Help don’t know where to put this (xifaxan)

[DammitJanet]

So gp gave me this new medication called xifaxan to kill off bad intestinal bacteria. He and the pharmacist said insomnia, anxiety, and depression aren’t side effects of this medication. But I’ve been on it for 6 days and after nearly 2 months of feeling pretty great, I’m suddenly experiencing all three of these symptoms severely. 

I’m just wanting to know if this has happened to anyone else on this med. it doesn’t show up on the common side effect profiles, but I looked further down at the doc pamphlet at bottom of the page and it does say it can do his. 

How do I get the doctor to believe me? She wants me to continue it but I woke up today feeling extremely depressed! And my Xanax isn’t even working for the anxiety! This all even being on vyvanse. 

@mikl_pls or @browri?

ps: why would they say this stuff can happen down in the physicians info and not list it in patient info???

shitty thing is, it’s definitely helping my stomach problem. 

Edited October 8, 2018 by DammitJanet

[DammitJanet]

Great...also started lo loestrin fe around the same time...bc pill. Rare side effect can also  be depression and anxiety...

[mikl_pls]

3 hours ago, DammitJanet said:

So gp gave me this new medication called xifaxan to kill off bad intestinal bacteria. He and the pharmacist said insomnia, anxiety, and depression aren’t side effects of this medication. But I’ve been on it for 6 days and after nearly 2 months of feeling pretty great, I’m suddenly experiencing all three of these symptoms severely. 

I’m just wanting to know if this has happened to anyone else on this med. it doesn’t show up on the common side effect profiles, but I looked further down at the doc pamphlet at bottom of the page and it does say it can do his. 

How do I get the doctor to believe me? She wants me to continue it but I woke up today feeling extremely depressed! And my Xanax isn’t even working for the anxiety! This all even being on vyvanse. 

@mikl_pls or @browri?

ps: why would they say this stuff can happen down in the physicians info and not list it in patient info???

shitty thing is, it’s definitely helping my stomach problem. 

Odd. I looked it up in Epocrates and it does, indeed, list depression as a "common reaction."

I don't really know what to do about this, I'm sorry.  

How long do you have to take it? I remember my dad was on this for a limited amount of time... Hopefully you don't have to take it long-term.

I remember also that his Medicare wouldn't pay for it, so his GI doc switched him to minocycline or something like that...

Edited October 8, 2018 by mikl_pls

[DammitJanet]

Just now, mikl_pls said:

Odd. I looked it up in Epocrates and it does, indeed, list depression as a "common reaction."

I don't really know what to do about this, I'm sorry.  

How long do you have to take it? I remember my dad was on this for a limited amount of time... Hopefully you don't have to take it long-term.

I remember also, that his Medicare wouldn't pay for it, so his GI doc switched him to minocycline or something like that...

14 days total. I’ve been on it for 6. My advantage plan payed for it and it is helping, but I’m in deep today. I’m terrified to take it even a day longer, cause what if the depression stays. ? I’d be so gd pissed after I was doing so well after doing so bad. 

Pill have to look up the medication you mentioned. 

Thanks SO much for answering. 

[mikl_pls]

32 minutes ago, DammitJanet said:

14 days total. I’ve been on it for 6. My advantage plan payed for it and it is helping, but I’m in deep today. I’m terrified to take it even a day longer, cause what if the depression stays. ? I’d be so gd pissed after I was doing so well after doing so bad. 

Pill have to look up the medication you mentioned. 

Thanks SO much for answering. 

You're quite welcome. I'm just sorry I couldn't offer much of any advice.

I think I remember some studies being done about minocycline helping depression, but I'm not sure about that. I know that minocycline crosses the blood-brain barrier more than most antibiotics, or at least in the tetracycline class of antibiotics.

[DammitJanet]

1 minute ago, mikl_pls said:

You're quite welcome. I'm just sorry I couldn't offer much of any advice.

I think I remember some studies being done about minocycline helping depression, but I'm not sure about that. I know that minocycline crosses the blood-brain barrier more than most antibiotics, or at least in the tetracycline class of antibiotics.

And it helps kill intestinal bacteria too?

[mikl_pls]

4 minutes ago, DammitJanet said:

And it helps kill intestinal bacteria too?

I would assume so. It is an antibiotic, and, in general, antibiotics do kill off bacteria in the intestines. Don't quote me on that though! lol

I actually want to say he put him on doxycycline, but I think minocycline would work too.

Do you know the name of the condition you have for which you are being treated with Xifixan?

[DammitJanet]

Just now, mikl_pls said:

I would assume so. It is an antibiotic, and, in general, antibiotics do kill off bacteria in the intestines. Don't quote me on that though! lol

I actually want to say he put him on doxycycline, but I think minocycline would work too.

Do you know the name of the condition you have for which you are being treated with Xifixan?

She actually said xifaxan specifically kills off the bad bacteria instead of all.  She said it could be SIBO, small intestine bacterial overgrowth. 

[mikl_pls]

6 minutes ago, DammitJanet said:

She actually said xifaxan specifically kills off the bad bacteria instead of all.  She said it could be SIBO, small intestine bacterial overgrowth. 

Yeah, Xifaxan is supposed to be a really good antibiotic for that indication.

