Bronchiectasis with Aspergillosis

[Janlyn1953]

Does anyone have this .I'm really struggling with Different fungus drugs which effects my Diverticulitis.

Does anyone have the same complaint.

[Ozzie3]

I took Sporanox (itraconazole) for 9 months and didn’t have any problems - but I don’t have diverticulitis. I had to swallow the capsules with coke because it they are better absorbed with an acid drink. It suited me because I like Diet Coke!😊. Which antifungal are you taking?

[Janlyn1953 in reply to Ozzie3]

Did you find the itraconazole worked?.I was given this also low dose of Steroids, which upset me.

Are you still taking them?

[Ozzie3 in reply to Janlyn1953]

I finished the course. I took it several years ago after an episode of coughing up blood. It cleared my lungs and i have not needed it again. I do have allergic bronchopulmonary aspergillosis and now have mild bronchiectasis. I am 72 years old and very well and full of energy. I cough up a bit of phlegm now and again. The only medication I take for my lungs now is an asthma inhaler that combines a steroid and broncholdilator (Breo Ellipta) I use it once a day (in the morning). I hope this helps.

[Janlyn1953 in reply to Ozzie3]

Hi.Did you take 10mg of Steroid with the itraconazole.

The specialist has given me Itraconazole 100mg one daily and 10mg of Prednisone.

To be honest I'm just trying the itraconazole again as last time I was poorly on them.

I'm okay up to now.

But not taking the steroid.

[Ozzie3 in reply to Janlyn1953]

I took a short course of oral steroid (Prednisone) before starting the itraconazole but that was all. I have never taken oral steroid subsequently, but I do use a steroid inhaler (preventer). My specialist doesn't routinely give oral steroid for allergic bronchopulmonary aspergillosis (ABPA) - only if its very bad.

My specialist did a blood test every now and again to check that the itraconazole level in my blood was adequate. The blood was always collected just before the morning dose to get a 'trough level'.

My levels were always good. I didn't have any side effects from the itraconazole, and I took 200mg twice daily!

My guess is that your specialist is giving you steroid and itraconazole together so that he/she can give you lower doses of each.

I don't know if you are taking your itraconazole with Coke as I did. If you are, I recommend drinking it through a straw to protect your teeth. I also only drank diet Coke to avoid the sugar.

[Janlyn1953 in reply to Ozzie3]

To be honest I haven't taken the steroids just 100mg of Itraconazole, with everything upsetting my tummy I get frightened. Why do you take it with coke?

I was told to take it on a full tummy so I take it with My evening meal.

Janet.

[Ozzie3 in reply to Janlyn1953]

Itraconazole is better absorbed with an acid and Coke is acid. I was on a medicine for gastric reflux which reduces the natural acid in the stoumach, so the Coke improved absorption of the itraconazole.

[Janlyn1953 in reply to Ozzie3]

That sounds a good idea.Anything to stop it upsetting my tummy and Diverticulitis.

Thank you for your advice.

Janet

[Bifocle]

I've had allergic bronchpulmonary aspergillosis and asthma for twelve years, and until recently have lead a very active life, hiking, traveling, and working. I self managed my ABPA flares with prednisone, usually two or three times a year (eventually developing secondary adrenal insufficiency, oh well).

But I'm struggling now, and completely understand how difficult it is to manage multiple disease treatments. I was hospitalized twice last month, had two bronchoscopies for a repeated right middle lobe collapse, and my culture came back positive for MAC and aspergillosis. The pulmonologist put me on voriconazole, which was horrible, frankly, as well as pred and two antibiotics.

Have you discussed going on a biologic with your pulmonologist? I asked to be put on Xolair for years, but it's very expensive and my HMO didn't want to pay for it. Now that I'm really sick I'm finally starting Xolair for my ABPA and hoping it makes a difference. Do you know if you have the allergic type of aspergillosis (ABPA) or a fungal infection (CPA)? If you are just on itraconazole (no steroids) you might have the CPA version. I highly recommend the Facebook group, "National Aspergillosis Centre Support" for information on this rare disease. It is a great source of information and support.