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katezzz
Member
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Posted: Tue Jun 30th, 2009 15:27 |
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Maybe it's brain fog, but the Phase 2 instructions seem to use the word "cycle" ambiguously. The Phase 2 PDF says:
"Ramp up Mino by 25mg increments during each cycle only if symptoms are tolerable.
Do not increase Mino on days when Zith usually peaks (days 3-6 and 9)"
The way this reads to my mind, the best-case (no intolerable IP) dosing schedule would be:
Day 1-Benicar + 25 Mino + 31mg of Zith (This is 1/8 of a 250mg tablet.)
Day 2-Benicar only
Day 3-Benicar + 25 Mino (symptoms may peak from days 3 to 6)
Day 4-Benicar only
Day 5-Benicar +50 Mino
Day 6-Benicar only
Day 7-Benicar + 75 Mino
Day 8-Benicar only
Day 9-Benicar + 100 Mino
Day 10-Benicar only
(But that means increasing Mino to 100 on Day 9, when it says not to)
Day 11 Cycle 2-Benicar + 25 Mino + 62mg of Zith (This is 1/4 of a 250mg tablet.) As above, ramping Mino from 25 to 100 mg in ten days.
Day 21 Cycle 3-Benicar + 25 Mino + 93mg of Zith (This is 3/8 of a 250mg tablet.) As above.
Day 31 Cycle 4-Benicar + 25 Mino + 125mg of Zith (This is 1/2 of a 250mg tablet.) As above.
But another MPer and her physician interpret the dosing instructions differently. They dose as follows:
First cycle, Day 1: 25 M, 31 Z (ten days)
Day 11: 50 M, 31 Z (ten days)
Day 21: 75 M, 31 Z (ten days)
Day 31: 100 M, 31 Z (ten days)
Second cycle, Day 1: 25 M 62 Z (ten days)
Day 11: 50 M and 62 Z (ten days)
Day 21: 75 M and 62 Z (ten days)
Day 31: 100 M and 62 Z (ten days)
Third cycle, Day 1: 25 M 93 Z (ten days)
Day 11 50 M and 93 Z (ten days)
Day 21: 75 M and 93 Z (ten days)
Day 31: 100 M and 93 Z (ten days)
Fourth cycle, Day 1: 25 M 125 Z (ten days)
Day 11 50 M and 125 Z (ten days)
Day 21: 75 M and 125 Z (ten days)
Day 31: 100 M and 125 Z (ten days)
Which is correct? I did it the second way for my first dose of Zith, taking 31 Z on Day 1 and staying at 25 M for ten days. Now it is day 11 and I need to know what to do. Should I take 50 M and 31 Z for the next ten days, or should I start over and take 31 Z + 25 M today, Benicar only on Day 2, then 50 M on Day 3 and so on, ramping Mino to 100 by Day 10?Last edited on Tue Jun 30th, 2009 15:31 by katezzz
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RA since 1988; AP since 1993; MP Nov. 2008; Phase 2:
Was up to Zith 62 but now stopping all antibiotics to manage IP; Benicar 40 mg q4 or q6, and sometimes 20 SL; Dilaudid q4. May: 25D= 14
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eClaire
Member
| Joined: | Thu Oct 18th, 2007 |
| Location: | Virginia USA |
| Posts: | 338 |
| Status: |
Offline
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Posted: Wed Jul 1st, 2009 00:53 |
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Kate,
You decide when to ramp based on how tolerable your IP is. If you cannot handle stronger IP, do not ramp with the next cycle. Stick where you are. If you think you can handle more IP, then ramp your Mino. How I read the text you quoted is that you ought not ramp during days 3-6 (as well as 9) unlike the example at the top of your post.
Hope this helps, Claire
P.S. I also think you probably would want to get a handle on how well your body handles Phase 2 before trying to ramp Mino during a 10-day cycle (or however long your cycle ends up being). As the guidelines indicate, if you get in over your head on a Zith cycle, you're living with it. So caution is advisable, particularly if your 25D is not in the therapeutic range.Last edited on Wed Jul 1st, 2009 01:02 by eClaire
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38mo on MP; CFS FMS MCS COPD hypermob. IBS/GERD osteopor.; 125D48 25D<4;
NoIRs during most daylight outings & covered up; home w/o NoIRs
Ph1.Dec06 * ModPh2.Jun07 * AbxBrk.Mar-May08 * Ph2.Oct-Nov08 * Ph1.Jan2009
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Molly30
Member
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Posted: Wed Jul 1st, 2009 19:25 |
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Kate,
I just finished Phase 2 and used the 10 day ramping cycle (the second method you describe in your post). It worked for me. I never had intolerable IP. If I had, I would have repeated 10 day cycles without ramping. You just have to do what's best for you and remember that this isn't a race. My 25 D is just at 22 now so I may find myself going back to Phase 2 when it drops into the therapeutic range.
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katezzz
Member
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Posted: Wed Jul 1st, 2009 23:16 |
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Thanks for the feedback Molly and Claire– cathys2007 PMed me her version which looks like this:
Level 1, cycle 3, days 1-10
Day 1-Benicar + 25 Mino + 31mg of Zith (This is 1/8 of a 250mg tablet.)
Day 2-Benicar only
Day 3-Benicar + 25 Mino (symptoms may peak from days 3 to 6)
Day 4-Benicar only
Day 5-Benicar + 25 Mino
Day 6-Benicar only
Day 7-Benicar + 50 Mino (ramp if IP tolerable)
Day 8-Benicar only
Day 9-Benicar + 50 Mino
Day 10-Benicar only
It's basically a cross between the two. Ramping on day 7 gives you a few days on that dose before taking another zith, which seems like a good, safe plan. Unless there's a reason to ramp the mino on the Day 1 of the next cycle... to give the bacteria a swift punch, for example. I hope a moderator will comment on this so I know.
____________________
RA since 1988; AP since 1993; MP Nov. 2008; Phase 2:
Was up to Zith 62 but now stopping all antibiotics to manage IP; Benicar 40 mg q4 or q6, and sometimes 20 SL; Dilaudid q4. May: 25D= 14
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eClaire
Member
| Joined: | Thu Oct 18th, 2007 |
| Location: | Virginia USA |
| Posts: | 338 |
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Offline
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Posted: Wed Jul 1st, 2009 23:31 |
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| I'm as interested in hearing other people's experiences as you are (even if our own experiences may end up being different). Claire
____________________
38mo on MP; CFS FMS MCS COPD hypermob. IBS/GERD osteopor.; 125D48 25D<4;
NoIRs during most daylight outings & covered up; home w/o NoIRs
Ph1.Dec06 * ModPh2.Jun07 * AbxBrk.Mar-May08 * Ph2.Oct-Nov08 * Ph1.Jan2009
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