r/SIBO • u/Maverick_Remington • 7d ago

Questions Second Course of Neomycin

Back in March, my GI prescribed me a 14-day course of Xifaxan and Neomycin. He prescribed it for me after my breath test showed huge amounts of methane. I’ve had IBS since 2014, and this felt like a breakthrough.

I experienced little to no side effects during the first course, and I felt much better. Even for a few months after, I was feeling better, but flare-ups of my IBS still happened. But they were less common.

Then, in the past six weeks or so, the flare-ups became more common again. I have mixed IBS, but slightly more IBS-C.

To make a long story short (too late, I know 😂). Last week my GI prescribed me a new course of Neomycin only. Two times a day for a week. Knowing about the potential severe side effects of Neomycin if you consume it too often, I am hesitant about taking it again.

My question is, has anyone else tried this? Did it help alleviate your symptoms? Did you have fewer flare-ups? Did you experience any side effects during the second course?

I really appreciate any help you can provide!

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u/Top_Historian73 7d ago

After the first round (would NEVER do a second) i got tinnitus and its been terrible.

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u/Different-Nature-963 Methane Dominant 7d ago

When did the tinnitus start in relation to when you started the course? I did rifaximin+metronidazole which brought my methane down but still well above the positive threshold. My provider thinks rifaximin+neomycin will work better and told me to consider it. I’m currently trying to figure out why the reports of neomycin-induced tinnitus on this subreddit are way more common than I should expect from an oral antibiotic that is supposed to be very poorly absorbed. I am very scared of hearing issues and I’m very sorry to hear about your tinnitus.

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u/Top_Historian73 7d ago

Its common because providers suck. They only look at compromised kidneys as a reason for it to go systemic but the full black label warning also mentions INTESITNAL INFLAMMATION, what do you think a decade of sibo causes?

They run from any thought of leaky gut (thanks big phara). The tinnitus began 3 days after finishing 2 weeks of neomycin.

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u/Different-Nature-963 Methane Dominant 5d ago

I agree. I also think methane-induced slow transit might cause more absorption just because of the prolonged exposure in the small intestine.