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Tetracycline

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Tetracycline, Doxycycline, Minocycline, Vibramycin, Monodox, Doryx

  • Preparations
  1. Tetracycline
  2. Minocycline
  3. Doxycycline
    1. Avoid substituting low-dose Doxycycline (Periostat, Oracea) products for systemic infections
    2. May substitute other Doxycycline salts
      1. Doxycycline hyclate (Vibramycin, Doryx)
      2. Doxycycline monohydrate (Monodox)
      3. (2013) Presc Lett 20(5):26
    3. Other formulations
      1. 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)
  1. Tetracycline 1 gram daily given in 2-4 divided doses
  2. Doxycycline 100-200 mg/day in divided doses (low doses, such as 50 mg daily, are often as effective for acne)
  3. Minocycline 50-200 mg/d in divided doses
  1. Doxycycline 100 mg daily
    1. Start 1-2 days before travel and continue for 4 weeks after return
  • Contraindications
  1. Pregnancy
    1. Pregnancy category D
  2. Children under age 8 years old
  • Drug Interactions
  • Food Related
  1. Tetracycline
    1. Milk and calcium-rich food decrease absorption
    2. Take 1 hour before or 2 hours after a meal
  2. Doxycycline and Minocycline
    1. Can be taken with milk or food (unlike Tetracycline)
  • Precautions
  1. Use Sunscreen with these agents due to Drug-induced Photosensitivity
  2. Pill Esophagitis
    1. Take with a full glass of water
  • Adverse Effects
  1. Tetracycline
    1. Photosensitivity
    2. Interferes with OCP action
  2. Doxycycline
    1. Photosensitivity
    2. Abdominal Pain
    3. Diarrhea
    4. Pill Esophagitis (see above)
  3. Minocycline
    1. Generally well tolerated
    2. Does not generally cause photosensitivity
    3. Rare adverse effects
      1. Lupus-like syndrome (1:20,000)
      2. Vertigo
      3. Oral Mucosa pigmentation (blue-black pigmentation)
      4. Hypersensitivity Syndrome within 1-3 months
      5. Delayed Arthralgias or Polyarthritis