Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C. Severe skin reactions, such as exfoliative dermatitis, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms DRESS have been reported in patients receiving doxycycline.
If severe skin reactions occur, doxycycline should be discontinued immediately and appropriate therapy should be instituted. Intracranial hypertension IH, pseudotumor cerebri has been associated with the use of tetracyclines including doxycycline.
Clinical manifestations of IH include headache, blurred vision, diplopia, and vision loss; papilledema can be found on fundoscopy. Women of childbearing age who are overweight or have a history of IH are at greater risk for developing tetracycline associated IH. Concomitant use of isotretinoin and doxycycline should be avoided because isotretinoin is also known to cause pseudotumor cerebri. Although IH typically resolves after discontinuation of treatment, the possibility for permanent visual loss exists.
If visual disturbance occurs during treatment, prompt ophthalmologic evaluation is warranted. Since intracranial pressure can remain elevated for weeks after drug cessation patients should be monitored until they stabilize. All tetracyclines form a stable calcium complex in any bone-forming tissue.
This reaction was shown to be reversible when the drug was discontinued. Results of animal studies indicate that tetracyclines cross the placenta, are found in fetal tissues, and can have toxic effects on the developing fetus often related to retardation of skeletal development. Evidence of embryotoxicity has also been noted in animals treated early in pregnancy.
If any tetracycline is used during pregnancy or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus. The antianabolic action of the tetracyclines may cause an increase in BUN. Studies to date indicate that this does not occur with the use of doxycycline in patients with impaired renal function. Photosensitivity manifested by an exaggerated sunburn reaction has been observed in some individuals taking tetracyclines.
Patients apt to be exposed to direct sunlight or ultraviolet light should be advised that this reaction can occur with tetracycline drugs, and treatment should be discontinued at the first evidence of skin erythema.
As with other antibacterial drugs, use of doxycycline may result in overgrowth of nonsusceptible organisms, including fungi. If superinfection occurs, doxycycline should be discontinued and appropriate therapy instituted. Incision and drainage or other surgical procedures should be performed in conjunction with antibacterial therapy, when indicated. Doxycycline offers substantial but not complete suppression of the asexual blood stages of Plasmodium strains.
Doxycycline does not suppress P. Subjects completing this prophylactic regimen may still transmit the infection to mosquitoes outside endemic areas. Prescribing doxycycline hyclate in the absence of proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.
Sunscreen or sunblock should be considered. However, the absorption of doxycycline is not markedly influenced by simultaneous ingestion of food or milk. Patients should be counseled that antibacterial drugs, including doxycycline hyclate should only be used to treat bacterial infections. They do not treat viral infections e. When doxycycline hyclate is prescribed to treat a bacterial infection, patients should be told that although it is common to feel better early in the course of therapy, the medication should be taken exactly as directed.
Skipping doses or not completing the full course of therapy may 1 decrease the effectiveness of the immediate treatment and 2 increase the likelihood that bacteria will develop resistance and will not be treatable by doxycycline hyclate or other antibacterial drugs in the future.
Diarrhea is a common problem caused by antibacterial drugs, which usually ends when the antibacterials are discontinued. Sometimes after starting treatment with antibacterial drugs, patients can develop watery and bloody stools with or without stomach cramps and fever even as late as two or more months after having taken the last dose of the antibacterial drug.
If this occurs, patients should contact their physician as soon as possible. In venereal disease, when co-existent syphilis is suspected, dark field examinations should be done before treatment is started and the blood serology repeated monthly for at least 4 months. In long-term therapy, periodic laboratory evaluation of organ systems, including hematopoietic, renal, and hepatic studies, should be performed.
Because tetracyclines have been shown to depress plasma prothrombin activity, patients who are on anticoagulant therapy may require downward adjustment of their anticoagulant dosage. Since bacteriostatic drugs may interfere with the bactericidal action of penicillin, it is advisable to avoid giving tetracyclines in conjunction with penicillin. Absorption of tetracyclines is impaired by antacids containing aluminum, calcium, or magnesium, and iron-containing preparations. False elevations of urinary catecholamine levels may occur due to interference with the fluorescence test.
Long-term studies in animals to evaluate carcinogenic potential of doxycycline have not been conducted. However, there has been evidence of oncogenic activity in rats in studies with the related antibacterial drugs, oxytetracycline adrenal and pituitary tumors , and minocycline thyroid tumors.
Likewise, although mutagenicity studies of doxycycline have not been conducted, positive results in in vitro mammalian cell assays have been reported for related antibacterial drugs tetracycline, oxytetracycline. Effect on male fertility has not been studied. There are no adequate and well-controlled studies on the use of doxycycline in pregnant women.
