Flagyl (metronidazole) versus Tinidazole (Tinactin): differential responses?
As we have more people on the CAP protocols longer, our community is accruing clincal priceless experience with the different medications used and course of improvement and diffficulties on the CAP. One of these areas for observation and discussion has been use of Tinidazole versus Flagyl, and it's effect on treatment and course of recovery. There has been another thread discussing these, but I thought it was time to restart the discussion now that a number of people have experienced switching back and forth between these meds. So my own comments (posted on Rica's blog also) below.
Tini vs Flagyl-- interesting questions.
I have to say, after doing Tini since pulse 3 and then trying Flagyl again for my last pulse (pulse 16) they do have different effects. Not just different side effects. It is possible, as our clinical experience accumulates, that there could even be good reason to do courses of both, or alternate them for pulses.
I had felt I'd reached, if not a plateau, at least a slowed rate of improvement in my major symptoms: brain fog, fatigue, flares of inflammation. The Flagyl pulse made for a significant improvement in brain fog and fatigue-- at least during the pulse (I got a stomach virus right after, so can't yet assess post-pulse baseline).
Although we know that Tini has longer half life and better minimum kill concentration than Flagyl, these are general blood levels. How they concentrate in different organ tissues is not at all clear.
It's also my impression, from reading reactions of people earlier in the protocol, that while Tini is easier to take (that's why i switched) and gentler in side effects during the pulse, people may have longer post-pulse reactions from it. So the notion that there is a "behind the scenes" process going on could be from it's longer action, as well as lack of clarity about improvements on multiple, closely spaced pulses with Tini, ie if you are still getting reactions by the time you pulse next, you may not be seeing improvements as your system doesn't get to repair (or at least not in a way you can discern).
So, if we hypothesize a situation where Tini & Flagyl get at Cpn better in different tissues, one from another, and that the concentrations and post-pulse profiles are different, there may be value in alternating. Clearly, for most of us it would be easier to start with Tini (although more costly). But worth trying a course of Flagyl after the bacterial load is down enough to see if it has some differential effect.
Let's keep gathering info on this. I'll post this on it's own thread to accumulate observations there, so we don't highjack Rica's.
Combined Antibiotic Protocol for Chlamydia pneumonia in Chronic Fatigue Syndrome & Fibromyalgia- Currently: 150mg INH, Doxycycline/Zithromycin, Tinidazole pulses. Northern Ohio, USA