Treatment of infections caused by susceptible strains of gram-positive and gram-negative bacteria (eg, Rickettsia , Mycoplasma pneumoniae );
Acute Epididymo-Orchitis Caused by Neisseria Gonorrhoeae or Chlamydia Trachomatis
Adults: PO 100 mg twice daily for at least 10 days.
Adults and Children 8 yr of age and older: PO 100 mg twice daily for 7 days.
Epididymitis Most Likely Caused by Gonococcal or Chlamydial Infection
Adults: PO 100 mg twice daily for 10 days plus a single dose of 250 mg ceftriaxone IM.
Adults and children older than 8 yr of age and weighing more than 45 kg: PO 200 mg on the first day (100 mg every 12 h) then 100 mg/day. For more severe infections (particularly chronic UTI), administer 100 mg every 12 h. In streptococcal infections, continue therapy for 10 days. IV 200 mg on the first day (as 1 or 2 infusions) then 100 to 200 mg/day, depending upon the severity of infections, with 200 mg administered in 1 or 2 infusions.
Children older than 8 yr of age and weighing 45 kg or less: PO 4.4 mg/kg divided into 2 doses on day 1 followed by 2.2 mg/kg/day as a single dose or divided into 2 doses on subsequent day. For more severe infections, 4.4 mg/kg may be used. In streptococcal infections, continue therapy for 10 days. IV 4.4 mg/kg on day 1 (in 1 or 2 infusions) followed with 2.2 to 4.4 mg/kg given as 1 or 2 infusions, depending on the severity of the infection.
Lymphogranuloma Venereum and Granuloma Inguinale
Adults: PO 100 mg twice daily for at least 21 days.
Adults: PO 100 mg daily, beginning 1 to 2 days before travel and continuing for 4 wk after leaving area.
Children older than 8 yr of age: PO 2 mg/kg daily up to 100 mg per day. Begin 1 to 2 days before travel and continue for 4 wk after leaving area.
Adults: PO 100 mg twice daily for 7 days.
Pelvic Inflammatory Disease
Adults: PO / IV 100 mg every 12 h plus 2 g cefotetan IV every 12 h or 2 g cefoxitin IV every 6 h. Parenteral therapy may be discontinued after 24 h; continue oral therapy with doxycycline for a total of 14 days.
Periodontitis ( Periostat , Atridox )
Adults: PO 20 mg twice daily as an adjunct following scaling and root planing for up to 9 mo. Administer tablets at least 2 h before or after meals.
Adults: Subgingival Injection Variable dose, depending on the size, shape, and number of pockets being treated (see product information for preparation and administration).
Rosacea ( Oracea )
Adults: PO 40 mg in the morning on an empty stomach, at least 1 h prior to or 2 h after a meal.
Sexual Assault Prophylaxis
Adults: PO 100 mg twice daily for 7 days plus ceftriaxone and metronidazole.
Early (except Adoxa , NutriDox , Monodox ) PO 100 mg twice daily for 14 days.
More than 1 yr duration (except Adoxa , NutriDox , Monodox ) 100 mg twice daily for 28 days.
Primary and secondary ( Adoxa , NutriDox , Monodox ) 300 mg/day in divided doses for at least 10 days.
Uncomplicated Gonococcal Infection (Except Anorectal Infections in Men)
Adults: PO 100 mg twice daily for at least 7 days. Single visit dose: 300 mg immediately followed with 300 mg in 1 h.
Uncomplicated Urethral, Endocervical, or Rectal Infections Caused by C. Trachomatis
Adults: PO 100 mg twice daily for at least 7 days.
Inhalation Anthrax (Post-exposure)
Adults and children (100 lb [45 kg] or more): PO 100 mg twice daily for 60 days.
Children (less than 100 lb [45 kg]): PO 2.2 mg/kg twice daily for 60 days.
|•||Administer tablets or capsules with a full glass of water.|
|•||tablets may be broken up and the contents sprinkled over applesauce. Do not crush/damage the pellets when breaking up the tablet. Swallow mixture immediately.|
|•||Shake suspension well before measuring dose.|
|•||Administer prescribed dose of suspension or syrup using dosing syringe, dosing spoon, or medicine cup.|
|•||Administer 2 h before or 2 h after antacids containing aluminum, calcium, or magnesium; preparations containing iron or zinc; or dairy products (eg, milk, cheese, ice cream).|
|•||Administer other oral doxycycline products 1 h before or 2 h after antacids containing aluminum, calcium, or magnesium, or preparations containing iron or zinc.|
|•||For IV infusion only.|
|•||Follow manufacturer’s guidelines for reconstituting and further diluting the powder for injection.|
|•||Do not administer if particulate matter, cloudiness, or discoloration noted.|
|•||Protect diluted solutions from direct sunlight during storage and infusion.|
|•||For solutions diluted with lactated Ringers injection or dextrose 5% in lactated Ringers, complete infusion within 6 h of reconstitution. Discard any remaining solution after 6 h|
Hypersensitivity to tetracyclines; nursing mothers, infants, and children .
CNS: Dizziness; headache; pseudotumor cerebri (manifested by headache and blurred vision).
DERM: Maculopapular and erythematous rashes; exfoliative dermatitis; photosensitivity.
GI: Anorexia; nausea; vomiting; diarrhea; glossitis; dysphagia; enterocolitis; inflammatory lesions (with monilial overgrowth) in anogenital area; abdominal pain or discomfort; bulky loose stools; sore throat.
GU: Increase BUN.
HEMA/LYMPH: Hemolytic anemia; thrombocytopenia; neutropenia; eosinophilia.
HYPERSEN: Hypersensitivity (including urticaria, angioneurotic edema, anaphylaxis, anaphylactoid reactions, purpura, pericarditis, exacerbation of SLE).
OTHER: Bulging fontanels (infants); benign intracranial hypertension (adults).
Antacids (containing aluminum, calcium, or magnesium), bismuth salts, divalent/trivalent cations, zinc salts
May decrease oral absorption of doxycycline.
Barbiturates, carbamazepine, hydantoins
May increase metabolism of and decrease effect of doxycycline.
May decrease absorption of doxycycline.
May increase digoxin serum levels.
May decrease absorption of doxycycline.
Because the risk of pseudotumor cerebri may be increased, avoid isotretinoin administration shortly before, during, or after doxycycline therapy.
Increased potential for nephrotoxicity exists; do not use together.
Milk and dairy products
Although the effects of milk and dairy products on doxycycline absorption are less than observed with other tetracycline derivatives, avoid the administration of milk or dairy products with all tetracycline derivatives.
May decrease contraceptive efficacy.
May interfere with bactericidal action of penicillins.
Anticoagulant effect may be increased; dose may need to be decreased.
Therapeutic Classification: anti-infectives
Pharmacologic Classification: tetracyclines
Absorption: Well absorbed from the GI tract.
Distribution: Widely distributed, some CSF and good bone penetration; crosses placenta and enters breast milk.
Metabolism/Excretion: 20–40% excreted unchanged in urine; some inactivation in intestine and some enterohepatic circulation with excretion in bile and feces.
Half-life: 14–17 hr ( increase in severe renal impairment).
|ORAL||1-2 HOUR||1.5-4 HOUR||12 HOUR|
|INTRAVENOUS||RAPID||END OF INFUSION||12 HOUR|