TETRACYCLINE

Indications & Dose:

Systemic: Infections caused by Rickettsiae (Rocky Mountain spotted fever, typhus fever, Q fever, rickettsial pox and tick fever), Mycoplasma pneumonia, agents of psittacosis and omithosis; agents of lymphogranuloma venerium and granuloma inguinale, relapsing fever (Borrelia recurrentis)

DOSE

Adult

• PO 250-500 mg q6h

• Gonorrhea: PO 1.5 g, then 500 mg qd for a total of 9g

• Chlamydia: PO 500 mg qid for 7 days

• Syphilis: (Benzathine penicillin is the drug of choice for syphilis) PO 23 g in divided doses for 10-15 days; if syphilis duration > 1 yr, must treat 30 days

• Brucellosis: PO 500 mg qid for 3 wk with 1 g streptomycin IM bid for 1 wk, and qd the 2nd wk 

Contraindications:

 Children <8 yr (systemic). 

Side Effects:

CNS: Fever, headache, paresthesia, pseudotumor cerebri

CV: Pericarditis

EENT: Dysphagia, esophagitis, oral candidiasis, oral ulcers

GI: Abdominal cramps, abdominal pain, anorexia, decreased calcification of deciduous teeth (children <8 yr), diarrhea, enterocolitis, epigastric burning, flatulence, glossitis, hepatotoxicity, nausea, stomatitis. vomiting

GU: Increased BUN, renal failure (associated with use of outdated products

HEME: Eosinophilia, hemolytic anemia, neutroptnia, thrombocytopenia

SKIN: Angioedema; exfoliative dermatitis, increased pigmentation, photosensitivity, pruritus, rush, stinging (top), urticaria

Cautions:

Precautions:

Renal disease, hepatic disease

Interaction:

Drugs

Antacids: Reduced tetracycline concentrations

Bismuth subsalicylate: Reduced tetracycline concentrations

Calcium: Reduced tetracycline concentrations

Cholestyramine colestipol: Reduced tetracycline concentrations

Digoxin: Decreased digoxin concentrations due to reduced GI flora

Food: Reduced tetracycline concentrations

Iron: Reduced tetracycline concentrations

Magnesium: Reduced tetracycline concentrations

Methoxyflurane: Increased renal toxicity

Oral contraceptives: Possible decreased contraceptive effect

Penicillin: Impaired efficacy of penicillin Sodium bicarbonate: Reduced tetracycline concentrations

Zinc: Reduced tetracycline concentrations 

Warnings:

Adverse Effects:

Lactations:

Systemic tetracycline excreted into breast milk in low concentrations; theoretically, dental staining could occur, but serum levels in infants undetectable, so considered compatible with breast feeding 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: