Medications And Supplements That May Be Used By MC Patients

Here you can find information on medications found by the members of this discussion board to be generally safe and effective, and to minimize the risk of provoking a microscopic colitis flare or relapse.

Moderators: Rosie, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh, mbeezie

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tex
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Post by tex »

Hi Busy Mom,

Thank you for posting your experience, because as far as I can tell, the personal experiences of the members here are worth more to newly-diagnosed people than just about anything that our doctors could tell us about the disease. Yes it's true that any antibiotic can cause a flare for some of us. The best that we can do is to try to pick the lesser of all the available evils and hope for the best. But unfortunately, sometimes that doesn't work.

I wish that we had some better choices, but the drug companies tend to ignore diseases with limited market potential when developing new medications.

Thank you again for sharing your experience, and for your kind words, and I hope that you don't have to go through that again.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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jmh
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Post by jmh »

Tex - Thank you for putting together the valuable information on Medications. I have a question: I've been taking a Women's One vitamin from Rainbow Light (I buy through Vitamin Shoppe). It says Gluten- and Soy-Free. What would I look for to ensure it is dairy-free as well? And Would I be better off taking one from the brands you listed?

Thanks!
Judy
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tex
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Post by tex »

Hi Judy,

Casein is the ingredient in dairy that causes many of us to produce antibodies, but lactose can also cause problems for most of us, and lactose is a common ingredient in pharmaceuticals and supplements. Your selection appears to be a good multivitamin. Here's what the website says:
GUARANTEE: 100% natural - Free of artificial colors, flavors, sweeteners, preservatives and other objectionable additives often found in vitamin products. Contains no sugar, lactose/dairy, wheat, gluten or yeast.
Of course sometimes a product can look safe and still cause problems, but that one appears to be safe.

You're very welcome.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by Skyward »

Tex- Thank you for making up this list. I am waiting for your book to arrive and I'm hoping that this information might be in there as well. Please forgive me if I am just having some cognitive difficulties right now... after the major problem I just had shopping the vitamin aisle at the CVS I am pretty sure that I am in a state which is easily confused... but as I read the list I had some trouble understanding the headings, the list under them- and where the list of helpful things turned to a list of things to be avoided. (I know not everything is black and white!!)

I'm going to C&P a piece of the top post to show you what I mean-

Medications known to either cause histamine reactions or interfere with the production of diamine oxidase:

Acetylcysteine
acetylsalicylic acid (aspirin)
alcuronium
alprenolol
ambroxol
Amiloride
Aminophylline
Amitriptyline
cefotiam
Cefuroxime
choroquine
Cimetidine
clavulanic acid
Cyclophosphamide
Dobutamine
D-tubocurarine
isoniazid
metamizole
Metoclopramide
Morphine
nonsteroidal anti-inflammatory drugs (NSAIDS)
Pancuronium
pentamidin
pethidine
Prilocaine
Propafenone
Thiopental
Verapamil


Antispasmodics:

hyoscyamine (Levsin)
So after Verapamil, we get to the Antispasmotics. Are they a subset of drugs that cause histamine reactions... or is this a continuation of types of drugs that we with MC generally tolerate well? I think a lot of the problem has to do with the formatting you have to work with. I'm reluctant to suggest color coding (like the histamine foods have green and pinks and red) just because of the black and white implications that aren't true for everyone. Maybe if (if I am understanding this correctly that is) the section of the histamine reaction causing drugs could be at the end?

A big part of my problem is that the names of the drugs, both the real name and the brand name, and the job they do and the types and classes- it is alien to me so it's like reading in a foreign language and trying to go between the text and the dictionary and I get lost every time.
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tex
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Post by tex »

Hi Sarah,

Sorry about the confusion. I was hoping that the size of the bold text used for each heading and subheading would provide an indication of which ones were categories (the largest size), and which ones were subcategories (the smaller size) within the categories. Unfortunately, bulletin board code does not allow for a practical way to use tabulated headings, so subheadings can't be offset.

The larger size text is supposed to indicate that "Antisposmodics:" are the next class of medications (in alphabetical order) going down the list (just as "Antihistamines" was the preceding category, and "Anti-Inflammatory medications:" are the next category after "Antisposmodics:".

