tetracycline hydrochloride


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tetracycline hydrochloride

Apo-Tetra, Novotetra, Nu-Tetra, Topicycline

Pharmacologic class: Tetracycline

Therapeutic class: Anti-infective

Pregnancy risk category B (topical form), D (oral form)

Action

Unknown. Thought to inhibit bacterial protein synthesis at level of 30S and 50S bacterial ribosomes and to alter cytoplasmic membrane of susceptible organisms.

Availability

Capsules: 250 mg, 500 mg

Indications and dosages

Mild to moderate infections caused by susceptible organisms

Adults: 500 mg P.O. b.i.d. or 250 mg P.O. q.i.d.

Severe infections caused by susceptible organisms

Adults: 500 mg P.O. q.i.d.

Children older than age 8: 25 to 50 mg/kg P.O. q.i.d.

Syphilis in penicillin-allergic patients

Adults: 500 mg P.O. q.i.d. for 14 days

Late syphilis (except neurosyphilis)

Adults: 500 mg P.O. q.i.d. for 28 days

Leptospirosis when penicillin is contraindicated or ineffective

Adults: 1 to 2 g P.O. daily in two to four divided doses for 5 to 7 days

Yaws

Adults: 1 to 2 g P.O. daily in two to four divided doses for 10 to 14 days

Gonorrhea in penicillin-allergic patients

Adults: Initially, 1.5 g P.O., followed by 500 mg P.O. q 6 hours for 4 days, up to a total of 9 g

Uncomplicated urethral, endocervical, or rectal infections caused by

Chlamydia trachomatis

Adults: 500 mg P.O. q.i.d. for 7 days

Rickettsial and mycoplasmal infections

Adults: 1 to 2 g P.O. daily in two to four divided doses for 7 days

Helicobacter pylori infection

Adults: In patients with active duodenal ulcer, 500 mg P.O. q.i.d. at meals and bedtime for 14 days, given with other drugs (such as metronidazole, bismuth subsalicylate, amoxicillin, or omeprazole)

Brucellosis

Adults: 500 mg P.O. q.i.d. for 3 weeks, given with streptomycin I.M. b.i.d. during week 1 and streptomycin once daily during week 2

Granuloma inguinale; chancroid

Adults: 1 to 2 g P.O. daily in two to four divided doses for 2 to 4 weeks

Cholera

Adults: 500 mg P.O. q 6 hours for 48 to 72 hours

Plague when streptomycin is contraindicated or ineffective

Adults: 2 to 4 g P.O. q.i.d. for 10 days

Children older than age 8: 30 to 40 mg/kg P.O. q.i.d. for 10 to 14 days

Tularemia as an alternative to streptomycin

Adults: 1 to 2 g P.O. daily in two to four divided doses for 1 to 2 weeks

Campylobacter infection

Adults: 1 to 2 g P.O. daily in two to four divided doses for 10 days

Relapsing fever caused by Borrelia recurrentis

Adults: 1 to 2 g P.O. daily in two to four divided doses for 7 days or until patient is afebrile

Adjunctive treatment of inflammatory acne

Adults and adolescents: 500 mg to 1 g P.O. q.i.d. for 1 to 2 weeks, decreased gradually to 125 to 500 mg P.O. daily

Dosage adjustment

• Renal impairment

Off-label uses

• Rosacea

• Anthrax

• Arthritis

• Lyme disease

• Sclerosing agent to control pleural effusions

Contraindications

• Hypersensitivity to drug, other tetracyclines, bisulfites, or alcohol (in some products)

Precautions

Use cautiously in:

• renal disease, hepatic impairment, nephrogenic diabetes insipidus

• cachectic or debilitated patients

• pregnant or breastfeeding patients (except in anthrax treatment)

• children younger than age 8 (except in anthrax treatment).

Administration

• Give with 8 oz of water at least 1 hour before or 2 hours after a meal (especially if it includes milk or other dairy products), antacids, laxatives, or antidiarrheal drugs.

