demeclocycline (Rx)

Brand and Other Names:Declomycin
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 150mg
  • 300mg

Susceptible Infections

150 mg PO QID or 300 mg PO BID

Dosing Considerations

Indicated in the treatment of infections caused by susceptible strains of the designated microorganisms in the conditions below:

Rocky Mountain spotted fever, typhus fever and the typhus group, Q fever, rickettsialpox and tick fevers caused by rickettsiae

Respiratory tract infections caused by Mycoplasma pneumoniae

Lymphogranuloma venereum due to Chlamydia trachomatis

Psittacosis (Ornithosis) due to Chlamydia psittaci

Trachoma due to Chlamydia trachomatis, although the infectious agent is not always eliminated, as judged by immunofluorescence

Inclusion conjunctivitis caused by Chlamydia trachomatis

Nongonococcal urethritis in adults caused by Ureaplasma urealyticum or Chlamydia trachomatis

Relapsing fever due to Borrelia recurrentis

Chancroid caused by Haemophilus ducreyi

Plague due to Yersinia pestis

Tularemia due to Francisella tularensis

Cholera caused by Vibrio cholerae

Campylobacter fetus infections cause by Campylobacter fetus

Brucellosis due to Brucella species (in conjunction with streptomycin)

Bartonellosis due to Bartonella bacilliformis

Granuloma inguinale caused by Calymmatobacterium granulomatis

Indicated for the following gram-negative microorganisms, when bacteriologic testing indicates appropriate susceptibility to the drug

  • Escherichia coli
  • Enterobacter aerogenes
  • Shigella species
  • Acinetobacter species
  • Respiratory tract infections caused by Haemophilus influenzae
  • Respiratory tract and urinary tract infections caused by Klebsiella species

Indicated for the following gram-positive microorganisms, when bacteriologic testing indicates appropriate susceptibility to the drug

  • Upper respiratory infections caused by Streptococcus pneumoniae
  • Skin and skin structure infections caused by Staphylococcus aureus (tetracyclines, including demeclocycline, are not the drugs of choice in the treatment of any type of staphylococcal infection)

When penicillin is contraindicated, tetracyclines, including demeclocycline are alternative drugs in the treatment of the following infections

  • Uncomplicated urethritis in men due to Neisseria gonorrhoeae, and for the treatment of other uncomplicated gonococcal infections
  • Infections in women caused by Neisseria gonorrhoeae
  • Syphilis caused by Treponema pallidum subspecies pallidum
  • Yaws caused by Treponema pallidum subspecies pertenue
  • Listeriosis due to Listeria monocytogenes
  • Anthrax due to Bacillus anthracis
  • Vincent’s infection caused by Fusobacterium fusiforme
  • Actinomycosis caused by Actinomyces israelii
  • Clostridial diseases caused by Clostridium species
  • In acute intestinal amebiasis, may be a useful adjunct to amebicides
  • In severe acne, may be a useful adjunctive therapy
  • Rocky Mountain spotted fever, typhus fever and the typhus group, Q fever, rickettsialpox, and tick fevers caused by rickettsiae

Dosage Forms & Strengths

tablet

  • 150mg
  • 300mg

Susceptible Infections

≤8 years: Safety and efficacy not established (see Cautions)

>8 years: 6.6-13.2 mg/kg/day PO divided BID/TID  

Alternatively, 300 mg/m²/day PO divided BID/TID

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Interactions

Interaction Checker

and demeclocycline

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    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

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            Adverse Effects

            Frequency Not Defined

            Photosensitivity rxn (more frequent & severe than other tetracyclines), reversible

            Dose-related diabetes insipidus (does not occur with other tetracyclines)

            Discoloration of teeth

            Superinfection, monilial

            Dysphagia

            Glossitis

            Nausea

            Vomiting

            Diarrhea

            Hepatotoxicity

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            Warnings

            Contraindications

            Documented hypersensitivity

            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 one-half of pregnancy through age 8 y) can cause permanent discoloration of teeth

            Fanconilike syndrome may occur with outdated tetracyclines

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            Pregnancy & Lactation

            Pregnancy

            Avoid during pregnancy; use alternant antibiotics

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

            Lactation

            Tetracyclines are excreted in breastmilk

            Avoided in breastfeeding women due to theoretical concerns that they may permanently stain the teeth of the breastfed infants

            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

            Bioavailability: 60-80% (fasting); reduced by ≥50% or more by food or milk

            Peak plasma concentration: 0.9-1.2 mcg/mL (150 mg x 1); 1.5-1.7 mcg/mL (300 mg x 1)

            Elimination

            Half-life: 11-17 hr; 42-68 hr (severe renal impairment)

            Excretion: 44% urine; 31% feces

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            Administration

            Oral Administration

            Administer 1 hr before or 2 hr after meals

            Do not take with milk, calcium or magnesium supplements, iron supplements, antacids, or multivitamins; separate doses by several hours

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            Formulary

            FormularyPatient Discounts

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            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.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.