Rosacea- doxycycline and nausea

I wonder if any folks with Rosacea have tried Oxytetracyline or Erythromycin instead of Doxycline? The Metro cream isnt effective on its own. No matter when or what dose of Doxy I take the nausea is a real problem. As long as I'm decreasing my Pred this is going to be a problem and I'm only at 12.5mgs now. My dermato has just retired so I scouting for a new one. The red cheeks I can put up with but I'm starting to develop a bit of Phyma on my nose which is one step too far🫣🫣. The stinging is quite uncomfortable as well. Many thanks for any advice.

🎄A very happy and peaceful Christmas to you all in spite of everything going on in this mad world 🎄

[PMRpro Ambassador]

Why not just ask your doctor if you can try another tetracycline? Doxy is the most commonly used so I suspect it is usually found to be the best but other things are used and maybe less unpleasant to take.

[Hidden in reply to PMRpro]

Thanks. My GP will prescribe but I am unsure whether another cycline would just give me the same nausea. I've never had occasion to take oxytet previously. Another delight that goes with the Pred/ low dose a/b combo is the recurrent nether region thrush that only responds to Fluconazole tabs. May as well pay my property taxes from the GP practice at the rate I have been there this year!

[PMRpro Ambassador in reply to Hidden]

Oh joy - NOT!

Not sure of the reliability of this

pmc.ncbi.nlm.nih.gov/articl...

as papers with loads of Chinese names are often a "publish to get your degree" exercise but the analysis seems to think minocycline has fewest adverse effects so possibly worth the try.

But this suggests other abx in the Abstract.

pubmed.ncbi.nlm.nih.gov/312...

Since you are in France - is there any chance of laser therapy or any of the other things that I have no doubt are NOT available on the NHS?!!!

[Hidden in reply to PMRpro]

Thanks for those references. Minocycline doesnt get good reports from the Br Ass Derm guideline due its side effects though. I'll try the Soolantra option as suggested by New PMR. Most academic articles relate to plain Rosacea rather than the steroid induced variety. Even more niche than PMR it would seem! I'm off to see our regional PMR Prof in early Jan, I cancelled two weeks ago due to snow. ( Norman drivers are clueless in snow so its best to stay off the roads) My local Rheumato is happy for me just to keep reducing, but she didn't factor in the Rosacea element, possibly cos masks are obligatory in hospital settings.The new French guideline reccomends Kevsara as first choice second line, so if the phyma cant be controlled I would be tempted to try it if offered, downsides not withstanding. Laser therapy is offered mainstream in UK and France but the phyma has to be quite florid and one has to be off or on low steroid. Hey ho!

[PMRpro Ambassador in reply to Hidden]

What downsides of Kevzara? I've been on Actemra for nearly 3 years with no problems I can identify.

You mean the UK inability to drive in a smidgeon of snow dates back to 1066? Amongst other things the locals here do well tends to be getting about in snow!!! Not a good idea to go out while actively snowing especially if Italian tourists are about but as soon as it stops the farmers are out clearing the villages and mountain roads and everyone MUST have winter tyres or chains.

[Hidden in reply to PMRpro]

I feel that going for second line treatment on account of the Rosacea carrys a less favourable risk/ benefit than if I was doing it because I couldnt reduce my Pred or had a high osteoporosis risk or some such imperative to get the pred dose down.

[PMRpro Ambassador in reply to Hidden]

But if money weren't involved, Kevzara would become first line - it is far superior to pred in achieving remission. If I were offered Kevzara without limitation I'd take it quite happily. Pred is well established, Kevzara is the new kid on the block.

[Hidden in reply to PMRpro]

Certainly worth thinking about then. Ive been very undecided about going for a second opinion given my local Rheumato is so easy to get along with. However she did let slip that she had no patients on Kevsara ; she's recently hatched I think.

[PMRpro Ambassador in reply to Hidden]

So is the drug in terms of PMR - it was approved in the USA last year and that would have been the first. I have no idea what the status is in Europe - not an option in the UK and according to Sarah Mackie unlikely to be for the foreseeable for PMR.

Just looked

ema.europa.eu/en/medicines/...

It has been used in RA previously - not a new drug in that sense. I'm on Actemra/tocilizumab which works on the same inflammatory substance, just in a different way.

[NewPMR]

Hi, the antibiotics and creams didn’t help me at all. I looked into this and found that some folks are sensitive to the Dermadex we all have on our skins, causing rosacea. I spoke to the dr about this and she prescribed Ivermectin cream, trade name Solantra. The difference was amazing and worked quite quickly. I’ve used it ever since and so far no problems. Might be worth trying, all the best

[NewPMR in reply to NewPMR]

Sorry that should have read Demodex

[Hidden in reply to NewPMR]

Thanks very much for that info. I will see if I can try it. The Doxy did well for my spot and pustule element but with the aforementioned undesirable side effects.

