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DOXYCYCLINE is a brand name for Amoxicillin. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: Doxycycline has been found clinically effective in the treatment of a variety of infections caused by susceptible strains of Gram-positive and Gram- negative bacteria and certain other micro- organisms. Respiratory tract infections Pneumonia and other lower respiratory tract infections due to susceptible strains of…
Verbatim from this product's MHRA label. Tap a section to expand.
The capsules should be swallowed with plenty of fluid in either the resting or standing position and well before going to bed for the night to reduce the likelihood of oesophageal irritation and ulceration. If gastric irritation occurs, it is recommended that Doxycycline Capsules be given with food or milk.
Studies indicate that the absorption of doxycycline is not notably influenced by simultaneous ingestion of food or milk. Posology Adults and children aged 12 years to less than 18 years The usual dosage of Doxycycline for the treatment of acute infections in adults and children aged 12 years to less than 18 years is 200mg on the first day (as a single dose or in divided doses) followed by a maintenance dose of 100mg/day.
In the management of more severe infections (particularly chronic infections of the urinary tract), 200mg daily should be given throughout the treatment period. Exceeding the recommended dosage may result in an increased incidence of side effects.
Therapy should be continued for at least 24 to 48 hours after the symptoms and fever have subsided. When used in streptococcal infections, therapy should be continued for 10 days to prevent the development of rheumatic fever or glomerulonephritis.
Dosage recommendations in specific infections:
Acne vulgaris50mg daily with food or fluid for 6 to 12 weeks. Sexually transmitted diseases 100mg twice daily for 7 days is recommended in the following infections: uncomplicated gonococcal infections (except anorectal infections in men); uncomplicated urethral, endocervical or rectal infection caused by Chlamydia trachomatis; non-gonococcal urethritis caused by Ureaplasma urealyticum.
Acute epididymo-orchitis caused by Chlamydia trachomatis or Neisseria gonorrhoea 100mg twice daily for 10 days. Primary and secondary syphilis:300mg a day in divided doses for at least 10 days. Louse and tick-borne relapsing fevers A single dose of 100mg or 200mg according to severity.
Treatment of chloroquine-resistant falciparum malaria 200mg daily for at least 7 days. Due to the potential severity of the infection, a rapid-acting schizonticide such as quinine should always be given in conjunction with Doxycycline; quinine dosage recommendations vary in different areas.
8. 5). Jarisch-Herxheimer reaction Some patients with spirochete infections may experience a Jarisch-Herxheimer reaction shortly after doxycycline treatment is started. Patients should be reassured that this is a usually self-limiting consequence of antibiotic treatment of spirochete infections.
5 Interaction with other medicinal products and other forms of interaction The absorption of doxycycline may be impaired by concurrently administered antacids containing aluminium, calcium, magnesium or other drugs containing these cations; oral zinc, iron salts or bismuth preparations.
Dosages should be maximally separated. Ergotamine and methysergide There is an increased risk of ergotism when doxycycline is co-administered with ergotamine and methysergide. Methotrexate Doxycycline increases the risk of methotrexate toxicity; prescribe with caution to patients on methotrexate.
Kaolin and sucralfate may reduce the absorption of doxycycline. Quinapril contains magnesium carbonate and may interfere with the absorption of doxycycline. Since bacteriostatic drugs may interfere with the bactericidal action of penicillin, it is advisable to avoid giving Doxycycline in conjunction with penicillin.
There have been reports of prolonged prothrombin time in patients taking warfarin and doxycycline. Tetracyclines depress plasma prothrombin activity and reduced dosage of concomitant anti- coagulants may be necessary. The serum half-life of doxycycline may be shortened when patients are concurrently receiving barbiturates, carbamazepine, primidone or phenytoin.
An increase in the daily dosage of Doxycycline should be considered. Alcohol may decrease the half-life of doxycycline. A few cases of pregnancy or breakthrough bleeding have been attributed to the concurrent use of tetracycline antibiotics with oral contraceptives.
Paediatric population The use of drugs of the tetracycline class during tooth development (last half of pregnancy, infancy and childhood to the age of 8years) may cause permanent discolouration of the teeth (yellow-grey-brown). This adverse reaction is more common during long-term use of the drugs but has been observed following repeated short-term courses.
Enamel hypoplasia has also been reported. g. Rocky Mountain spotted fever), only when there are no adequate alternative therapies. Although the risk of permanent teeth staining is rare in children aged 8 years to less than 12 years, the use of doxycycline should be carefully justified in situations where other drugs are not available, are not likely to be effective or are contraindicated.
