Doxycycline

Doxycycline is a prescription antibiotic medication indicated for the treatment of the following infections and diseases:

• Rocky Mountain spotted fever,
• typhus fever and the typhus group,
• Q fever,
• rickettsialpox,
• tick fevers,
• respiratory tract infections,
• urinary tract infections.
• lymphogranuloma venereum,
• psittacosis (ornithosis),
• trachoma,
• inclusion conjunctivitis,
• uncomplicated urethral/endocervical/rectal infections in adults,
• nongonococcal urethritis,
• relapsing fever,
• chancroid, plague,
• tularemia,
• cholera,
• campylobacter fetus,
• brucellosis,
• bartonellosis,
• granuloma inguinale,
• Escherichia coli,
• enterobacter aerogenes,
• Shigella species,
• Acinetobacter species,
• anthrax,
• Uncomplicated gonorrhea,
• Syphilis,
• Yaws,
• Listeriosis,
• Vincent's infection,
• Actinomycosis, and
• infections caused by Clostridium species.

In acute intestinal amebiasis, doxycycline may be a useful adjunct to amebicides.

In severe acne, doxycycline may be useful adjunctive therapy.

Because many strains of microorganisms have been shown to be resistant to doxycycline, culture and susceptibility testing are recommended.

Doxycycline is available under the following different brand names: Vibramycin, Monodox, Acticlate, Atridox, Avidoxy, Doxy, Doxycin, Doryx, Oracea, Periostat, Adoxa, Ocudox, and Doryx MPC.

Dosages of Doxycycline Should Be Given As Follows:

Adult Dosage Forms & Strengths

Capsules

• 50 mg (Monodox, generic)
• 75 mg (Monodox)
• 100 mg (Monodox, Vibramycin, generic)
• 150 mg (Adoxa)

The solution reconstituted powder for IV

• 100 mg (Doxy, generic)

Syrup

• 50 mg/5 mL (Vibramycin)

Oral Suspension

• 25 mg/ 5mL (Vibramycin, generic)

Tablet

• 20mg (generic)
• 50mg (Adoxa, generic)
• 75mg (Acticlate, Adoxa, generic)
• 100mg (Adoxa, generic)
• 150mg (Acticlate, generic)

Tablet, delayed-release

• 50mg (Doryx)
• 60mg (Doryx MPC)
• 75mg (generic)
• 100mg (generic)
• 120mg (Doryx MPC)
• 150mg (Doryx, generic)
• 200mg (Doryx)

Capsule, delayed-release

• 40 mg (Oracea, generic)

Periodontal extended-release liquid

• 10%

Dosage Considerations – Should be Given as Follows:

General Dosage

• Initial: 200 mg/day divided twice daily orally/intravenously (IV) on the first day (IV may be given once/day), THEN
• Maintenance: 100-200 mg/day once/day or divided once every 12 hours orally/intravenously (IV) (IV may be given once/day)
• Specific dosing varies depending on the condition being treated; consult your doctor.

Dosage Considerations

• Propionibacterium acnes,
• Actinomyces israelii,
• Acinetobacter spp,
• Bacillus anthracis,
• Bacteroides spp.,
• Bartonella bacilliformis,
• Bartonella henselae,
• Bartonella Quintana,
• Borrelia recurrentis,
• Brucella spp,
• Campylobacter jejuni,
• Chlamydia psittaci,
• Chlamydia trachomatis,
• Capnocytophaga canimorsus,
• Citrobacter diversus,
• Citrobacter freundii,
• Escherichia coli,
• Eikenella corrodens,
• Francisella tularensis,
• Haemophilus ducreyi,
• Helicobacter pylori,
• Klebsiella granulomatis,
• Klebsiella pneumoniae,
• Listeria monocytogenes,
• Mycoplasma hominis,
• Mycoplasma pneumoniae,
• Neisseria gonorrhoeae,
• Propionibacterium acnes,
• Rickettsiae,
• Shigella spp,
• MRSA,
• Staphylococcus saprophyticus,
• Streptococcus spp,
• Treponema pallidum,
• Ureaplasma urealyticum,
• Vibrio cholerae,
• Yersinia enterocolitica,
• Yersinia pestis,
• VRE, and
• mycobacteria other than tuberculosis.

