Submitted by Len O on Tue, 2011-04-12 20:29

Hi everyone!  I took a very cautious approach with my very first Flagyl pulse last weekend and took only one capsule to see what the die off would be (as per Dr. Statton's advice to go slow due to a previous overwhelming reaction to Rifabutin). Luckily had no reaction so not so nervous to take the next step towards the goal of a five day pulse. First, though, I hope you can help me with two questions: 1. If I had no die-off reaction to just one 400 mg dose of Flagyl last weekend, do I still have to wait 3-4 weeks to try a full one-day pulse, or could I try a full day's worth (i.e. 3 X 400 mg) only one week later (i.e. this weekend)?2. Do you recommend taking the Flagyl with one of the daily doxy doses or separating it from other antibiotics?  For example, on a Wednesday at noon I take 100 mg doxy, 250 azithro, and di-sodium EDTA plus buluoke (I have biofilm and hypercoagulation issues). Would I just add the Flagyl to that or do I need to take the 400 mg Flagyl separately from the other abx? Hope you can help with these questions; you are a very knowledgable and experienced bunch! Thanks very much, Len 

Hi Len

My abx are never separated except Rifampin, which must be after a two-hour fast.  Then I take Doxy, Azithromycin. Amoxicillin, and flagyl.  I think flagyl takes close to ten days to get completely out of your systen, but I take two 500 mg pills a day.   Go for it!  Do you work?  (Dumb question - everyone we know works!).  Do what you can.


3/9 Symptoms returning. Began 5 abx protocol 5/9 Rifampin 600, Amox 1000, Doxy 200, MWF Azith 250, flagyl 1000 daily. Began Sept 04 PPMS EDSS 6.7 Now good days EDSS 1 Mind, like parachute, work only when open. Charlie Chan  In for the duration.&am

Len- no reason to wait. Mostly waiting is geared to give people time to recover from a pulse as reactions can continue for days to weeks for some. I'd try a twice a day pulse for three days and see what that is like before gearing up to a three times a day pulse for five days!

Agreed. A couple of days should be enough to know if you're going to have a really dramatic response.

As for taking flagyl apart from other meds, I never have.   I usually chug a handful of meds (doxy, vitamin D, azith, flagyl, vitamin A, NAC) together, with enough water to float a small elephant.

You might want to take it alone, then use a chaser of something tasty, like pudding, or jam, or a peppermint, because the pills are vile-tasting. I started wrapping them in a coating of jam, on a spoon, tossing them far back in my mouth, then drinking my water. Over time, I just toughed it out and took them with everything else.

Best of luck!

The difference between what we do and what we are capable of doing would suffice to solve most of the world’s problems. Mohandas Gandhi

Hello Len,

Re the pulse, since you've not done a full weekly one...... I agree with the others and Jim, why not just take it a day at a time; and , if you get to feeling bad then stop/mop and wait until it's time to pulse again. :)

I, personally, have always had to space out my meds.... never been able to handle all of them at once, even with food in my stomach.


JeanneRoz ~ DX'd w/ CPN 4/2007; 6/07 -"officially" dx'd w/CFIDS/FM; also: HHV6, EBV, IBS-C, 100 Doxy:BID; 500 mg Biaxin BID; Tindamax Pulses, B12 shots, ERFA Dessicated Thyroid,Cortef, Iodoral 25 mg, Vit D-6,000 uni

I would agree with JeanneRoz.  Start with one dose of Flagyl in the morning for a couple of consecutive days and then go up to two doses per day if you are coping fine.  You can always stop if you need to.

Don't underestimate the benefit of moppers.  I find charcoal works best but I use chlorella more because I take too many meds/supplements to find many four hour windows for a dose of charcoal.  I take 2 g or chlorella 2-4 times per day and then 2 g of charcoal either first thing in the morning or last thing at night.

Started CAP for Cpn on 11/14/10 - Per my doctor, paused Abx 5/18/13 - NAC, B-complex, Vit D3 (50,000/week), Niacin (100 mg/BID). Started Buhner protocal (2nd edition) on 8/30/16. Currently using a blend of Buhner's Cpn and Mycoplasma protocols

Thanks for the advice everyone!  Was able to get 400 mg Flagyl compounded by a local pharmacy so I could avoid jumping into the 500 mg dose at start. Took one Flagyl on Friday evening, then one each twelve hours for total of four doses. Will now stop and wait since have to go to work tomorrow.

 Can there be a delayed reaction?  So far after 4 X 400 mg doses of Flagyl have not seen much reaction. (Of course spaced Charcoal in between as well as mopper.)  I think I read somewhere that some people get a reaction up to 3 days later so will wait and see. Just wondering, because, in 2008, after only ONE day of Rifabutin (mycobutin), within 24 hours I was shivering, had  a headache and lost my appetite and ended up in bed very sick. Any ideas? Is flagyl quite a bit different in its capability to provoke a die-off from Rifabutin?



Started Wheldon CAP Nov 2010 for interstitial cystitis suspected to be caused by Cpn. Now on all supplements, Doxy 100 mg 2/day, Azithromycin 250 mg M,W,F, one complete Flagyl pulse completed.

Len O... it is my understanding that Flagyl (and Tindamax) target the cryptic form of CPN whereas, Rifampin mainly affects the elementary bodies.  That may be why you had an immediate reaction to the Rifampin. Most of my pulsing reactions were always delayed. 

A lot of this treatment depends on your physiological makeup, immune system (gut/biofilm), and other possible bacterial pathogens you may have, in addition to CPN. 

Many here have similar treatment experiences but none of us can really say we react exactly like someone else here (IMO) :).  BUT we can sure relate and sympathize!!




JeanneRoz ~ DX'd w/ CPN 4/2007; 6/07 -"officially" dx'd w/CFIDS/FM; also: HHV6, EBV, IBS-C, 100 Doxy:BID; 500 mg Biaxin BID; Tindamax Pulses, B12 shots, ERFA Dessicated Thyroid,Cortef, Iodoral 25 mg, Vit D-6,000 uni

Hi Len,
Delayed reactions can be common. Even differ from one pulse to another. That seems to my experience. Expect the unexpected seems to be the motto around here.

Feeling 98% well-going for 100. Very low test for Cpn. CAP since 8-05 for Cpn/Mycoplasma P.,Lyme, Bartonella, Mold exposure,NAC,BHRT, MethyB12 FIR Sauna. 1-18-11 begin new treatment plan with naturopath