Anyone try COARTEM & ATOVAQUONE combo ?

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in-this-together
New Member


Date Joined Jan 2018
Total Posts : 9
   Posted 1/18/2018 12:33 PM (GMT -6)   
I'm new to this forum, feeling my way through. This is my first posting.

My spouse has been on Atovaquone+Doxy+Azithromycin for about 2-3 months and although he has made considerable improvement for Lyme and Babesia, some of his symptoms are not improving and are worsening despite a gradual increase in the Atovaquone up to 3 tsp, twice a day.

His doctor wants to remove the Azithromycin from his treatment & add COARTEM along to Atovaquone & Doxycycline. Has anyone been on this combo and if so please provide feedback. I'm a little worried about an overload of the anti-malarials.

tickbite666
Veteran Member


Date Joined Mar 2014
Total Posts : 1664
   Posted 1/18/2018 12:52 PM (GMT -6)   
I have used coartem twice, and both times it was used alone with my normal sups. My LLMD said it reacts with a lot of other Rx, so best to use it alone. And I usually tolerated a lot of combo's in the past.

Girlie
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Date Joined May 2014
Total Posts : 33907
   Posted 1/18/2018 2:12 PM (GMT -6)   
I subscribe to LLMD MR TreatLyme book.

He doesn't mention taking any other anti-malarials with it.

I put them in the Drug Interaction checker that I use and it didn't come up showing anything except some food recommendations (one is Grapefruit may cause higher blood levels of it)

Doesn't work as well on an empty stomach.
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

BabsBunny
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Date Joined Mar 2017
Total Posts : 563
   Posted 1/18/2018 4:33 PM (GMT -6)   
in-this-together said...


His doctor wants to remove the Azithromycin from his treatment & add COARTEM along to Atovaquone & Doxycycline. Has anyone been on this combo and if so please provide feedback. I'm a little worried about an overload of the anti-malarials.


Yes! This was my latest protocol- Atovaquone (which I’ll call Mepron bc it’s easier to write) + Coartem + Doxy + Biaxin.
However, I never made it far enough to add the Coartem. My insurance doesn’t cover it completely so I just used Artemisinin instead. Doxy is messing with my gut big time so I’m going to go off that for a rest. And I’m sensitive to the corn-based sweetener and thickener in Mepron so I’m switching to Malarone.

So I’m not going on that exact combo, but that WAS prescribed to me by my doctor, so if you can handle it, I’d say go for it. Babs is a beast, I’ve made the most improvements overall while focusing on it. If I wasn’t sensitive to the Mepron and the doxy didn’t tear me up so much, I would have done that protocol.

Once I get squared away with my doc, I will be on Malarone + Coartem, then add in the rest when my gut gets healed.
Lyme, Babesia, Bartonella. Symptoms began 5/2016, didn't start treatment until 9/2016. Slow but steady recovery.

*twitch twitch*

Girlie
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Date Joined May 2014
Total Posts : 33907
   Posted 1/18/2018 4:58 PM (GMT -6)   
BabsBunny - thanks for posting your experience with those meds. How long have you been treating Babs?
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

in-this-together
New Member


Date Joined Jan 2018
Total Posts : 9
   Posted 1/18/2018 8:33 PM (GMT -6)   
Thanks to all for your input, much appreciated.

BabsBunny: we are not sure how much our insurance will cover of the Coartem either, may not be a sufficient enough time or dosage to be adequate. I guess we should investigate this first before my husband starts it.

Do you recall-- what was the prescribed dosage of Atovaquone/Mepron to be taken with the Coartem? My husband is on 3 tsp twice a day and since it has been increased from 2.5 tsp dosage he has not been able to sleep.

Please keep me posted on your success with the Malarone & Coartem combo once started.

Girlie
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Date Joined May 2014
Total Posts : 33907
   Posted 1/18/2018 8:41 PM (GMT -6)   
in-this-together (I love your name)

3 tsp twice a day of the Mepron? That's a high dose. I don't think I've seen anyone taking that dose before.


Many people are prescribed 1 tsp twice daily...and others' 2 tsp twice daily.

No wonder he's not sleeping at 5 tsp per day.

Does he have anxiety from it?
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

in-this-together
New Member


Date Joined Jan 2018
Total Posts : 9
   Posted 1/18/2018 9:11 PM (GMT -6)   
Yes, it is a high dosage. His doctor has been checking his Atovaquone levels every few weeks and has increased the dosage when the levels come back low. He just had his levels checked last week but we don't have the results yet.

I just spoke to doctor today and she is going to decrease the dosage back to the 2.5 tsp (twice day) after I reported the insomnia and irritability to her.

He was making much progress prior to the "3-tsp" dosage increase.

Still---I am worried that even 2.5 tsp, twice a day, may be an overload when combined with Coartem. When I questioned this, the doctor said the Coartem will not work without other drugs.

Girlie
Forum Moderator


Date Joined May 2014
Total Posts : 33907
   Posted 1/18/2018 9:16 PM (GMT -6)   
Wow - you have a LLMD who checks blood levels of the medication? That's great!



from what I've read - the Coartem is a short protocol of a few days...and can be repeated every few weeks.

Is that the schedule for your husband?
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

BabsBunny
Veteran Member


Date Joined Mar 2017
Total Posts : 563
   Posted 1/18/2018 10:29 PM (GMT -6)   
I was taking Mepron 2 tsp twice a day, and was supposed to add 2 Coartem twice a day for 3 days every week.
My insurance only gave me two weeks of Coartem, at a $50 copay. I have refills though. Don’t know what they’ll pay for each month.


I’ve been treating Babs since about February or March of 2017. Almost a year. I had a break for a few months in between because symptoms improved so much, but they came back.
Lyme, Babesia, Bartonella. Symptoms began 5/2016, didn't start treatment until 9/2016. Slow but steady recovery.

*twitch twitch*
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