tetracycline (Rx)

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Brand and Other Names:Sumycin, Actisite, more...Achromycin V

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule/tablet

  • 250mg
  • 500mg

syrup (extemporaneously prepared)

  • 125mg/5mL
more...

Chronic Bronchitis, Acute Exacerbation

500 mg PO q6hr

Acne

250-500 mg PO q12hr

Ehrlichiosis

500 mg PO q6hr for 7-14 days

Vibrio Cholera

500 mg PO q6hr for 3 days

Malaria, Severe Treatment (Unlabeled)

500 mg PO q6hr for 7 days with quinidine gluconate

Dosage Modifications

Renal impairment

  • CrCl 50-80 mL/min: Dose frequency q8-12hr
  • CrCl 10-50 mL/min: Dose frequency q12-24hr
  • CrCl <10 mL/min: Dose frequency q24hr

Dosing Considerations

Susceptible organisms

  • Acinetobacter spp, Actinomyces israelii, Afipia felis, Bacillus anthracis, Bacteroides spp, Bartonella bacilliformis, Bartonella quintana, Bordetella pertussis, Borrelia recurrentis, Brucella spp, Capnocytophaga canimorsus, Campylobacter jejuni, Chlamydia spp, Citrobacter spp, Coxiella burnetii, Eikenella corrodens, Escherichia coli, Francisella tularensis, Leptospira interrogans, Helicobacter pylori, Klebsiella spp, Listeria monocytogenes, Moraxella catarrhalis, Mycoplasma pneumoniae, Neisseria gonorrhoeae, Propionibacterium acnes, Rickettsiae, Shigella spp, Staphylococcus aureus, Streptococcus pneumoniae, Treponema pallidum, Ureaplasma urealyticum, Vibrio cholerae, Yersinia pestis, Yersinia enterocolitica, Yersinia pseudotuberculosis

Dosage Forms & Strengths

capsule/tablet

  • 250mg
  • 500mg

syrup

  • 125mg/5mL
more...

General Dosing Guidelines

<8 years: Not recommended; tooth discoloration and enamel hypoplasia may occur with use in young children

>8 years: 25-50 mg/kg/day PO divided q6hr; not to exceed 3 g/day 

Malaria, Severe Treatment (Unlabeled)

<8 years: Not recommended; tooth discoloration and enamel hypoplasia may occur with use in young children

>8 years: 25-50 mg/kg/day PO divided q6hr, not to exceed 250 mg/dose q6hr for 7 days with quinidine gluconate 

Vibrio Cholera

Single dose: 25 mg/kg PO; not to exceed 1 g/dose  

Multiple dose: 40 mg/kg/day PO divided q6hr for 3 days; not to exceed 2 g/day

Administration

Take on empty stomach; do not take with dairy products

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Interactions

Interaction Checker

and tetracycline

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Discoloration of teeth and enamel hypoplasia (young children)

            1-10%

            Diarrhea

            Nausea

            Photosensitivity

            <1%

            Anorexia

            Abdominal cramps

            Antibiotic-associated pseudomembranous colitis

            Bulging fontanels in infants

            Diabetes insipidus syndrome

            Esophagitis

            Exfoliative dermatitis

            Incr ICP

            Pericarditis

            Pseudotumor cerebri

            Pancreatitis

            Pruritus

            Pigmentation of nails

            Vomiting

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            Warnings

            Contraindications

            Documented hypersensitivity

            Severe hepatic dysfunction

            Cautions

            Photosensitivity may occur with prolonged exposure to sunlight or tanning equipment

            Reduce dose in renal impairment

            Consider drug serum level determinations in prolonged therapy

            Tetracycline use during tooth development (last half of pregnancy through age 8 years) can cause permanent discoloration of teeth

            Fanconilike syndrome may occur with outdated tetracyclines

            IV/IM no longer commercially available

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            Pregnancy & Lactation

            Pregnancy category: D (systemic), C (periodontal fiber)

            Lactation: Enters breast milk; some manufacturers say do not nurse; however, AAP considers nursing compatible due to calcium chelation of drug and prevention of its absorption (long-term safety of prolonged exposure unknown)

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Inhibits bacterial protein synthesis by binding with 30S and possibly 50S ribosomal subunit(s)

            Absorption

            Absorption: 75% (PO)

            Peak plasma time: 2-4 hr (PO)

            Distribution

            Small amount appears in bile; relative diffusion from blood into CSF: good only with inflammation (exceeds usual MICs) CSF: blood level ratio: inflamed meninges: 25%

            Protein bound: 65%

            Elimination

            Half-life: 8-11 hr (normal renal function); 57-108 hr (end-stage renal disease)

            Excretion: Urine (60% as unchanged drug); feces (as active form)

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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