Use in patients with impaired hepatic function Doxycycline should be administered with caution to patients with hepatic impairment or those receiving potentially hepatotoxic drugs. Abnormal hepatic function has been reported rarely and has been caused by both the oral and parenteral administration of tetracyclines, including doxycycline.
Use in patients with renal impairment Excretion of doxycycline by the kidney is about 40%/72 hours in individuals with normal renal function. This percentage excretion may fall to a range as low as 1-5%/72 hours in individuals with severe renal insufficiency (creatinine clearance below 10ml/min).
Studies have shown no significant difference in the serum half-life of doxycycline in individuals with normal and severely impaired renal function. Haemodialysis does not alter the serum half-life of doxycycline. The anti-anabolic action of the tetracyclines may cause an increase in blood urea.
Studies to date indicate that this anti- anabolic effect does not occur with the use of Doxycycline in patients with impaired renal function. 8). If serious skin reactions occur, doxycycline should be discontinued immediately and appropriate therapy should be instituted.
1 or to any of the tetracyclines. Sucrose intolerance Patients with rare hereditary problems of fructose intolerance, glucose galactose malabsorption or sucrose-isomaltase insufficiency should not take doxycycline. 6). 4 regarding use during tooth development).
4 regarding use during tooth development).
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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Prophylaxis of malaria 100mg daily in adults and children over the age of 12 years. Prophylaxis can begin 1-2 days before travel to malarial areas. It should be continued daily during travel in the malarial areas and for 4 weeks after the traveller leaves the malarial area.
For current advice on geographical resistance patterns and appropriate chemoprophylaxis, current guidelines or the Malaria Reference Laboratory should be consulted, details of which can be found in the British National Formulary (BNF).
For the prevention of scrub typhus 200mg as a single dose. For the prevention of travellers' diarrhoea in adults 200mg on the first day of travel (administered as a single dose or as 100mg every 12 hours) followed by 100mg daily throughout the stay in the area.
Data on the use of the drug prophylactically are not available beyond 21 days. For the prevention of leptospirosis 200mg once each week throughout the stay in the area and 200mg at the completion of the trip. Data on the use of the drug prophylactically are not available beyond 21 days.
Children aged 8 years to less than 12 years. 4) The use of doxycycline for the treatment of acute infections in children aged 8 years to less than 12 years should be carefully justified in situations where other drugs are not available, are not likely to be effective or are contraindicated.
2 mg/kg (in single or 2 divided doses). 4 mg/kg should be given throughout treatment. For children, over 45 kg - Dose administered for adults should be used. Children aged from birth to less than 8 years. Doxycycline should not be used in children aged younger than 8 years due to the risk of teeth discolouration.
8) Elderly patients Doxycycline may be prescribed in the usual dose with no special precautions. No dosage adjustment is necessary in the presence of renal impairment.
Renal impairment:
Studies to date have indicated that administration of doxycycline at the usual recommended doses does not lead to excessive accumulation of the antibiotic in patients with renal impairment. Rocky Mountain spotted fever Adults: 100 mg every 12 hours.
2 mg/kg body weight given twice a day. 4 paediatric population). Patients should be treated for at least 3 days after the fever subsides and until there is evidence of clinical improvement. Minimum course of treatment is 5- 7 days. The anti-anabolic action of the tetracyclines may cause an increase in blood urea.
Studies to date indicate that this does not occur with the use of doxycycline in patients with impaired renal function. Haemodialysis does not alter the serum half-life of doxycycline.
Doxycycline may increase the plasma concentration of ciclosporin. Co- administration should only be undertaken with appropriate monitoring. Drugs that induce hepatic enzymes such as rifampicin may accelerate the decomposition of doxycycline, thereby decreasing its half-life.
Sub- therapeutic doxycycline concentrations may result. Monitoring concurrent use is advised and an increase in doxycycline dose may be required. There is a possible increased risk of benign intra-cranial hypertension when doxycycline given with retinoids.
Concomitant use should be avoided. Each of these agents used alone has been associated with benign intracranial hypertension (pseudotumor cerebri). 4). Antibacterials inactivate oral typhoid vaccines. Avoid administration of vaccine during treatment with doxycycline.
Laboratory test interactions False elevations of urinary catecholamine levels may occur due to interference with the fluorescence test. 6 Fertility, Pregnancy and lactation Doxycycline is contraindicated in pregnancy and lactation. 3.
