Doxycycline

Doxycycline Brand Names

Acticlate | Adoxa | Adoxa Pak | Avidoxy | Doryx | Doxal | Doxy 100 | LYMEPAK | Mondoxyne NL | Monodox | Morgidox 1x | Morgidox 2x | Okebo | Oracea | Oraxyl | Periostat | TARGADOX | Vibramycin | Vibra-Tabs

What is Doxycycline

Doxycycline is a tetracycline derived from oxytetracycline.

It is classified as a long-acting tetracycline, although this classification scheme is somewhat artificial since tetracycline (classified as short-acting) can be dosed at longer intervals than usually occurs in clinical practice.

While once daily dosing is an advantage for doxycycline, adverse reactions were less for minocycline when these two agents were compared in the treatment of urethritis and cervicitis.

Nevertheless, doxycycline is one of the most frequently prescribed tetracyclines.

Doxycycline, along with minocycline, can be administered without regard to meals, although some cations can still significantly reduce oral bioavailability. Clinically, doxycycline can be used to treat non-gonococcal urethritis and cervicitis, exacerbations of bronchitis in patients with COPD, and acne vulgaris.

Doxycycline is considered the tetracycline of choice in patients with poor renal function due to its limited renal clearance.

The Centers for Disease Control have suggested doxycycline be considered as an alternative to ciprofloxacin for the treatment of anthrax. Doxycycline was originally approved by the FDA in 1967.

Atridox, a subgingival controlled-release product, was approved September 4, 1998 for the treatment of chronic adult periodontitis.

Periostat capsules were approved by the FDA in October 1998 as adjunct to scaling and root planing for the treatment of adult periodontitis; Periostat tablets were approved February 2001 for the same indication.

Doryx, a delayed-release enteric-coated oral formulation, was FDA approved in May 2005.

A dual-release capsule (Oracea), containing immediate- and delayed-release beads, was approved May 2006 for treating inflammatory lesions (papules and pustules) of rosacea in adults.

Indications

1. Acinetobacter sp.
2. acne rosacea
3. acne vulgaris
4. Actinomyces israelii
5. actinomycosis
6. amebiasis
7. anthrax
8. anthrax prophylaxis
9. Bacillus anthracis
10. bacterial conjunctivitis
11. Bacteroides sp.
12. Balantidium coli
13. Bartonella bacilliformis
14. Bartonella quintana
15. bartonellosis
16. bone and joint infections
17. Bordetella pertussis
18. Borrelia burgdorferi
19. Borrelia recurrentis
20. Brucella sp.
21. brucellosis
22. Burkholderia mallei
23. Burkholderia pseudomallei
24. Campylobacter fetus
25. cellulitis
26. cervicitis
27. chancroid
28. chlamydia infection
29. Chlamydia trachomatis
30. chlamydial infection prophylaxis
31. Chlamydophila psittaci
32. cholera
33. Clostridium sp.
34. community-acquired pneumonia
35. Coxiella burnetii
36. dental infection
37. dentoalveolar infection
38. endocarditis
39. Entamoeba histolytica
40. Entamoeba sp.
41. Enterococcus sp.
42. epididymitis
43. erythema migrans
44. Escherichia coli
45. filariasis
46. Francisella tularensis
47. Fusobacterium fusiforme
48. gonorrhea
49. granuloma inguinale
50. Haemophilus ducreyi
51. Haemophilus influenzae (beta-lactamase negative)
52. Haemophilus influenzae (beta-lactamase positive)
53. Helicobacter pylori
54. Helicobacter pylori (H. pylori) eradication
55. Klebsiella aerogenes
56. Klebsiella granulomatis
57. Klebsiella sp.
58. Legionella pneumophila
59. Legionnaire’s disease
60. Leptospira sp.
61. leptospirosis
62. Leptotrichia buccalis
63. Listeria monocytogenes
64. listeriosis
65. lower respiratory tract infections
66. Lyme arthritis
67. Lyme carditis
68. Lyme disease
69. Lyme disease prophylaxis
70. Lyme meningitis
71. lymphogranuloma venereum
72. malaria
73. malaria prophylaxis
74. melioidosis
75. murine typhus
76. Mycobacterium fortuitum
77. Mycoplasma hominis
78. Mycoplasma pneumoniae
79. necrotizing ulcerative gingivitis
80. Neisseria gonorrhoeae
81. Neisseria meningitidis
82. Nocardia sp.
83. non-gonococcal urethritis (NGU)
84. Orientia tsutsugamushi
85. orthopedic device-related infection
86. osteomyelitis
87. Pasteurella multocida
88. pelvic inflammatory disease (PID)
89. periodontitis
90. pharyngitis
91. plague
92. plague prophylaxis
93. Plasmodium falciparum
94. pleural effusion
95. pneumonia
96. proctitis
97. Propionibacterium acnes
98. Propionibacterium propionicum
99. prostatitis
100. psittacosis
101. Q fever
102. relapsing fever
103. Rickettsia akari
104. Rickettsia prowazekii
105. Rickettsia rickettsii
106. Rickettsial pox
107. Rocky Mountain spotted fever
108. scrub typhus
109. Shigella sp.
110. sinusitis
111. skin and skin structure infections
112. Spirillum minus
113. Staphylococcus aureus (MRSA)
114. Staphylococcus aureus (MSSA)
115. Streptobacillus moniliformis
116. Streptococcus pneumoniae
117. Streptococcus pyogenes (group A beta-hemolytic streptococci)
118. Streptococcus sp.
119. surgical infection prophylaxis
120. syphilis
121. Treponema pallidum
122. Treponema pertenue
123. tubo-ovarian abscess
124. tularemia
125. tularemia prophylaxis
126. upper respiratory tract infections
127. Ureaplasma urealyticum
128. urethritis
129. urinary tract infection (UTI)
130. Vibrio cholerae
131. Vibrio parahaemolyticus
132. Viridans streptococci
133. Wuchereria bancrofti
134. yaws
135. Yersinia enterocolitica
136. Yersinia pestis