Side effects of doxycycline include:

• Diarrhea
• Difficulty swallowing
• Drug rash
• Esophageal ulcer
• Esophagitis
• Facial redness
• Headache
• Hives
• Inflammation of the small intestine and colon (enterocolitis)
• Lesions on the genitals or anus
• Loss of appetite
• Low blood sugar (hypoglycemia)
• Low levels of white blood cells or platelets
• Skin hyperpigmentation
• Skin peeling (exfoliative dermatitis)
• Tongue swelling
• Tooth discoloration
• Upper abdominal pain

Serious side effects of doxycycline include

• Drug rash with eosinophilia and systemic symptoms
• Exacerbation of systemic lupus erythematosus
• Hemolytic anemia
• Hepatotoxicity
• Low platelet count (thrombocytopenia)
• Low white blood cell count (neutropenia)
• Intracranial hypertension
• Pericarditis
• Serum sickness
• Toxic epidermal necrolysis

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Doxycycline has contraindicated interactions of doxycycline include:
  • acitretin
  • allogeneic cultured keratinocytes/fibroblasts in bovine collagen
  • flibanserin
  • lomitapide
  • tretinoin
• Doxycycline has serious interactions with at least 81 different drugs.
• Doxycycline has severe interactions with at least 74 different drugs.
• Doxycycline has moderate interactions with at least 30 different drugs.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Warnings

This medication contains doxycycline. Do not take Vibramycin, Monodox, Acticlate, Atridox, Avidoxy, Doxy, Doxycin, Doryx, Oracea, Periostat, Adoxa, Ocudox, or Doryx MPC if you are allergic to doxycycline or any ingredients contained in this drug

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

Hypersensitivity

Effects of Drug Abuse

• None

Short-term Effects

• See "What Are Side Effects Associated with Using Doxycycline?"

Long-term Effects

• See “What Are Side Effects Associated with Using Doxycycline?”

Cautions

• Not drug of choice for any staphylococcal infection.
• Risk of thrombophlebitis when given IV.
• History of candidiasis overgrowth.
• Hepatotoxicity may occur; if symptoms occur, measure LFTs and discontinue the drug.
• Photosensitivity may occur with prolonged exposure to sunlight or tanning equipment; reduce dose in renal impairment.
• May increase BUN due to its anti-anabolic effects; use caution in patients with renal impairment.
• Consider drug serum level determinations in prolonged therapy.
• Tetracycline use during tooth development (last half of pregnancy through age 8 years) can cause permanent discoloration of teeth; use doxycycline in pediatric patients 8 years of age or less only when potential benefits are expected to outweigh risks in severe or life-threatening conditions (e.g., anthrax, Rocky Mountain spotted fever); particularly when there are no alternative therapies.
• The Fanconi-like syndrome may occur with outdated tetracyclines.
• Intracranial hypertension (pseudotumor cerebri) reported (rare) may occur; symptoms include headache, blurred vision, diplopia, and vision loss; papilledema can be found on funduscopy; women of childbearing age who are overweight or have a history of IH are at greater risk; possibility for permanent visual loss exists; if a visual disturbance occurs during treatment, prompt ophthalmologic evaluation is warranted; intracranial pressure can remain elevated for weeks after drug cessation; monitor patients until they stabilize.
• Doxycycline offers substantial but not complete suppression of asexual blood stages of Plasmodium strains; doxycycline does not suppress P. falciparum's sexual blood stage gametocytes; subjects completing a prophylactic regimen may still transmit the infection to mosquitoes outside endemic areas.
• Prolonged use may result in super-infection
• Overgrowth of non-susceptible organisms, including fungi, may occur; if such infections occur, discontinue use and institute appropriate therapy.
• May induce hyperpigmentation in many organs including skin, eyes, nails, thyroid, and bone.
• If Clostridium difficile associated diarrhea is suspected or confirmed, may need to discontinue ongoing antibacterial use not directed against C. difficile; may also need to institute appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C. difficile, and surgical evaluation as clinically indicated.
• Use in pediatric patients 8 years of age or less only when potential benefits are expected to outweigh risks in severe or life-threatening conditions (e.g., anthrax, Rocky Mountain spotted fever), particularly when there are no alternative therapies.

Pregnancy and Lactation

Only use doxycycline in LIFE-THREATENING emergencies when no safer drug is available. There is positive evidence of human fetal risk. Tetracycline use during tooth development (last half of pregnancy through age 8 years) can cause permanent discoloration of teeth.