7 Effects on ability to drive and use machines Visual disturbances such as blurring of vision may occur during treatment with doxycycline and in such cases, patients must be informed to refrain from driving or operating machinery. 8 Undesirable effects The following adverse reactions have been observed in patients receiving tetracyclines, including doxycycline.
System Organ Class Common ≥1/100 to <1/10 Uncommon ≥1/1000 to <1/100 Rare ≥1/10,000 to <1/1000 Not known Cannot be estimated from the available data. 4) Endocrine disorders Brown-black microscopic discolouration of thyroid glands Metabolism and nutrition disorders porphyria, decreased appetite Nervous system disorders Headache Anxiety, fontanelles Bulging benign intracranial hypertension (pseudotumor cerebri A) Ear and labyrinth disorders Tinnitus Eye disorders Visual disturbance D Vascular disorders flushing Gastrointestinal disorders nausea, vomiting dyspepsia (heartburn/ gastritis) pancreatitis, glossitis, pseudomembranou s colitis, Clostridium difficile colitis, oesophageal ulcer, oesophagitis, enterocolitis, inflammatory lesions (with monilial overgrowth) in the anogenital region dsysphagia, abdominal pain, diarrhoea, glossitis, stomatitis Tooth discolourationE Hepatobiliary disorders Hepatotoxicity, hepatic function abnormal, hepatitis, jaundice, hepatic failure Skin and subcutaneous tissue disorders Photosensitivity reaction, rash including maculopapular and erythematous rashes, Skin Hyperpigmentation C erythema multiforme, dermatitis exfoliative, Stevens-Johnson syndrome and toxic epidermal necrolysis and photo-onycholysis have been reported.
4). A In association with tetracyclines, including doxycycline, benign intracranial hypertension has been reported with possible symptoms of headache, vomiting, visual disturbances including blurred vision, scotoma, diplopia or permanent loss of vision.
The manifestation of clinical symptoms, including headache or visual disturbances, should suggest a possible diagnosis of intracranial hypertension. If an increase in intracranial pressure is suspected during treatment with tetracyclines, […]
Photosensitivity Photosensitivity manifested by an exaggerated sunburn reaction has been observed in some individuals taking tetracyclines, including doxycycline. Patients likely to be exposed to direct sunlight or ultraviolet light should be advised that this reaction can occur with tetracycline drugs and treatment should be discontinued at the first evidence of skin erythema.
8). Microbiological overgrowth The use of antibiotics may occasionally result in the overgrowth of non- susceptible organisms including Candida. If a resistant organism appears, the antibiotic should be discontinued and appropriate therapy instituted.
Pseudomembranous colitis has been reported with nearly all antibacterial agents, including doxycycline, and has ranged in severity from mild to life- threatening. It is important to consider this diagnosis in patients who present with diarrhoea subsequent to the administration of antibacterial agents.
Clostridium difficile associated diarrhoea (CDAD) has been reported with use of nearly all antibiotics, including doxycycline, and has ranged in severity from mild diarrhoea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C.
difficile. C. difficile produces toxins A and B, which contribute to the development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy.
CDAD should be considered in all patients who present with diarrhoea after antibiotic treatment. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.
Oesophagitis Instances of oesophagitis and oesophageal ulcerations have been reported in patients receiving capsule and tablet forms of drugs in the tetracycline class, including doxycycline. Most of these patients took medications immediately before going to bed or with inadequate amounts of fluid.
Benign intracranial hypertension(pseudotumor cerebri) has been associated with the use of tetracyclines including doxycycline. Benign intracranial hypertension (pseudotumor cerebri) is usually transient; however cases of permanent visual loss secondary to benign intracranial hypertension (pseudotumor cerebri) have been reported with tetracyclines including doxycycline.
If visual disturbance occurs during treatment, prompt ophthalmologic evaluation is warranted. Since intracranial pressure can remain elevated for weeks after drug cessation patients should be monitored until they stabilize. Concomitant use of isotretinoin or other systemic retinoids and doxycycline should be avoided because isotretinoin is also known to cause benign intracranial hypertension (pseudotumor cerebri).
5). Porphyria There have been rare reports of porphyria in patients receiving tetracyclines. Venereal disease When treating venereal disease where co-existent syphilis is suspected, proper diagnostic procedures, including dark-field examinations, should be utilised.
In such cases monthly serological tests should be performed for at least four months. Beta-haemolytic streptococci infections Infections due to Group A beta-haemolytic streptococci should be treated for at least 10 days. Myasthenia gravis Due to a […]