I agree that it is somewhat confusing to include that list of drugs under "Antihistamines:", but I thought that it was appropriate because they are capable of causing histamine reactions either directly, or by interfering with the production of diamine oxidase enzyme (which the body uses to purge unused histamine). Yes, this is discussed in more detail in the book, but all those details obviously couldn't be included in the list without causing it to become too long and complex.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by BusyMom »

So am I reading correctly that the benzodiazepine family including diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin), flurazepam (Dalmane), and others, are not good to be taking with MC? I either missed them on the list or they are named something else I am not recognizing.

Thanks.
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tex
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Post by tex »

I didn't include them in the listing, because most of them are not widely used my members and/or few experiences either pro or con have been posted, and so we don't really have enough member experience to provide a basis for a good specific opinion about this class of medications. And medical research data that would be applicable are not available either. Most likely, some people will be able to tolerate specific medications in this group while other will not. That said, the vast majority of mood-altering medications in general carry at least some degree of risk for triggering MC reactions. Trial and error is the only way to be sure, in specific cases, because we simply don't have enough data available on which to base a practical risk assessment, unfortunately.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Erica P-G
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Post by Erica P-G »

This is a wonderful breakdown!
Thank you Tex, this was a lot of research.

How would Imatrex or any triptans fall into the MC flare up category?

Thanks so much,
Erica
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T
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Post by T »

I have been taking KLONOPIN for about 6 weeks .50 2x A day so far no problems.But I will be asking my NP to up the dosage
along with more blood tests on Thursday


Terry
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tex
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Post by tex »

Hi Erica,

I'm not aware of any evidence that they cause IBDs, but they may have a worse risk than that, in some cases. They have been associated with ischemic colitis. With ischemic colitis, the flow of blood to certain sections of the intestines may be interrupted. If not corrected, this can lead to the death of that part of the intestine (which of course can have fatal consequences). I have no idea how significant this risk might be, but presumably the risk is small or we would have heard more about it. Here is some information on it:
Discussion: Previously published case reports have suggested an association between 5-HT 1 receptor agonists and ischemic colitis. These reports have been dismissed because the patients were taking oral contraceptives, serotonin agonists, or had other comorbidities. This healthy patient lacked risk factors for ischemia, is the youngest to be reported, and is the first without hematochezia.

Conclusion: 5-HT 1 receptor agonists are generally considered safe. Ischemic colitis is a potentially serious complication of these agents. A retrospective review of 5-HT 1 receptor agonist users who have presented with acute onset abdominal pain or hematochezia is necessary to elucidate the incidence of this adverse event.
Ischemic Colitis Related to Sumatriptan Overuse

Of course, theoretically an ischemic event could certainly eventually trigger an IBD flare, but this would be somewhat irrelevant in light of the seriousness of the ischemic event itself.

You're very welcome.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by care314 »

I must take amoxicillin before dental work because I have a hip replacement and rods and screws in my back and atrial flutter. I'm due for routine teeth cleaning. Do you have any suggestions that I could make to my dentist as to an alternative to the amoxicillin?
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tex
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Post by tex »

At one time I would have considered Ciprofloxacin to be a reasonable option, but as the list of black box warnings on it's label continues to grow, I'm no longer convinced that it's a good choice.

I believe that the next time I need an antibiotic for dental work, I will try azithromycin (Zithromax, Zmax, Z-Pak). Most members here who have used it have reported good results, without adverse effects on their MC. See what your dentist thinks about azithromycin.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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care314
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Post by care314 »

Tex,

Thank you for the suggestion. I'll call the office tomorrow and see what happens. Just now getting clear of a flare of lymphocytic, and I certainly don't intend to take anything that will put me back into another one.

Still getting used to your site and how to respond and so forth.

care 314
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Just double-checking Wellbutrin

Post by TheNutmegger »

Hi Tex (or anyone else who might be kind enough to respond) -

My doctor recently prescribed me Wellbutrin/Buprion and I wanted to confirm that it is safe (in most cases). I've been asymptomatic for one-year now and really don't want to risk it at all.

Thanks so much for all you. Always great to know I have a place I can turn to with my questions.

Ed
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Erica P-G
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Post by Erica P-G »

Hi Ed,

I found this
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=19771

Antidepressant/anti-anxiety medications

amitriptyline (Elavil — at very low doses, such as 10 mg, Elavil seems to be relatively well tolerated)
bupropion (Wellbutrin)

Caution: SSRIs and SNRIs are known to cause MC for many patients. At higher (more typical) doses, the tricyclic antidepressants (such as amitriptyline) are also known to trigger the development of MC for some patients.


Hope this helps...
Erica
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Dx LC April 2012 had symptoms since Aug 2007
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