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Tetracycline information from DrugsUpdate  

See Available Brands of Tetracycline in India

P - Cautioned in pregnancy
L - Contraindicated in lactation
FI - Food *
LI - Lab *

Tetracycline is a broad-spectrum polyketide antibiotic produced by the Streptomyces genus of Actinobacteria, indicated for use against many bacterial infections. It is a protein synthesis inhibitor. It is commonly used to treat acne today, and more recently, rosacea, and played a historical role in stamping out cholera in the developed world. It is sold under the brand names Sumycin, Terramycin, Tetracyn, and Panmycin, among others. Actisite is a thread-like fiber form, used in dental applications. It is also used to produce several semi-synthetic derivatives, which together are known as the tetracycline antibiotics.

Pharmacodynamics

Pharmacokinetics

Tetracycline exhibits its bacteriostatic action by reversible binding to the 30s subunits of the ribosome thus preventing protein synthesis and arresting cell growth. It has a broad spectrum of antimicrobial activity including Chlamydiaceae, Mycoplasma spp., Rickettsia spp., spirochaetes, many aerobic and anaerobic Gram-positive and Gram-negative pathogenic bacteria, and some protozoa.

Absorption
Absorbed incompletely from the GIT (oral) with oral bioavailability 60-80%; absorption affected by the presence of divalent ot trivalent metal ions, food and milk.

Distribution
Widely distributed to body tissues and fluids, CSF (low, may be increased in meningitis), saliva (small amounts), eye, lung, bone (newly formed), teeth (recently calcified and newly developed). Crosses the placenta into the foetal circulation and enters breast milk. Protein-binding: 20-65%. Half life: 6-12 hours.

Excretion
Via urine by glomerular filtration (as unchanged, 55% via oral and 60% via IV); may be increased in alkaline urine. Via bile; may undergo enterohepatic reabsorption.

Tetracycline Indications / Tetracycline Uses

Information Not Available

Tetracycline Adverse Reactions / Tetracycline Side Effects

Oesophageal ulceration, nausea, vomiting, oral candidiasis, diarrhoea, epigastric burning, sore throat, black hairy tongue, pancreatitis, oncholysis, discolouration of tooth (children with developing teeth) and nails, tinnitus, visual disturbances, superinfections, photosensitivity, hypersensitivity,

Potentially Fatal: Anaphylaxis, hepatotoxicity, nephrotoxicity, blood dyscrasias.

Precautions

As with other antibiotics, use of this drug may result in overgrowth of nonsusceptible organisms, including fungi. If superinfection occurs, the antibiotic should be discontinued and appropriate therapy should be instituted.

All infections due to Group A betahemolytic streptococci should be treated for at least ten days.

Bulging fontanels in infants and benign intracranial hypertension in adults have been reported in individuals receiving Tetracyclines. These conditions disappeared when the drug was discontinued.

Incision and drainage or other surgical procedures should be performed in conjunction with antibiotics therapy, when indicated.

Special Precautions

Hepatic impairment. Myasthenia gravis, SLE. Should be administered with plenty of water, while sitting or standing, and well before going to bed to avoid oesophageal ulceration. Avoid exposure to sunlight. Periodic evaluation of renal, hepatic and haematological system during prolonged therapy.

Other Drug Interactions

Absorption reduced by divalent and trivalent cations, Fe prep and antacids. Decreases effectiveness of oral contraceptives. Concurrent use may increase levels of lithium, digoxin, halofantrine and theophylline; decrease concentrations of atovaquone; increase anticoagulant effects with warfarin; increase risk of ergotism with ergot alkaloids.

Potentially Fatal: Nephrotoxic effects exacerbated by diuretics, methoxyflurane or other nephrotoxic drugs; avoid concurrent use with potentially hepatotoxic drugs. Increased incidence of benign intracranial hypertension with retinoids.

Other Interactions

Food Interaction
Absorption reduced by milk, milk products, antacids containing aluminum, magnesium iron preparations and food.

Dosage

Oral
Susceptible Infections
Adult: As hydrochloride: 250 or 500 mg every 6 hours, increased to 4 g daily in severe infections.
Child: As hydrochloride: ≥12 years: usual adult dose. Max: 2 g daily.

Renal impairment: Mild impairment: Avoid.
Hepatic impairment: Max: 1 g daily.

Oral
Acne
Adult: As hydrochloride: 500 mg-1 g daily in 4 divided doses for 1–2 weeks or until clinical improvement occurs, then decreased slowly to maintenance dose of 125–500 mg daily until clinical improvement allows discontinuation of the drug.

Renal impairment: Mild: Avoid
Hepatic impairment: Max: 1g/day.

Intrapleural
Pleural Effusions
Adult: As hydrochloride: 500 mg dissolved in 30-50 mL of 0.9% NaCl instilled into pleural spaces.

Food(before/after)

Should be taken on an empty stomach. (Take on an empty stomach 1 hour before or 2 hours after meals with a full glass of water, in upright position. May be taken with meals to reduce GI discomfort.)

List of Contraindications

Tetracycline and Pregnancy

Contraindicated in pregnancy

Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).

Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

Tetracycline and Lactation

Contraindicated in lactation

Tetracycline and Children

The use of drugs of the tetracycline class during tooth development (last half of pregnancy, infancy and childhood to the age of 8 years) may cause permanent discoloration of the teeth (yellow-gray-brown). this adverse reaction is more common during long-term use of the drugs but has been observed following repeated short-term courses. enamel hypoplasia has also been reported. tetracycline drugs, therefore, should not be used in this age group unless other drugs are not likely to be effective or are contraindicated.

Tetracycline and Geriatic

Information Not Available

Tetracycline and Other Contraindications

Hypersensitivity; pregnancy, lactation, children; renal impairment.

Storage

Information Not Available

Lab interference

Information Not Available

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