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)


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


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


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)


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


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


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


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).


• 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


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.

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References in periodicals archive ?
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] .
Subsequently, predetermined amounts of the silica sol (0 vol%, 10 vol%, 15 vol%, and 20 vol% in relation to PCL) were added to the PCL solutions and vigorously mixed by magnetic stirring for 30 min, after which, tetracycline hydrochloride (TCH) used as a drug with a concentration of 20 mg/mL was added to the PCL/silica hybrid mixtures, followed by magnetic stirring for 2 h at room temperature.
Releaseof tetracycline hydrochloride from electrospun poly(ethylene-co-vinylacetate), poly(lactic acid), and a blend.
The inspection also found that the facility, which is situated in a densely populated suburban area, failed to maintain documentation for quantities of ethylbenzene, tetracycline hydrochloride, and xylene that were manufactured, processed or otherwise used at the facility during 2007.
The possible explanation of these results seen in tetracycline hydrochloride could be that tetracycline hydrochloride was successful in removing the smear layer and exposed the opening of dentinal tubules with collagen matrix.1,28 In the present study TTC HCl fared better than EDTA group as regards to fibrin network and blood cell attachment.
Diffraction data collected from a polycrystalline sample of tetracycline hydrochloride (capillary, station 9.1 Daresbury SRS, [lambda] = 0.692 [Angstrom], image plate detector, data range 2[degrees] to 40[degrees] 2[theta]) were posted on a web site along with the chemical formula ([C.sub.22][H.sub.24][N.sub.2][O.sub.9]HCl), unit cell and space group (a = 10.981 [Angstrom], b = 12.853 [Angstrom], c = 15.733 [Angstrom], P[2.sub.1][2.sub.1][2.sub.1]) of the previously unsolved crystal structure.
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 available system is a fiber or cord 23 cm in length and 0.5 mm in diameter containing 12.7 mg of tetracycline hydrochloride.