fatten myself up, without consuming any of the milk products that he warns about, in his patent, too. Am now down to 93.6 lbs...the lowest that I have ever weighed in my life! Am also having pain in my jaw so can't chew too much, either. Cry

Minai -  Sorry things are

Minai -  Sorry things are so rough!  I am sending you loads of good vibes!

I thought I remembered the bit about exercise and CPNi and secondary porphyriai from his patent - perhaps it was from one of his other articles or interviews...

The rationale if I remember correctly is that CPN steals ATP from the cell and that since exercise is also a heavy user of ATP this may leave cells at risk for incomplete hemei and then results in porphyria. 

For my husband, when in the midst of a clear porphyria attack, I severely restrict his exercise.  Otherwise on a day to day basis he exercises although no where near as intensely as he'd like.  When he is exercising more vigorously, he takes 1 to 2 of the 4 gram glucose tabs every 20 minutes and this seems to help things stay in balance. 

We walk a fine balance on exercise.  He has to have it to recover but we have to moderate the intensity to help control the porphyria. 

You might consider keeping up with the PT and then take some glucose to minimize the porphyric effects.

It's also difficult to get well when your body is in a starved state.  This alone could make porphyria worse as in a starved state, the body is cannobalizing glucose and ATP anywhere it can find it.

My husband dropped at one point to a very emaciated 143 lbs.  I used shakes at the time to get his weight back up. 

For the shakes - Mixed several tablespoons of coconut oil (very good fat), several tablespoons organic nut butters (almond, macadamia, cashew) plus some frozen organic fruit and some Rice Dream in a blender.  Amazingly it was very tasty, easy for my husband to swallow and I could easily get 2000 calories in one shake.  You could also add some powdered glucose to the shake for more antiporphyria measures.

If you get desparate - another option - although not the most pleasant - also not the worst - is to talk to your doctor and to get a NG tube and pump and get your nutition auto delivered to your stomach. 

I would bet if you can get more complex calories into your body it will help with the porphyria.

Don't know if any of this helps but throwing it out there...

Again - sending you loads of good vibes !

 

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Daisy - Husband on CAPi 5/07.  "When Going Thru Hell, Just Keep Going", Winston Churchill

Thank you, Daisy! Am

Thank you, Daisy! Am sending as many positive thoughts as I am able to muster to you and to yours, too!

 

My mother has just arrived to help feed and care for me. Will print out a copy of your suggestions for her, too. Hopefully, no NG tube will be needed. But am glad to know of the option, regardless of its unpleasantness.

 

I did a word search of every one of Stratton's articles and patents for "exercise." But still haven't found it mentioned by name. So, maybe it was his article about how CPni steals ATP that you were thinking of. I can see how this applies to exercise. You are remembering his rationale, correctly.

 

Great to know of your experience with your husband, the exercise restriction and how you've used the glucose. We do have all of the ingredients in your recipe, so will have my mother prepare it...as I have been unable to do any food prep or cooking.

 

It most definitely has made me sicker being in such a starved state...

 

Doctor is now suggesting Plaquenil, since I wasn't able to handle steroid bursts. Something you've tried with your husband, or, no? It is mentioned in the patent...

 

I think that I will see how it goes with a new P.T. The one that I fired was treating for M.S. relapse, nevermind that relapses are rarely bilateral, nor do they last for months. She was uncompromsing about using a quad cane, exclusively, in spite of balance problems and club-foot-like edema. Ignoring the fact that I couldn't even lift it and was falling down and being injured, because of it. But, it was I who was uncompliant?! I am now using a rollator and doing so much better. Can now, get to the kitchen for food (which was a major compromise to eating) and make it to the stairs to get to the bathroom, in time, without having to rely on a female urinal, instead. But, if the new P.T. turns out to be as uncompromising, I will have to have the case closed.

 

Thanks, again. for sharing all that you have learned/continue to learn, in caring for your husband!

 

--Minai

 

RRMSi, diagnosed 2/04. NACi 4/06. Started Wheldon/Stratton regime 8/30/06. Doxycycline, 8/06, Azith, 10/06. Switched to Roxithromycin 11/06. Psuedo relapse/die-off with hospitalization 1/07. GAD-enhanced MRI of brain and spine shows NO NEW DISEASE ACTIVITY. LDN 4/07. 1st Tinidazole Pulse, 8/11/07. Keflex 2/08. IV Rocephini 3/08. IV Clindamycin 5/08. USA

 

 

 

Daisy, I can now highly

Daisy, I can now highly recommend your coconut oil shake recipe. The only thing that I am a bit concerned about is that it may contain high amounts of arginine. I would like to avoid another Shingles attack, but don't see how this can be done if one must avoid dairy products/lysine. But, then, I suppose that's what Lysine supplementsi are for Wink

 

Am also searching for Protein drinks that are soy-free. NESTLES does make some.

 

The visit with my new PT went well. because my BP was so low, 86/40, all she had me do was some dancer stretches and strenghtening exercises, on the sofa. Now, that I can handle Smile

 

Thanks, again!

 

--Minai

 

RRMSi, diagnosed 2/04. NACi 4/06. Started Wheldon/Stratton regime 8/30/06. Doxycycline, 8/06, Azith, 10/06. Switched to Roxithromycin 11/06. Psuedo relapse/die-off with hospitalization 1/07. GAD-enhanced MRI of brain and spine shows NO NEW DISEASE ACTIVITY. LDNi 4/07. 1st Tinidazole Pulse, 8/11/07. Keflex 2/08. IV Rocephini 3/08. IV Clindamycin 5/08. USA

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