Infectious Disease Book

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Doxycycline

Aka: Doxycycline, Vibramycin, Monodox, Doryx
  1. See Also
    1. Tetracyclines
  2. Indications
    1. Skin disorders
      1. Methicillin-Resistant Staphylococcus aureus (MRSA) Skin Infections
      2. Acne Vulgaris
      3. Acne Rosacea
    2. Gastrointestinal disorders
      1. Helicobacter Pylori (part of quadruple therapy protocol)
    3. Tick Borne Illness
      1. Lyme Disease
      2. Human Granulocytic Anaplasmosis (Human Granulocytic Ehrlichiosis)
      3. Rocky Mountain Spotted Fever
      4. Ehrlichiosis
    4. Miscellaneous disorders
      1. Community Acquired Pneumonia
      2. Acute Exacerbation of Chronic Bronchitis
      3. Malaria Prophylaxis
      4. Anthrax
    5. Sexually Transmitted Disease
      1. Chlamydia trachomatis
      2. Lymphogranuloma venereum
      3. Pelvic Inflammatory Disease
  3. Precautions
    1. AAP now approves Doxycycline for ANY age up to 21 day duration (esp. Tick Borne Illness)
  4. Formulations
    1. Capsule (Doxycycline Monohydrate)
      1. Strengths: 50,75,100,150 mg (generics available)
    2. Tablet (Doxycycline Monohydrate)
      1. Strengths: 50,75,100,150 mg (generics available)
    3. Tablet (Doxycycline Hyclate)
      1. Strengths: 20,50,75,100,150 mg (generics available)
    4. Doxycyline Hyclate Delayed-Release (Doryx MPC)
      1. Expensive ($10/pill) formulated to by-pass the esophagus for less side effects
      2. Alternatively, take the doxycyline with 8 oz water and food
      3. (2016) Presc Lett 23(11)
  5. Dosing: Adults (weight >45 kg)
    1. Typical dose: 100 mg orally twice daily
    2. Low doses, such as 50 mg daily, are often as effective for Acne Vulgaris
    3. Avoid substituting low-dose Doxycycline (Periostat, Oracea) products for systemic infections
    4. May substitute other Doxycycline salts
      1. Doxycycline hyclate (Vibramycin, Doryx)
      2. Doxycycline monohydrate (Monodox)
      3. (2013) Presc Lett 20(5):26
  6. Pregnancy
    1. All Trimesters - Category D
  7. Adverse Effects
    1. Photosensitivity
      1. Use sun protection (e.g. Sunscreen)
    2. Pill Esophagitis
      1. Take with 8 ounces fluid
    3. Drug-Induced Tooth Staining
      1. Compared with Tetracycline, Doxcycyline is unlikely to cause tooth staining in children, even under age 8 years.
      2. Frequency: Uncommon to rare
    4. Abdominal Pain
    5. Diarrhea
  8. Drug Interactions
    1. Doxycycline Decreases Absorption Of Other Substances
      1. Antacid
      2. Calcium Supplementation
    2. Doxycycline Level Decreased By Other Substance
      1. Barbiturate
      2. Carbamazepine
      3. Rifampin
      4. Phenytoin
  9. Pharmacokinetics
    1. Absorption: Not affected by food or milk intake (unlike Tetracycline)
    2. Peak Activity: >2.6 hours
    3. Half Life: 18-22 hours
    4. Primary Elimination: Renal (>40%)
    5. Other Elimination: Hepatic
  10. Resources
    1. Moses, Fpnotebook (accessed 10/3/2021)
      1. https://fpnotebook.com/ID/Pharm/Ttrcycln.htm
    2. DailyMed (accessed 10/3/2021)
      1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=712965e2-c089-46c3-9a86-d3f61673b25d
    3. DailyMed (accessed 10/3/2021)
      1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3e7cf78f-3b48-4614-9fa4-c6d1e0c05a35
Medication Costs
doxycycline (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing)
DOXYCYCLINE 25 MG/5 ML SUSP Generic $0.29 per ml
DOXYCYCLINE HYC DR 100 MG TAB Generic $8.83 each
DOXYCYCLINE HYCLATE 100 MG CAP Generic $0.49 each
DOXYCYCLINE HYCLATE 100 MG TAB Generic $0.63 each
DOXYCYCLINE HYCLATE 20 MG TAB Generic $0.36 each
DOXYCYCLINE HYCLATE 50 MG CAP Generic $0.59 each
DOXYCYCLINE IR-DR 40 MG CAP Generic $15.88 each
DOXYCYCLINE MONO 100 MG CAP Generic $0.42 each
DOXYCYCLINE MONO 100 MG TABLET Generic $0.50 each
DOXYCYCLINE MONO 150 MG TABLET Generic $5.36 each
DOXYCYCLINE MONO 50 MG CAP Generic $0.31 each
DOXYCYCLINE MONO 50 MG TABLET Generic $0.44 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

Doxycycline (C0013090)

Definition (CHV) a kind of antibiotics
Definition (MSH) A synthetic tetracycline derivative with similar antimicrobial activity.
Definition (NCI_NCI-GLOSS) A drug used to treat many types of bacterial infections. It stops the growth of bacteria by keeping them from making proteins. It is a type of antibiotic.
Definition (NCI) A synthetic, broad-spectrum tetracycline antibiotic exhibiting antimicrobial activity. Doxycycline binds to the 30S ribosomal subunit, possibly to the 50S ribosomal subunit as well, thereby blocking the binding of aminoacyl-tRNA to the mRNA-ribosome complex. This leads to an inhibition of protein synthesis. In addition, this agent has exhibited inhibition of collagenase activity.
Definition (PDQ) A synthetic, broad-spectrum tetracycline antibiotic exhibiting antimicrobial activity. Doxycycline binds to the 30S ribosomal subunit, possibly to the 50S ribosomal subunit as well, thereby blocking the binding of aminoacyl-tRNA to the mRNA-ribosome complex. This leads to an inhibition of protein synthesis. In addition, this agent has exhibited inhibition of collagenase activity. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42494&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42494&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C457" NCI Thesaurus)
Concepts Antibiotic (T195) , Organic Chemical (T109)
MSH D004318
SnomedCT 10504007, 372478003
LNC LP14992-9, MTHU002295
English Doxycycline, 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-(4alpha,4aalpha,5alpha,5aalpha,6alpha,12aalpha))-, doxycycline, DOXYCYCLINE, Doxycycline [Chemical/Ingredient], Alpha 6 Deoxyoxytetracycline, Alpha-6-Deoxyoxytetracycline, Doxycycline (product), Doxycycline (substance)
Swedish Doxycyklin
Czech doxycyklin
Finnish Doksisykliini
Russian VIBRAMITSIN, DOKSITSIKLIN, ВИБРАМИЦИН, ДОКСИЦИКЛИН
Italian alfa-6-Deossi-ossitetraciclina, Doxiciclina
Croatian DOKSICIKLIN
Polish Doksycyklina, Wibramycyna
Japanese ドキシサイクリン, 塩酸ドキシサイクリン
Norwegian Doksycyklin
Spanish doxiciclina (producto), doxiciclina (sustancia), doxiciclina, Doxiciclina
French Doxycycline
German Doxycyclin
Portuguese Doxiciclina
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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