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Difficulties with Latent TB antibiotic Rifampin while on Clonazepam


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Hi all, I was advised to post my introduction on this forum. I have been on Klonopin since 2013. At some point i titrated down from .5 to .125 without a problem. I have been taking .125mg for a few years at bedtime. Recently it was discovered that I have Latent Tuberculosis and have been on Anti-TNF medication for Ankylosing Spondylitis and Crohns for years so it must be treated. I have been having a hell of a difficult time starting antibiotic treatment (which can either decrease or increase benzos), mostly due to at minimum tingling lips and at worst lots of pressure or numbness in the face, teeth, lips. Definitely going to be needing support.

 

I also take Mirtazapine (Remeron) and Gabapentin at bedtime. Rifampin also clear Mirtazapine, and Isoniazid enhances.

 

The details: The first day i started Rifampin (which can clear Klonopin from your system faster and reduce effectiveness) I got tingling lips while eating breakfast. The dr stopped it after the second day out of fear i was having an anaphylactic or other allergic reaction. Then i tried Isoniazid (which can enhance klonopin) also for only two days, same issue with tingly or numb lips, which still continued sporadically for a while. Then last week while not on any TB drugs at all, 3 weeks after the last Isoniazid dose (when the MAOI food restrictions ere passed), and 2 days before i restarted Rifampin I ate a high histamine meal i had been avoiding while on isoniazid and got very tingly nose, lips and teeth again, lasting through the next day. Still two days later i restarted the Rifampin because I need to do this treatment (and dr told me since it is not allergic i should retry and hopefully can tolerate it). On the first day of Rifampin when my tingling started to becoming pressures and numbness in the face, which has continued sporadically though the only four days that i have resumed it. Today i was even considering going to the ER afraid i was having a transient mini strokes. Feel like I am improving now (though the transient strokes improve too and they say you should still be checked out). My lips still tingle though and are getting kind of ulcerated, hopefully from me rubbing them with my tongue and not some other mucous membrane reaction, but i will keep a close watch.

 

Thanks for reading.

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