[NewPMR in reply to Hidden]

It was the pustule element that persuaded my dr to try ivermectin. It does upset me to think there might be loads of folks taking antibiotics unnecessarily.

[waltztherapy]

Hi Rosacea hit me in my mid 50's, (menopause).

After researching for alternatives to the nauseating tetracycline antibiotics, I discovered my trigger factors through Rosacea UK, and careful food elimination, so have been able to control any 'red face rash' outbreaks for over 20 years. When PMR struck, after my second hip replacement 4 years ago, I tried to apply similar tactics to reduce the inflammatory condition. I like to think that avoiding my known trigger factors, does bring some relief, but of course, it's only prednisolone that works for relieving PMR.

Now in year 4 and struggling to get below 7.5 mg prednisolone, I do still maintain a regular exercise regime, tailored to suit flare-ups and 'brick wall' fatigue. Still dreaming that I will eventually return to where I was before PMR, but being realistic at the age of 81.

Good luck and seasons greetings to all.

[Hidden in reply to waltztherapy]

Thanks. Goodbye alcohol, spicy foods, warm weather............on the plus side good reason to avoid folks that wind one up, purely medicinal of course!

[waltztherapy in reply to Hidden]

Luckily, I can still enjoy a glass of white wine, a mild curry, but not too often in one week. As for stress, I expect to live with a planned reduced amount of stress, cos that's life and living.

[byebyebicycle]

Hi, My Rosacea has got very much worse since starting on Pred, at least that's what I've put it down to. I've had Rosacea for at least 15 years and learnt to control it pretty well with occasional application of Metronidazole and an emollient cream like Zerobase. Now I'm using the Metronidazole every other night and lots of zero base in the day and it's just about in control. I use Metronidazole only at night since I believe that the metronidazole will react with sunlight with adverse effects.

[Hidden in reply to byebyebicycle]

Thanks. I have only just discovered the advice to use water based moisturiser , for the moment I am using Aqueous cream. The intermittent use is not mentioned many places but makes sense if it works just as well.

[waltztherapy in reply to byebyebicycle]

Can you think of a possible trigger food, that you eat on a daily basis? Mine was bananas and tomatoes.

[waltztherapy in reply to byebyebicycle]

Can you think of a possible trigger food, that you eat on a daily basis? Mine was bananas and tomatoes.

[Hidden in reply to waltztherapy]

Yo! I have had a banana for breakfast every day for ever. Only had Pred for 18 months and Rosacea for 4 months. Will drop it but what to substitute..... I'm intolerant of all cereals. 😱 I can do without curries and alcohol But🍌🍌🍌🍌!!! 😢😢😢

[waltztherapy in reply to Hidden]

I felt exactly the same about bananas. Had eaten them daily for over 50 years. But when I stopped eating bananas, a wonderful thing happened. Within a week the redness subsided, followed by disappearing papules and pustules. By the third week without a scrap of banana, I had my lovely clear complexion back. Pure joy!! You will happily live without bananas, I'm sure. There are many alternatives that I can and do eat, like peaches, nectarines, apples, blueberries, raspberries not strawberries, and definitely not raw tomatoes - cooked and tinned tomatoes are fine!Good luck. I would love to hear that this works for relieving your Rosacea. I've kept mine at bay for years.

Take a look at the National Rosacea Society, where I found "Factors that may trigger flare ups". If I suspect redness returning, I consult the list. Only do one food elimination at a time, I was warned.

Hope this helps.

[Hidden in reply to waltztherapy]

👍

[Countrykitten]

Everyone is different..I don't have Rosacea but am fine with Doxycyline for Sinusitis but can't tolerate Erythromycin, it gives me violent stomach pains, nausea and diahorrhea, Good luck finding an alternative and have a very happy Christmas.

[Meezamom]

Hi, I have had rosacea for decades and tried all the antibacs, the only thing that has worked properly is a cream I read about online. It is called Soolantra and is available on the NHS (for UK readers). I have been using it a couple of years and it has made an amazing difference. It must have been relatively new, because my GP wouldn't prescribe it (calling it faddy🙄) and it was only when I insisted he search on the NICE website, did he find it and reluctantly prescribe it. Apologies if my post is a little off topic and to answer your question, Minocycline and Erythromycin didn't make me feel nauseous. Good luck

[Hidden]

Thanks, its not at all off topic. I would prefer to use topical products if possible. Both yourself and NewPMR have reccomended it and, since my nose is the worst affected at the moment I will ask my Dr for some. He only has ever had two patients with PMR and is happy for me to research ideas. It is available in France. 🎄

[NewPMR]

There are some recent posts about the Ivermectin/Soolantra cream. Were you able to get any. Whereabouts roughly are you in France?

[PMRpro Ambassador in reply to NewPMR]

The poster now appears as Hidden - that means they have left the forum and won't get a notification and see your reply.

[NewPMR]

oh what a shame, thanks for letting me know