Side Effects

1. abdominal pain
2. acute generalized exanthematous pustulosis (AGEP)
3. anaphylactoid reactions
4. angioedema
5. anorexia
6. anxiety
7. azotemia
8. back pain
9. blurred vision
10. candidiasis
11. cough
12. diarrhea
13. diplopia
14. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
15. dyspepsia
16. dysphagia
17. elevated hepatic enzymes
18. enamel hypoplasia
19. enterocolitis
20. eosinophilia
21. erythema
22. erythema multiforme
23. esophageal ulceration
24. esophagitis
25. exfoliative dermatitis
26. glossitis
27. growth inhibition
28. headache
29. hemolytic anemia
30. hepatic failure
31. hepatitis
32. hyperglycemia
33. hypertension
34. increased intracranial pressure
35. infertility
36. influenza
37. injection site reaction
38. Jarisch-Herxheimer reaction
39. lupus-like symptoms
40. maculopapular rash
41. musculoskeletal pain
42. nail discoloration
43. nasal congestion
44. nausea
45. neutropenia
46. odynophagia
47. onycholysis
48. pancreatitis
49. papilledema
50. paresthesias
51. pericarditis
52. pharyngitis
53. phlebitis
54. photosensitivity
55. pseudomembranous colitis
56. pseudotumor cerebri
57. purpura
58. rash
59. serum sickness
60. sinusitis
61. skin hyperpigmentation
62. Stevens-Johnson syndrome
63. superinfection
64. throat irritation
65. thrombocytopenia
66. tooth discoloration
67. toxic epidermal necrolysis
68. urticaria
69. vomiting
70. xerostomia

Monitoring Parameters

• LFTs

Contraindications

• achlorhydria
• asthma
• breast-feeding
• chemotherapy
• children
• diabetes mellitus
• diarrhea
• geriatric
• human immunodeficiency virus (HIV) infection
• immunosuppression
• increased intracranial pressure
• infants
• infertility
• laboratory test interference
• neonates
• obesity
• periodontal disease
• pregnancy
• pseudomembranous colitis
• radiation therapy
• reproductive risk
• sexually transmitted disease
• sulfite hypersensitivity
• sunlight (UV) exposure
• tetracyclines hypersensitivity