The vast majority of reported experience with doxycycline during human pregnancy is short-term, first trimester exposure. There are no human data available to assess the effects of long-term therapy of doxycycline in pregnant women, such as that proposed for treatment of anthrax exposure. An expert review of published data on experiences with doxycycline use during pregnancy by TERIS — the Teratogen Information System — concluded that therapeutic doses during pregnancy are unlikely to pose a substantial teratogenic risk the quantity and quality of data were assessed as limited to fair , but the data are insufficient to state that there is no risk.
Sixty-three 0. This association was not seen when the analysis was confined to maternal treatment during the period of organogenesis i. A small prospective study of 81 pregnancies describes 43 pregnant women treated for 10 days with doxycycline during early first trimester. All mothers reported their exposed infants were normal at 1 year of age. Tetracyclines are excreted in human milk; however, the extent of absorption of tetracyclines, including doxycycline, by the breastfed infant is not known.
Short-term use by lactating women is not necessarily contraindicated; however, the effects of prolonged exposure to doxycycline in breast milk are unknown. Because of the effects of drugs of the tetracycline-class on tooth development and growth, use doxycycline in pediatric patients 8 years of age or less only when the potential benefits are expected to outweigh the risks in severe or life-threatening conditions e.
The following adverse reactions have been observed in patients receiving tetracyclines:. Gastrointestinal: anorexia, nausea, vomiting, diarrhea, glossitis, dysphagia, enterocolitis, inflammatory lesions with monilial overgrowth in the anogenital region, and pancreatitis. Hepatotoxicity has been reported rarely. These reactions have been caused by both the oral and parenteral administration of tetracyclines. Superficial discoloration of the adult permanent dentition, reversible upon drug discontinuation and professional dental cleaning has been reported.
Permanent tooth discoloration and enamel hypoplasia may occur with drugs of the tetracycline class when used during tooth development. Rare instances of esophagitis and esophageal ulcerations have been reported in patients receiving capsule and tablet forms of the drugs in the tetracycline class.
Most of these patients took medications immediately before going to bed. Skin: toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme, skin hyperpigmentation, maculopapular and erythematous rashes. Exfoliative dermatitis has been reported but is uncommon.
Photosensitivity is discussed above. Renal toxicity: Rise in BUN has been reported and is apparently dose related. Immune: Hypersensitivity reactions including urticaria, angioneurotic edema, anaphylaxis, anaphylactoid purpura, serum sickness, pericarditis, exacerbation of systemic lupus erythematosus, and drug reaction with eosinophilia and systemic symptoms DRESS , and Jarisch-Herxheimer reaction has been reported in the setting of spirochete infections treated with doxycycline.
Other: Bulging fontanels in infants and intracranial hypertension in adults. When given over prolonged periods, tetracyclines have been reported to produce brown-black microscopic discoloration of the thyroid gland. No abnormalities of thyroid function studies are known to occur. Monohydrate and hyclate are simply two different salt forms of doxycycline, with each salt form possessing slightly different absorption properties.
Both are sold in tablet and capsule form. Doxycycline monohydrate and doxycycline hyclate are equally effective in their role as antibiotics. Our guide to doxycycline explains how it works in more detail, as well as its dosages, side effects, interactions and more. This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice.
Always talk to your doctor about the risks and benefits of any treatment. Insider tips, early access and more. Popular Treatments. Doxycycline monohydrate and doxycycline hyclate are variations of the same drug, used to treat the same conditions. The differences are miniscule, particularly when it comes to actual size — the differences are molecular. If you want to get scientific, the differences boil down to some carbon, hydrogen, nitrogen and oxygen molecules.
Also, the molecular weight of doxycycline monohydrate is about half that of doxycycline hyclate. Namely, the differences in doxycycline hyclate and doxycycline monohydrate come down to dosing or the amount you might have to take. Because of the different chemical compositions, it is not advisable to use these two forms interchangeably, and you should consult a healthcare professional before changing varieties. To get straight to the point: doxycycline hyclate and monohydrate are equally effective from a medical standpoint.
That said, one practical area to scrutinize is price. It turns out that the price of these two doxycycline molecules have been particularly volatile in the past and prices can still be quite a bit different.
According to GoodRx. Keep an eye on the price tag of doxycycline. You can always check with your provider about other available options if the price looks off. All prescription drugs come with potential side effects. With doxycycline, the most likely side effects include photosensitivity leading to sunburns and other skin irritations, and digestive distress including diarrhea.
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