Doxycycline

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Inhibits
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Atridox, Dotur, Doxybene, Doxycyclin, Doxyderm, Doxydyn, Doxystad, Oraycea, Periostat, Vibramycin, Vibravenös; Belgium: Doxycycline, Doxylets, Doxytab, Vibratab; Bulgaria: Dotur, Doxat, Doxycyclin; Cyprus: Biodox, Doxat, Doxycycline, Doxymine, Medomycin, Remycin, Vibramycin; Czech Republic: Deoxymykoin, Doxybene, Doxycyclin, Doxyhexal; Denmark: Vibradox; Estonia: Dotur, Doxitin, Doxy M, Doxycyclin, Doxylan; Finland: Atridox, Doximed, Doximycin, Doxitin, Oracea; France: Doxy, Doxycycline, Doxylis, Granudoxy, Spanor, Tolexine, Vibramycine, Vibraveineuse; Germany: Aknefug Doxy, Ambrodoxy, Ambroxol, Amdox, Antodox, Atridox, Doxakne, Doxam, Doxy, Doxycyclin, Doxyderma, Doxyhexal, Doxymono, Ligosan, Neodox, Oraycea, Sigamuc, Supracyclin; Greece: Atridox, Doxycyclin, Doxycycline, Doxyhexal, Impalamycin, Linexine, Microvibrate, Novimax, Otosal, Relyomycin, Smilitene, Vibramycin, Vibravenos, Vibravenosa; Hungary: Doxycyclin, Doxyhexal, Doxypharm, Vibramycin; Ireland: Periostat, Vibramycin; Italy: Bassado, Doxicicl, Miraclin, Periostat; Lithuania: Doxycyclin; Luxembourg: Dagramycine, Doxicline, Doxy, Doxycycline, Doxyhexal, Doxylets, Doxymycine, Granudoxy; Malta: Doxat, Remycin, Retens; Netherlands: Dagracycline, Doxy, Doxycycline, Efracea, Periostat, Unidox, Vibramycin; Poland: Dotur, Doxicin, Doxycyclin, Doxycyclinum, Doxyratio, Supracyclin, Unidox, Vibramycin; Portugal: Actidox, Atridox, Doxytrex, Periostat, Pluridoxina, Sigadoxin, Vibramicina; Romania: Doxiciclina, Unidox, Vibramycin; Slovakia: Deoxymykoin, Doxycyclin, Doxybene, Doxyhexal; Spain: Atridox, Dosil, Doxiciclina, Doxiclat, Doxicrisol, Doxipil, Doxiten, Mededoxi, Proderma, Retens, Rexilen, Vibracina, Vibravenosa; Sweden: Atridox, Doxycyklin, Doxyferm, Oracea, Vibranord; UK: Doxycycline, Efracea, Periostat, Vibramycin.

North America

Canada: Atridox, Doxirobe, Doxy, Doxycin, Doxycycline, Doxylin, Doxytab, Periostat, Vibra-Tabs; USA: Atridox, Doryx-Mayne Pharma, Doxy, Doxycycline, Monodox, Oracea, Periostat, Vibra-Tabs, Vibramycin.

Latin America

Argentina: Asolmicina Dox, Atridox, Ciclidoxan, Doxiciclina, Granudoxy, Verboril, Vibramicina; Brazil: Ciclisan-Doxicilina, Clordox, Doxicilin, Doxicilina, Doxilegrand, Protectina, Vibramicina; Mexico: Bioximicina, Doranbax, Doxiciclina, Doxynonflam, Kenciclen, Periosan, Vibramicina, Vivradoxil.

Asia

Japan: Paldomycin, Piperamycin, Rasenamycin, Vibramycin.

