Positives

• CIRS patients with resistant MARCoNS combined oral rifampin 300 mg twice daily with BEG spray for about a month and reported clearance when sprays alone had failed Surviving Mold.
  
  
• Patients who finally cleared MARCoNS with rifampin saw downstream inflammation labs improve enough to advance to later Shoemaker steps Surviving Mold.
  
  

Negatives

• A patient on rifampin plus BEG developed excruciating migraines and intense pain across the nasal bridge that hadn't been there before treatment Surviving Mold.
  
  
• Patients consistently report orange-red discoloration of urine, sweat, and tears throughout treatment, plus stomach upset and fatigue Drugs.com.
  
  

Hurdles & Side Effects

• Rifampin can injure the liver, especially when combined with other CIRS medications, requiring patients to avoid alcohol and monitor LFTs NIH LiverTox.
  
  
• Rifampin is a potent CYP450 inducer that can wreck the levels of birth control, statins, and many other meds patients are also taking Mayo Clinic.