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Thread: Antibiotics: is low-dose as effective as high dose?

  1. #1
    Senior Member TheMediumDog's Avatar
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    Default Antibiotics: is low-dose as effective as high dose?

    Anybody have any experiences with this?

    By "high dose" I just mean the normal levels you are usually prescribed, like 100mg for doxy and minocycline, or 1000mg for oxytetracycline etc.

    Like, anybody tried dropping down to a low dose (like 40mg for doxy etc) and experienced problems? (Or maybe improvements?)

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    Senior Member J-Mill's Avatar
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    Default Low vs. High Dose

    I can tell you that I didn't do great on periostat (doxy 20 mg/2x a day) but did improve with doxy 100 mg/2x a day.

    I asked my derm about this and he said that when Collagenex did their trials they obtained substantial data that some people do not improve on low dose regimes but do on high dose. My derm says that it has been mistakingly reported that doxy's anti-inflammatory effects cap out at 40 mg/day. He said that was nonsense and common sense (along with studies) show that the effect increases with dosage. He said many people just get better with the low dose because it does exhibits a substantial anti-inflammatory effect, and for some it is enough.

    With accutane he said that the anti-inflammatory effect at low dose is even more substantial than doxy and the reason they do not use high dose is the negative side effects on the skin counteracting the good of the anti-inflammatory effect. They try and use the lowest dose possible for that reason.

    I have not seen any of the data personally.
    "Get busy living or get busy dying."

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    Senior Member TheMediumDog's Avatar
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    Default

    Thanks J-Mill,

    How long did you take the periostat for? (Just wondering if your experience could have been of periostat not getting up to full working speed; and the 200mg per day just getting there quicker? Just a thought).

    Must say, it does look common-sensical that 40mg would have less of an effect, as your derm says. It would be rather scandalous if the data-suppression you refer to is true. More scandalous that its legal.

    By the way, are the effects of low-dose accutane of the same type as
    those of (e.g) doxy? Suppression of p&p's etc?

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    Senior Member J-Mill's Avatar
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    Default length of time

    Quote Originally Posted by TheMediumDog View Post
    Thanks J-Mill,

    How long did you take the periostat for? (Just wondering if your experience could have been of periostat not getting up to full working speed; and the 200mg per day just getting there quicker? Just a thought).

    Must say, it does look common-sensical that 40mg would have less of an effect, as your derm says. It would be rather scandalous if the data-suppression you refer to is true. More scandalous that its legal.

    By the way, are the effects of low-dose accutane of the same type as
    those of (e.g) doxy? Suppression of p&p's etc?
    I took periostat for 4 full months before going on full dose. Periostat did help but not much, full dose really kicked back the redness on my forehead.

    I am not sure if they are supressing the data per se, it came out of their clinical trials and had to be forwarded to the FDA. You will note that the study they released for publication pitted 40 mg/day against 100/mg a day (nott 200/mg which is considered the starting dosage for initially treating rosacea). Similarly when the study was repeated "independently" (I am cynical) they also pitted 40 vs. 100 per day. In short they have choosen not to release a study for publication and peer review with this data. I am sure that the FIA allows access to it through the FDA some how but I don't know who could be bothered to actually apply.

    Like the antibiotics no one knows necessarily why low dose accutane works for Rosacea but it is theorized that its potent anti-inflammatory action on the skin (it is I beleive the most powerful anti-inflmmatory for the skin that is available) is the reason. It supresses p&p's, and is supposed to lessen inflammation and therefore ameliorate other symptoms as well such as redness, itching, scaling, etc. Some people have posted about how low dose accutane actually reversed their early stage rhinophyma, now that's an anti-inflammatory.
    "Get busy living or get busy dying."

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    Senior Member TheMediumDog's Avatar
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    Default

    Thanks again.

    I'm not completely clear what you're saying re. the study trials. That they omitted to release data for 40mg v 200mg (but just versus 100mg); is that right?

    4 months is certainly long enough, so that answers that thought.

    My interest is piqued in low-dose accutane. I actually went so far as to obtain some 10mg tabs from Turkey ('genuine Roche') a while back. But I always quake in fear in front of 'tane. Its reputation is vicious.

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    Senior Member J-Mill's Avatar
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    Default Sorry

    Quote Originally Posted by TheMediumDog View Post
    Thanks again.

    I'm not completely clear what you're saying re. the study trials. That they omitted to release data for 40mg v 200mg (but just versus 100mg); is that right?

    4 months is certainly long enough, so that answers that thought.

    My interest is piqued in low-dose accutane. I actually went so far as to obtain some 10mg tabs from Turkey ('genuine Roche') a while back. But I always quake in fear in front of 'tane. Its reputation is vicious.
    What I meant was that during their phase trials testing first periostat and then the time released version of 40 mg doxy that they would come to call Oracea they collected data about the comparative success of using that dose versus 200 mg/day but did not submit that for publication because it was not as positive as 100 mg/day data (where they saw no change).

    This is what I am told, I have no first hand knowledge of this.

    If you are going to take it just make sure you check the expiry date, I think it normally sells with about a one year shelf life left.
    "Get busy living or get busy dying."

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