Adverse reactions

CNS: paresthesia, benign intracranial hypertension

CV: pericarditis

EENT: abnormal conjunctival pigmentation, hoarseness, pharyngitis

GI: nausea, vomiting, diarrhea, loose bulky stools, esophageal ulcers, epigastric distress, enterocolitis, oral and anogenital candidiasis, stomatitis, black hairy tongue, glossitis, anorexia, pancreatitis

GU: dark yellow or brown urine, vaginal candidiasis, anogenital lesions

Hematologic: eosinophilia, hemolytic anemia, neutropenia, thrombocytopenia, thrombocytopenia purpura

Hepatic: fatty liver

Musculoskeletal: retarded bone growth, polyarthralgia

Respiratory: pulmonary infiltrates

Skin: photosensitivity, maculopapular or erythematous rash, increased pigmentation, urticaria, onycholysis

Other: permanent tooth discoloration (in children younger than age 8), tooth enamel defects, superinfection, hypersensitivity reactions including anaphylaxis, serum sickness-like reaction, exacerbation of systemic lupus erythematosus

Interactions

Drug-drug. Adsorbent antidiarrheals, antacids, calcium, cholestyramine, cimetidine, colestipol, iron, magnesium, sodium bicarbonate: decreased tetracycline absorption

Digoxin: increased digoxin blood level, greater risk of toxicity

Hormonal contraceptives: decreased contraceptive efficacy

Insulin: reduced insulin requirement

Lithium: increased or decreased lithium blood level

Methoxyflurane: increased risk of nephrotoxicity

Penicillin: decreased penicillin activity

Sucralfate: prevention of tetracycline absorption from GI tract

Warfarin: enhanced warfarin effects

Drug-diagnostic tests. Alanine aminotransferase, alkaline phosphatase, amylase, aspartate aminotransferase, bilirubin, blood urea nitrogen: increased levels

Hemoglobin, neutrophils, platelets, white blood cells: decreased levels

Urinary catecholamines: false elevation

Drug-food. Dairy products, foods containing calcium: decreased drug absorption

Drug-behaviors. Alcohol use: decreased drug efficacy

Sun exposure: increased risk of photosensitivity

Patient monitoring

• Monitor for signs and symptoms of superinfection and hypersensitivity reaction.

• With long-term use, monitor CBC, liver function tests, and (in prepubertal patients) bone growth.

• Assess neurologic status. Stay alert for benign intracranial hypertension (especially in children).

Patient teaching

• Tell patient to take oral form with 8 oz of water at least 1 hour before or 2 hours after eating a meal, consuming dairy products, or taking antacids, laxatives, or antidiarrheal drugs. Advise him to take last daily dose at least 1 hour before bedtime.

• Stress importance of completing entire course of therapy as ordered, even after symptoms improve.

Caution patient not to use outdated tetracycline, because it may cause serious kidney disease.

• Teach patient to recognize and report signs and symptoms of yeast infection and other infections.

• With long-term therapy, tell patient he'll undergo regular blood testing. Advise parents that prepubertal child should have periodic bone X-rays.

• Caution patient to avoid alcohol during therapy.

• Tell parents that tetracycline use during tooth development period (last half of pregnancy, infancy, and childhood to age 8) may cause permanent yellow, gray, or brownish tooth discoloration.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, and behaviors mentioned above.

tetracycline hydrochloride

an antibiotic.
indications It is prescribed in the treatment of bacterial infections.
contraindications Known hypersensitivity to this drug or to other tetracyclines prohibits its use. Use during pregnancy or in children under 8 years of age may result in discoloration of the child's teeth. It is to be administered with caution with renal or liver impairment.
adverse effects Among the most serious effects are potentially serious superinfections, allergic reactions, phototoxicity, and GI disturbances.
References in periodicals archive ?
Photo-onycholysis due to tetracycline hydrochloride and doxycycline.
Tetracycline hydrochloride [(4S 4aS 5aS 6S 12aS) 4 - Dimethylamino-1 4 4a 5 5a 6 11 12a-octahydro - 3 6 10 12 12apentahydroxy-6- methyl 1 11 -dioxonaphthacene-2-carboxamide hydrochloride] [1] is an effective antibiotic in treating infections [5] its absorption is reduced by anti-acids and milk because it can form insoluble complexes with Ca Mg Al and Fe [6] .
2002) Release of tetracycline hydrochloride from electrospun poly (ethylene-co-vinylacetate), poly(lactic acid), and a blend, J.
14 Each of the four groups analysed in this study contained 6 samples: 1) Immersed in citric acid solution 2) in tetracycline hydrochloride solution 3) in EDTA solution 4) in PBS.
aureus in a manner which is similar to that exhibited by tetracycline hydrochloride or erythromycin.
The vehicle is a polymer, ethylene vinyl acetate, that is 25 percent saturated with tetracycline hydrochloride.
The list also includes common drugs such as tetracycline hydrochloride, an antibiotic believed to harm fetuses, and phenytoin, an anticonvulsive that may have carcinogenic effects.