Interactions

• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acitretin
• Aluminum Hydroxide
• Aluminum Hydroxide; Magnesium Carbonate
• Aluminum Hydroxide; Magnesium Hydroxide
• Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
• Aluminum Hydroxide; Magnesium Trisilicate
• Amobarbital
• Amoxicillin
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amoxicillin; Clavulanic Acid
• Ampicillin
• Ampicillin; Sulbactam
• Antacids
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Bacillus Calmette-Guerin Vaccine, BCG
• Barbiturates
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Bexarotene
• Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
• Bismuth Subsalicylate
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Butabarbital
• Calcium
• Calcium Acetate
• Calcium Carbonate
• Calcium Carbonate; Magnesium Hydroxide
• Calcium Carbonate; Risedronate
• Calcium Carbonate; Simethicone
• Calcium Chloride
• Calcium Gluconate
• Calcium; Vitamin D
• Carbamazepine
• Carbenicillin
• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Chlorpheniramine; Pseudoephedrine
• Cholestyramine
• Chromium
• Colesevelam
• Colestipol
• Dicloxacillin
• Didanosine, ddI
• Dienogest; Estradiol valerate
• Digoxin
• Drospirenone
• Drospirenone; Estradiol
• Drospirenone; Ethinyl Estradiol
• Drospirenone; Ethinyl Estradiol; Levomefolate
• Elagolix; Estradiol; Norethindrone acetate
• Estradiol
• Estradiol Cypionate; Medroxyprogesterone
• Estradiol; Levonorgestrel
• Estradiol; Norethindrone
• Estradiol; Norgestimate
• Ethinyl Estradiol
• Ethinyl Estradiol; Desogestrel
• Ethinyl Estradiol; Ethynodiol Diacetate
• Ethinyl Estradiol; Etonogestrel
• Ethinyl Estradiol; Levonorgestrel
• Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
• Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
• Ethinyl Estradiol; Norelgestromin
• Ethinyl Estradiol; Norethindrone
• Ethinyl Estradiol; Norethindrone Acetate
• Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
• Ethinyl Estradiol; Norethindrone; Ferrous fumarate
• Ethinyl Estradiol; Norgestimate
• Ethinyl Estradiol; Norgestrel
• Ethotoin
• food
• Fosphenytoin
• Halobetasol; Tazarotene
• Heparin
• Hetastarch; Dextrose; Electrolytes
• Hydantoins
• Hydrochlorothiazide, HCTZ; Quinapril
• Insoluble Prussian Blue
• Iron
• Iron Salts
• Iron Sucrose, Sucroferric Oxyhydroxide
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Isotretinoin
• Lanthanum Carbonate
• Leuprolide; Norethindrone
• Levonorgestrel
• Lomitapide
• Magnesium
• Magnesium Citrate
• Magnesium Hydroxide
• Magnesium Salts
• Mephobarbital
• Mestranol; Norethindrone
• Methohexital
• Methotrexate
• Methoxsalen
• Mipomersen
• Molindone
• Nafcillin
• Neuromuscular blockers
• Norethindrone
• Norgestrel
• Omeprazole; Amoxicillin; Rifabutin
• Omeprazole; Sodium Bicarbonate
• Oral Contraceptives
• Oxacillin
• Penicillin G
• Penicillin G Benzathine
• Penicillin G Benzathine; Penicillin G Procaine
• Penicillin G Procaine
• Penicillin V
• Penicillins
• Pentobarbital
• Phenobarbital
• Phenytoin
• Photosensitizing agents (topical)
• Piperacillin
• Piperacillin; Tazobactam
• Polycarbophil
• Polysaccharide-Iron Complex
• Porfimer
• Primidone
• Pyridostigmine
• Quinapril
• Rifampin
• Rifapentine
• Secobarbital
• Segesterone Acetate; Ethinyl Estradiol
• Sodium Bicarbonate
• Sodium Ferric Gluconate Complex; ferric pyrophosphate citrate
• Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
• St. John’s Wort, Hypericum perforatum
• Sucralfate
• Sulfonylureas
• Tazarotene
• Thiopental
• Ticarcillin
• Ticarcillin; Clavulanic Acid
• Tretinoin, ATRA
• Verteporfin
• Vitamin C
• Warfarin
• Zinc
• Zinc Salts