neomycin daily would that be too much?

Thank you.

[Rockerforlife]

Ive read that taking antiboitics while on TX is not wise,it somehow lowers the the TX drugs effects

[Bill1954]

There are a number of new management techniques available for hepatic encephalopathy, a condition associated with End Stage Liver Disease. I think you’ll find that few members here are up to date on these; here’s an article that addresses the issue a little:

http://www.liverdisease.com/encephalopathy_hepatitis.html

I understand that Xifaxin has been officially approved by the U.S. FDA recently as well; you should discuss this with your doctor if the Lactulose isn’t effective--

Bill

[HectorSF]

Here is more info on HE.

Hepatic Encephalopathy

The diagnosis of hepatic encephalopathy is based on clinical examination demonstrating decreased attention, altered personality, and reversal of day/night cycle, and on physical examination (eg, asterixis). The severity of a hepatic encephalopathy episode is graded according to the West Haven criteria (grade 1-4) based on state of consciousness, intellectual function, behavior, and neuromuscular signs.

Treatment:
    * Lactulose (dose titrated to 2-4 bowel movements per 24 hours) is the initial treatment for hepatic encephalopathy.
    * Nonabsorbable antibiotics such as rifaximin 400 mg 3 times daily or neomycin 1000 mg twice daily are second-line treatment for hepatic encephalopathy.
    * Minimal hepatic encephalopathy is common in patients with Child B/C cirrhosis, although diagnosis is difficult.
    * Treatment of hepatic encephalopathy improves quality of life.

Antibiotics, particularly nonabsorbable antibiotics such as neomycin 1000 mg twice daily, are currently the recommended second-line treatment for hepatic encephalopathy. Rifaximin 400 mg 3 times daily is a newer nonabsorbable antibiotic that, according to 2 meta-analyses, is at least as effective as nonabsorbable disaccharides for the treatment of hepatic encephalopathy but with a lower incidence of abdominal pain (P = .04) and fewer hospitalizations. A third meta-analysis found rifaximin to be more effective than lactulose in the treatment of hepatic encephalopathy.  A recent phase III trial in patients with recurrent hepatic encephalopathy found that rifaximin reduced hospitalizations for hepatic encephalopathy by approximately 50% and reduced the risk of hepatic encephalopathy breakthrough by 58%.

I currently take Lactulose and rifaximin for my minimal HE.

Hope this helps.
HectorSF