Drug combinations

Chemistry

Doxycycline: C~22~H~24~N~2~O~8~ H~2~O. Mw: 462.45. (1) 2-Naphthacenecarboxamide, 4-(dimethylamino)-1,4,4a,5,5a,6,11,12a-octahydro-3,5,10,12,12a-pentahydroxy-6-methyl-1,11-dioxo-, [4S-(4α,4aα,5α,5aα,6α,12aα)]-, monohydrate; (2) 4-(Dimethylamino)-1,4,4a,5,5a,6,11,12a-octahydro-3,5,10,12,12a-pentahydroxy-6-methyl-1,11-dioxo-2-naphthacenecarboxamide monohydrate. CAS-17086-28-1; CAS-564-25-0 (anhydrous)(1966).

Doxycycline Hyclate: (C~22~H~24~N~2~O~8~.HCl)~2~ C~2~H~6~O H~2~O. Mw: 1025.87. 2-Naphthacenecarboxamide, 4-(dimethylamino)-1,4,4a,5,5a,6,11,12a-octahydro-3,5,10,12,12a-pentahydroxy-6-methyl-1,11-dioxo-, monohydrochloride, compd. with ethanol (2:1), monohydrate, [4S-(4α,4aα,5α,5aα,6α,12aα)]. CAS-24390-14-5.

Pharmacologic Category

Skin and Mucous Membrane Agents, Miscellaneous. Antibacterials; Tetracyclines. Antiprotozoals; Antimalarials. EENT Preparations; Antibacterials. (ATC-Code: A01AB22; J01AA02).

Mechanism of action

Tetracycline antibiotic; also has anti-inflammatory and immunomodulatory effects. Inhibits protein synthesis by binding with the 30S and possibly the 50S ribosomal subunit(s) of susceptible bacteria. May also cause alterations in the cytoplasmic membrane.

Therapeutic use

Infections caused by susceptible Rickettsia, Chlamydia, and Mycoplasma. Alternative to mefloquine for malaria prophylaxis. Treatment for syphilis, uncomplicated Neisseria gonorrhoeae, Listeria, Actinomyces israelii, and Clostridium infections in penicillin-allergic patients. Community-acquired pneumonia and other common infections due to susceptible organisms. Anthrax due to Bacillus anthracis, including inhalational anthrax (postexposure). Infections by Gram-negative and Gram-positive organisms including Borrelia recurrentis, Ureaplasma urealyticum, Haemophilus ducreyi, Yersinia pestis, Francisella tularensis, Vibrio cholerae, Campylobacter fetus, Brucella spp, Bartonella bacilliformis, and Calymmatobacterium granulomatis, Q fever, Lyme disease. Treatment of inflammatory lesions associated with rosacea. Intestinal amebiasis. Severe acne.

Pregnancy and lactiation implications

Potential small increased risk for cleft palate or esophageal atresia/stenosis. Lactation is not recommended. Use during pregnancy may cause fetal harm. Exposure to tetracyclines during the 2^nd^ or 3^rd^ trimester may cause permanent discoloration of the teeth. Breast-feeding is not recommended (tetracyclines, including doxycycline, are excreted in breast milk).

Unlabeled use

Sclerosing agent for pleural effusion injection. Vancomycin-resistant enterococci (VRE).

Contraindications

Hypersensitivity to doxycycline, tetracycline or any component of the formulation. Children ≤8 years of age, except in treatment of anthrax (including inhalational anthrax postexposure prophylaxis). Severe hepatic dysfunction. Pregnancy.

Warnings and precautions

Autoimmune syndromes reported. Hepatotoxicity (rarely). Possible increased BUN secondary to antianabolic effects (use caution in renal impairment). May cause photosensitivity; discontinue if skin erythema occurs. Pseudotumor cerebri reported (rarely). Prolonged use may result in fungal

or bacterial superinfection, including C. difficile-associated diarrhea and pseudomembranous colitis. May cause tissue hyperpigmentation, enamel hypoplasia, or permanent tooth discoloration in children. Avoid use during pregnancy. Retardation of skeletal development and reduced bone growth. Syrup contains sodium metabisulfite.

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