Doxycycline

Doxycycline: May be taken with or without food. May be taken w/ meals to decrease GI upset. Take w/ at least 240 mL of water & sit up for at least 30 min-2 hr after to reduce the risk of oesophageal irritation & ulceration. Cap: Swallow whole, do not open/break/crush/dissolve/chew.
Doxycycline: Should be taken with food. For acne vulgaris: Take w/ food/fluid. Take w/ adequate amount of water to reduce risk of oesophageal irritation & ulceration.

Hypersensitivity to doxycycline or other tetracyclines. Pregnancy and lactation. Concomitant treatment with methoxyflurane and isotretinoin or other systemic retinoids.

Patient with myasthenia gravis, SLE, history of intracranial hypertension. Women of childbearing age who are overweight. Patient with history of or predisposition to oral candidiasis (for periodontitis indication). Hepatic impairment. Children. Patient Counselling Avoid excessive exposure to sunlight or artificial UV light, consider applying sunscreen or wear protective clothing when going outdoors. Monitoring Parameters Perform culture and susceptibility tests; consult local institutional recommendations before treatment initiation due to antibiotic resistance risks. Monitor CBC, hepatic and renal functions periodically with prolonged therapy. In patients with venereal disease when co-existing syphilis is suspected: Perform dark field examinations before initiating treatment and repeat blood serology monthly for at least 4 months.

Significant: Permanent discolouration (yellow-grey-brown) of the teeth (when given during tooth development [last half of pregnancy; infancy and childhood to the age of 8 years]), enamel hypoplasia, photosensitivity, benign intracranial hypertension (pseudotumour cerebri), overgrowth of nonsusceptible organisms (including fungi), exacerbation of SLE; Jarisch-Herxheimer reaction (particularly in some patients with spirochete infections); may decrease fibula growth rate (particularly in premature infants). Rarely, oesophagitis and oesophageal ulceration (cap/tab); porphyria, photoonycholysis. Blood and lymphatic system disorders: Haemolytic anaemia, thrombocytopenia, neutropenia, eosinophilia. Gastrointestinal disorders: Nausea, vomiting, diarrhoea, upper abdominal pain, dry mouth, dysphagia, glossitis, black hairy tongue; periodontal abscess, tooth disorder, toothache. General disorders and administration site conditions: Pain. Hepatobiliary disorders: Cholestatic hepatitis, fatty liver degeneration. Immune system disorders: Hypersensitivity reactions (e.g. urticaria, angioneurotic oedema, anaphylaxis, anaphylactoid purpura, serum sickness, pericarditis). Investigations: Increased lactate dehydrogenase, blood glucose, AST, or BUN; brown-black microscopic discolouration of thyroid gland (prolonged use). Metabolism and nutrition disorders: Anorexia. Musculoskeletal and connective tissue disorders: Back pain. Nervous system disorders: Headache, dizziness; bulging fontanelles (in infants). Psychiatric disorders: Anxiety. Respiratory, thoracic and mediastinal disorders: Nasopharyngitis, sinusitis. Skin and subcutaneous tissue disorders: Rash (e.g. maculopapular, erythematous or morbilliform rash), nail discolouration. Vascular disorders: Hypertension.
Potentially Fatal: Serious skin reactions (e.g. exfoliative dermatitis, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms [DRESS]), pseudomembranous colitis, Clostridium difficile-associated diarrhoea (CDAD).

Absorption may be impaired by concurrently administered antacids or other drugs containing Al, Ca, or Mg; oral Zn, Fe salts, or bismuth preparations. May interfere with the bactericidal action of penicillin. May potentiate the effects of anticoagulants. Reduced half-life with barbiturates, rifampicin, carbamazepine, and phenytoin. May diminish the efficacy of oral contraceptives and breakthrough bleeding may occur. May increase the plasma concentration of ciclosporin. May potentiate the hypoglycaemic effect of sulfonylureas.

Acne Treatment Preparations / Tetracyclines

A01AB22 - doxycycline ; Belongs to the class of local antiinfective and antiseptic preparations. Used in the treatment of diseases of the mouth.
J01AA02 - doxycycline ; Belongs to the class of tetracyclines. Used in the systemic treatment of infections.