Doxycycline question for ladies

[lizlou29]

Hi all. I've been on Doxycycline for 6 months and was due to have a break. My eyes have only got worse in last 6 months but Ophthalmologist thinks it may start to kick in now and wants me to try it for a couple more months. Problem is I've just had my 3rd yeast infection whilst on it. GP prescribed Diflucan and said to stop Doxy for one week. She doesn't know anything about Doxy for ocular rosacea anyway so she couldn't tell me if stopping it for a week would mean it would be like starting all over again. Is this my body's way of telling me to stop the antibiotics? I'm really keen to try the natural route but my MG's are still producing thick yellowish oil and my TBUT is a few secs. Schirmmer's 2-3mm in both eyes. Just been prescribed Plaquenil and don't really want to be on a load of meds. So what do you think? Will I miss out on the miracle of Doxy if I stop now?

[Roe72]

I have been on it for over a year. Having the same problem with yeast infections. I can't tell it has helped the ocular rosacea but like you, terrified to stop because things could get worse. My MG function still not good either.

[alisonW]

I would think that in 6 months you would have already seen a positive change so I'd be hesitant to continue. I've been on it many times over the years (even for a year and a half continuously) and have never, ever had a yeast infection. I think that alone would make me stop taking it. Interestingly I was just prescribed this again on Wednesday (I've been off of it for a year now) since my right eye glands are completely clogged and my left isn't much better.

[Almondiyz]

I have been on it for over a year. Having the same problem with yeast infections. I can't tell it has helped the ocular rosacea but like you, terrified to stop because things could get worse. My MG function still not good either.

Roe & ladies,
I have Ocular Rosacea & MGD. I've been on Doxycycline for a year now without stopping.

Initially I was prescribed Doxycycline 100 mg capsule once daily for four weeks.
The dosage was reduced to a 50 mg capsule once daily, my eyes flared up.
Currently taking Doxycycline 50 mg twice daily.

Doxycycline is certainly not a miracle cure.
I can say that it has helped a lot with eyelid margin & ocular surface irratation/inflammation.
The results were so slow that I didn't notice until the dosage was reduced.

Also, there have been times I've forgotten my evening dose & my eyes would become more irritated/inflammation increased, so I know it does help with inflammation. It just is difficult to tell it's working because when I started taking it I couldn't notice any improvements because it happened so slowly.

Yeast Infections happened after taking Doxycyline within the first two weeks. I treated it with OTC products. It kept returning for months. Then what finally worked for me was the way I treated the infections. It took about 3 months to cure the problem. Please ask your doctor (GYN) if what worked for me, works for you.

Links to what I'm talking about since I don't know what products UK has, the active ingredients are mainly what's important so generic or substitutes are fine.

Monistat 1 1-Day Treatment Day or Night Combination
I used Three (3) Boxes/Three (3) Days of 1200 mg dose
every other week for about 3-4 months.
(Expensive so I used generic equivalent)
http://www.drugstore.com/monistat-1-...6?catid=184085


Also, I sprinkled Desenex Antifungal Powder on THIN Liners. Change liners frequently & sprinkle lightly with fresh antifungal powder each change. Any thin liner will work, link just shows what I'm referring to as liners. It's just for example, doesn't need to be for bladder protection except the longest version is best.
Poise Liners, Discreet Bladder Protection Long and Very Light
http://www.drugstore.com/products/pr...4&catid=110681


Desenex Antifungal Powder, Cures Athlete's Foot, 2% Miconazole Nitrate
http://www.drugstore.com/desenex-ant...4?catid=184116


Again, store brand generics are your best bet for cost. Both the yeast infection medication & antifungal powder are Miconazole Nitrate. Continue to use the powder even after the yeast infections clear up as a preventative measure. That's how I cured my yeast infection. I don't use the powder right now, yet will probably begin using the antifungal powder in the summer.

[LaDiva]

Hi Liz,
I take 50mg of minocycline once a day, and have for over a year. When I was on Doxy, I had two yeast infections, and so quit taking it. I've not had problems with the minocycline, but I also take a good probiotic every night, and capryl for seven days on, off seven days, on seven, off seven. No sugar, and no bread. No yeast!

[lizlou29]

Thanks everyone. It's really helpful to know what others have experienced with Doxy. I don't like taking meds at all really and I was told originally wait 3 to 6 months until it kicks in. My eyes are worse (both signs and symptoms) than when I started it so whatever underlying immune system problem I have has fought against it in simplistic terms.

Omega 3 hasn't helped, Doxy hasn't helped, warm compresses generally make the ocular rosacea worse though I try to do one a day which ophths are saying is not enough but my eyelids are a lot redder and eyelids swollen for doing them and they provide no relief. Really think the ocular rosacea needs to be taken into account as no ophths I've seen will listen when I say the warm compresses make it worse. I wonder if finding a good derm would help.

LaDiva I take a probiotic. I'm sure they'd me willing to try me on minocycline. Doxy seems to be the go-to in the UK.

Almodiyz Thanks for such a detailed response. I will have a look online, as you say there is normally the same active ingredient to be found ever if I can't get the exact products here.

[spmcc]

I take minocycline 50mg and have fewer yeast infections than when I was taking doxycycline 100mg (which I was told was the lowest dose I could get in Canada).

Because I was diagnosed with rosacea in the mid-1980s (and then ocular rosacea in the mid-1990s), I've basically been on antibiotics since the first diagnosis. Yeast infections seem to go hand-in-hand with this treatment. I need to be extra careful with sugar/sweets and alcohol (esp white wine).

If someone is interested in more 'natural' treatments for yeast infections, you can try boric acid suppositories. They're behind the pharmacy desk ('pre-packaged' in pill/suppository form), but they are NOT prescription. They're much cheaper than Monistat or Canesten. My GP also had a DPharm and told me about this option. I've moved to another city and no longer see this GP and now realize how valuable he was!

[unicorn]

Lizlou have you thought about asking to be switched to Efracea? This is the 40mg slow-release Doxy (US name Oracea). Most doctors I've asked about it have never heard of it. But you can definitely get it NHS (I've had it).

It is supposedly a sub-antimicrobial dose so should help with the yeast infections, and some studies suggest it is as effective as 100mg a day.

[Peppermint]

I am on 50mg doxy and I take a high potency probiotic daily approx 6 hours post doxy dose. You have to wait that long so the doxy doesn't kill the good bacteria in the probiotic. Knock on wood, no yeast issues thanks to the probiotic.

[spmcc]

Lizlou have you thought about asking to be switched to Efracea? This is the 40mg slow-release Doxy (US name Oracea). Most doctors I've asked about it have never heard of it. But you can definitely get it NHS (I've had it).

It is supposedly a sub-antimicrobial dose so should help with the yeast infections, and some studies suggest it is as effective as 100mg a day.

The main problem with Oracea (US)/ Efracea (UK)/ Apprilon (Canada) is the cost!! It's so expensive compared to regular ol' doxy or mino. And another formulation called Periostat (20mg doxy) is also expensive. My insurance won't cover these because they say there's a (much) less expensive alternative (I.e. regular doxy). Grrrrrrr.

[lizlou29]

Unicorn, would Efracea just bean NHS prescription charge?

I take the Doxy in the morning then a probiotic in the evening at the moment.

SPMCC - is the minocycline as effective as Doxy supposedly is? I saw a Moorfields Ophthalmologist who said they've found that Lymecycline is more effective.

Still got the stupid yeast infection despite Diflucan, don't think I'm meant to take another dose so soon after the last. May try a natural approach that has been suggested.

Liz x

[unicorn]

Efracea was normal NHS prescription. I get mine free 'coz I live in Scotland I don't know maybe if it depends on your local primary care trust and their budgeting decisions.