Here's an article that discusses the treatment (I think) of SIBO (small intestine bacterial overgrowth).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3099351/

Quote

A variety of antibiotics have been useful in the treatment of SIBO, most with little supporting evidence. Ideally, antibiotic therapy would be based on bacterial culture and sensitivity data. However, this approach is impractical in the clinical setting and treatment is thus directed at likely organisms based on reports of culture data from SIBO paitents. Tetracycline (and its derivatives) was the first drug to be recommended, although no published data are available on its efficacy. A recent trial showed decreased efficacy of chlortetracycline at improving hydrogen breath tests and symptoms if SIBO compared to newer antibiotics. Other broad-spectrum antibiotics advocated for the treatment of SIBO include amoxicillin/clavulanate, ciprofloxacin, and doxycycline. However, these recommendations are based on uncontrolled data. More recently, direct comparisons between antimicrobial agents have emerged. Rifaximin (Xifaxan, Salix; a nonabsorbed rifamycin derivative) proved better than chlortetracycline at improving hydrogen breath testing and symptoms of SIBO. However, a recent randomized crossover trial comparing rifaximin and metronidazole demonstrated superiority of metronidazole at improving hydrogen breath test results and symptoms of SIBO.

 

[DammitJanet]

She’s grasping I think. I’m pretty sure it’s just IBS-d. But it is seeming to help. But ffs my depression came back like a meteor the last couple days. Too depressed to read the article completely, but thank you for the synopsis. 

It was a shot in the dark, having had to d/c viberzi which worked pretty well, but has some contraindications for me. Though, sshhhh I still take one dose before bed every night, instead of twice a day. 

Keeps me from having serious issues while sleeping. 

[mikl_pls]

This also looked handy...

https://www.invivoclinical.co.uk/files/antibiotic_alternatives_to_rifaximin.pdf

"Alternatives to rifaximin [Xifaxan]"

 

[DammitJanet]

Just now, mikl_pls said:

This also looked handy...

https://www.invivoclinical.co.uk/files/antibiotic_alternatives_to_rifaximin.pdf

"Alternatives to rifaximin [Xifaxan]"

 

Oh wow Michael, thank you!

Will give it a shot in the morning when the caffeine drip is started. 

Right now I’m crumbling with extreme anxiety and horrible sadness. 

[mikl_pls]

1 minute ago, DammitJanet said:

Oh wow Michael, thank you!

You're welcome! Some of them might not be available in the US since it came from a UK site. But there might be some on there that you could get in the US.

Edited October 8, 2018 by mikl_pls

[DammitJanet]

Just now, mikl_pls said:

Some of them might not be available in the US since it came from a UK site. But there might be some on there that you could get in the US.

Bless you 

[DammitJanet]

I think she was just shooting in the dark when guessing sibo anyway...I don’t belch much at all. Pretty sure it’s just IBS. 

[mikl_pls]

Very well could be the case. In that case, that would require a completely different class of medications.

[DammitJanet]

Using my propanalol as an emergency anxiety med just so I can regulate my breathing. Xanax I cannot even feel since starting this med. how high can you personally go on propranolol?

1 minute ago, mikl_pls said:

Very well could be the case. In that case, that would require a completely different class of medications.

Oh christ. Ha. 

Well, xifaxan site did say it was fda approved for IBS in 2015. 

[mikl_pls]

1 minute ago, DammitJanet said:

Using my propanalol as an emergency anxiety med just so I can regulate my breathing. Xanax I cannot even feel since starting this med. how high can you personally go on propranolol?

It depends on the individual. You have to watch out for things like inducing bradycardia and bronchospasm. If you're only taking it acutely, I would say only 10-20 mg twice daily to be safe, but if you take it more regularly, maybe up to 20-40 mg 2-4x/day. But if you are taking it as an every day medicine, people can go up to, I believe, a max of 640 mg/day. But that is a very heroic dose of propranolol for very severe cases of hypertension. For anxiety, I probably would personally not want to go over 160-240 mg/day. That's just me. But that, again, would be if I were taking it every day, and also if I were taking the extended release version probably, too.

5 minutes ago, DammitJanet said:

Oh christ. Ha. 

It's not bad. They're just anticholinergics, most of them I believe.

[DammitJanet]

1 minute ago, mikl_pls said:

It depends on the individual. You have to watch out for things like inducing bradycardia and bronchospasm. If you're only taking it acutely, I would say only 10-20 mg twice daily to be safe, but if you take it more regularly, maybe up to 20-40 mg 2-4x/day. But if you are taking it as an every day medicine, people can go up to, I believe, a max of 640 mg/day. But that is a very heroic dose of propranolol for very severe cases of hypertension. For anxiety, I probably would personally not want to go over 160-240 mg/day. That's just me. But that, again, would be if I were taking it every day, and also if I were taking the extended release version probably, too.

It's not bad. They're just anticholinergics, most of them I believe.

Well, guess I better lay off that one then. ? but my breathing is still very rapid and hands trembly. Guess I can take extra Xanax but pdoc would be pissed. 

[mikl_pls]

2 minutes ago, DammitJanet said:

Well, guess I better lay off that one then. ? but my breathing is still very rapid and hands trembly. Guess I can take extra Xanax but pdoc would be pissed. 

There's nothing wrong with the propranolol. Just be cautious that you don't take too much at once. What's your dosage?