doxycycline calcium
Author: michaelrussell
Author: michaelrussell
HOW SUPPLIED
doxycycline calcium
Oral suspension: 50 mg/5 ml
doxycycline hyclate
Tablets (film-coated): 100 mg
Capsules: 50 mg, 100 mg
Capsules (enteric-coated pellets): 100 mg
Injection: 100 mg, 200 mg
doxycycline hydrochloride
Tablets: 50 mg:, 100 mg:
Capsules: 50 mg:, 100 mg:
doxycycline monohydrate
Capsules: 50 mg, 100 mg
Oral suspension: 25 mg/5 ml
ACTION
Unknown. Thought to exert bacteriostatic effect by binding to the 30S and possibly 50S ribosomal subunits of microorganisms, thus inhibiting protein synthesis. May also alter the cytoplasmic membrane of susceptible microorganisms.
INDICATIONS & DOSAGE
Infections due to susceptible grampositive and gram-negative organisms (including Haemophilus ducreyi, Yersinia pestis, and Campylobacter fetus), Rickettsiae, Mycoplasma pneumoniae, Chlamydia trachomatis, and Borrelia burgdorferi (Lyme disease); psittacosis; granuloma inguinale -
Adults and children over age 8 weighing at least 45 kg (99 lb): 100 mg P.O. q 12 hours on first day; then 100 fig P.O. daily. Or, 200 mg I.V. on first day in one or two infusions; then 100 to 200 mg I.V. daily.
Children over age 8 and under 45 kg: 4.4 mg/kg P.O. or I.V. daily, in divided doses q 12 hours on first day; then 2.2 to 4.4 mg/kg daily in one or two divided doses.
Give LV. infusion slowly (minimum 1 hour). Infusion must be completed within 12 hours (within 6 hours in lactated Ringer's solution or dextrose 5% in lactated Ringer's solution).
Gonorrhea in patients allergic to penicillin -
Adults: 100 mg P.O. b.i.d. for 7 days (10 days for epididymitis).
Primary or secondary syphilis in patients allergic to penicillin -
Adults: 300 mg P.O. daily in divided doses for at least 10 days.
Uncomplicated urethral, endocervical, or rectal infections due to C. trachomatis or Ureaplasma urealyticum -
Adults: 100 mg P.O. b.i.d. for at least 7 days (10 days for epididymitis).
Prophylaxis of malaria
Adults: 100 mg P.O. daily.
Children over age 8: 2 mg/kg P.O. once daily. Dose shouldn't exceed that of adults.
Note: Prophylaxis should begin 1 to 2 days before travel to endemic area and continued until 4 weeks after travel.
Pelvic inflammatory disease
Adults: 100 mg I.V. q 12 hours with cefoxitin or cefotetan and continued for atleast 2 days after symptomatic improvement; thereafter, 100 mg P.O. q 12 hours for a total course of 14 days.
ADVERSE REAOIONS
CNS: intracranial hypertension.
CV: pericarditis, thrombophlebitis.
EENT: glossitis, dysphagia.
GI: anorexia, epigastric distress, nausea, vomiting, diarrhea, oral candidiasis, enterocolitis, anogenital inflammation.
Hematologic: neutropenia, eosinophilia, thrombocytopenia, hemolytic anemia.
Hepatic: elevated liver enzymes. Musculoskeletal: bone growth retardation in children under age 9.
Skin: maculopapular and erythematous rashes, photosensitivity, increased pigmentation, urticaria.
Other: hypersensitivity reactions, anaphylaxis, superinfection; permanent discoloration of teeth, enamel defects.
INTERACTIONS
Drug-drug. Antacids (including sodium bicarbonate) and laxatives containing aluminum, magnesium, or calcium; antidiarrheals: decreased antibiotic absorption. Antibiotic is given 1 hour before or 2 hours after any of these drugs.
Carbamazepine, phenobarbital: decreased antibiotic effect. Avoid if possible.
Ferrous sulfate and other iron products, zinc: decreased antibiotic absorption. Drug is given 2 hours before or 3 hours after iron administration.
Methoxyflurane: may cause nephrotoxicity with tetracyclines. Monitor carefully. Oral anticoagulants: increased anticoagulant effect. PT and INR must be monitored, and dosage adjusted as needed.
Oral contraceptives: decreased contraceptive effectiveness and increased risk of breakthrough bleeding. A nonhormonal form of birth control should be recommended.
Penicillins: may interfere with bactericidal action of penicillins. Avoid use together.
Drug-lifestyle. Alcohol use: decreased antibiotic effect. Avoid use together.
Sun exposure: photosensitivity reactions may occur. Take precautions.
EFFECTS ON DIAGNOSTIC TESTS
Drug causes false-negative results in urine glucose tests using glucose oxidase reagent (Diastix or Chemstrip uG). Parenteral dosage form may cause false-positive Clinitest results. Drug also causes false elevations in fluorometric tests for urine catecholamines.
CONTRAINDICATIONS
Contraindicated in patients with hypersensitivity to drug or other tetracyclines.
SPECIAL CONSIDERATIONS
* Use cautiously in patients with impaired renal or hepatic function.
* Use of these drugs during last half of pregnancy and in children under age 9 may cause permanent discoloration of teeth, enamel defects, and bone growth retardation.
* A specimen for culture and sensitivity tests should be obtained before giving first dose. Therapy may begin pending test results.
* Alert: Expiration date should be checked. Outdated or deteriorated tetracyclines have been associated with reversible nephrotoxicity (Fanconi's syndrome).
* Drug is administered with milk or food if adverse GI reactions develop.
* Reconstituted injectable solution is stable for 72 hours if refrigerated and protected from light.
* With large doses or prolonged therapy, there is a potential for superinfection, especially in high-risk patients.
* Patient's tongue should be checked for signs offungal infection. Stress good oral hygiene.
* Drug is not indicated for the treatment of neurosyphilis.
Alert: Don't confuse doxycycline, doxylamine, and dicyclomine
I. V. administration
* Powder for injection is reconstituted with sterile water for injection. 10 ml is used in 100-mg vial and 20 ml in 200-mg vial. Solution is diluted to 100 to 1,000 ml for I. V infusion. Extravasation must be avoided. Solutions that are more concentrated than 1mg/m1 should not be infused. Infusion time varies with dose, but usually ranges from 1 to 4 hours. I. V infusion site is monitored for signs of thrombophlebitis, which may Occur with I. V administration.
* Drug should not be exposed to light or heat. Protect it from sunlight during infusion.
Patient teaching
* Take entire amount of drug exactly as prescri bed, even after feeling better.
* Report adverse reactions promptly. If drug is being administered I. V, alert health care provider if discomfort Occurs at I.V. site.
* Take oral form of drug with food or milk if stomach upset Occurs. Don't take oral tablets or capsules within 1 hour of bedlime because of possible esophageal irritation or ulceration.
* Avoid direct sunlight and ultraviolet light, wear protective clothing, and use sunscreen. Photosensitivity reactions may occur within a few minutes to several hours lifter exposure. Photosensitivity persists for some time after therapy ends.
* Report signs and symptoms of superinfection to the health care provider.
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