Spmcc - do you think Oracea/Efracea would be a good long term option if it weren't for the cost? I have just been at the hospital where we kind of decided (ie, I suggested) that the best course of action is to treat the rosacea in the hope that it'll improve my eyes. I have been given a prescription for 1g Azithromycin to be taken three days a week, every six weeks. I'm not too sure about this and am hoping to find out what a more suitable long-term option might be. Also, do you use any topicals ie Metrogel, and do you know if topical facial treatments affect the eyes? I don't really have p&p.

It is very hard to find anyone who knows what the most effective/safest antibiotic is for this condition. I've never even heard of Lymecycline.

Lizlou I hope you can at least ask to try the Efracea. Good luck x

[lizlou29]

Unicorn - a well regarded Dermatologist I saw prescribed Finacea and Metrogel. They both burned my skin like crazy for me and my rosacea isn't that bad, I don't have the P&P but I think she felt she had to prescribe something. Well she did push £1500 of Laser treatments on me at her brand new cosmetic treatments clinic only after I actually removed my make up as she said no it's fine, leave it on, I actually wanted her to LOOK at my skin. I guess diet is one of the best ways to treat rosacea and avoiding all the obvious flares. That is why the Ophthalmologist at Moorfields wanted me to try Hydrocortisone on my eyelids "to attack it from the rosacea angle". He also suggested tar treatments which I thought were more for psoriasis. Anyway my facial rosacea has been vlassed as 'mild' and it doesn't bother me too much. You can't see it with make up on and even then my boyfriend didn't know I had it until I told him after a year of being together.

Lymecycline was used years ago but they are starting to think it may be one of the more effective tetracyclines with less gastro side effects. I could be wrong but I think there was a shortage of it in the States for a while and that is why it fell out of favour.

[spmcc]

I've never heard of lymecycline. I'll have to do some googling. I do think that any antibiotic can lead to yeast infections so that wouldn't change. Plus I think any dose can lead to yeast infections for some people. It could be related to diet (e.g. supplying yummy sugar for the yeast to grow).

But Yes, I think that lower dose doxy (i.e. Oracea/Efracea/Apprilon at 40mg) would be the best for long term use. That's one reason why I made the decision to take 50mg minocycline daily. Originally I switched to 50mg mino a few summers ago to reduct my risk of sunburn (I joke that I can get a sunburn inside on a cloudy day). Then one year I had a bunch of mino left over so just stayed on it.

I'm not 100% certain that these systemic antibiotics do anything for my eyes (or for my facial rosacea since I don't get P&P much or often. Unfortunately, derms only know how to prescribe oral antibiotics and topicals for rosacea. They don't take into account that flushing/blushing aka erythematous rosacea isn't fazed by these treatments!)

All I know is that my doctors (dermatologist and ophthalmologist) want me on oral antibiotics.

And about topicals... I have them all! Metrocream (Metrogel is too harsh as it contains alcohol), Financea, Protopic and on and on. I even have "the latest and greatest" Mirvaso. But my face (skin and blood vessels) is soooo darned sensitive to everything. Even just applying (touching my face) makes me red. Everything stings, burns or in some way causes a negative reaction. Mirvaso gives me horrible rebound flushing!! Bah!

[unicorn]

Thanks for that, spmcc. I saw my GP yesterday to discuss this prescription for Azithromycin I've got. It's not clear at all how often I should take it - tbh I think my ophth just wanted rid of me and wrote the prescription in a hurry. The dose is 1g, three times a week, for one week and I think he said I could repeat this every 6 weeks. I think it's called pulse dosing. However, looking it up I see that a lot of people seem to be using a much lower dose - even 250mg three times a week rather than 1g. And it's mainly used for Acne Vulgaris, rather than rosacea or ocular rosacea.

Long term though my GP agreed I could take Efracea if I would prefer it... I do feel a bit like I'm now 'self-medicating' somewhat and wish I had clearer advice from someone I could trust.

Sorry about your experience with Mirvaso, spmcc. I read a little about it and didn't like the sound of it much. I have used Metrogel in the past (many years ago now) and it didn't do much for me although it didn't burn. I don't have much of a reaction to topical things on my face (unlike my eyes!) apart from anything with AHAs in it.