Doxy-1, Doxycin, Doxcap, Vibramycin
Generic Name
doxycycline
Manufacturer
Square Pharmaceuticals, Beximco Pharma, Renata, Pfizer (globally)
Country
Bangladesh, Global
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Description
Overview of the medicine
Doxycycline is a broad-spectrum tetracycline antibiotic used to treat various bacterial infections, including respiratory tract infections, urinary tract infections, skin infections, and certain sexually transmitted infections. It is also used for malaria prophylaxis and severe acne.
Uses & Indications
Dosage
Adults
Typically 100 mg once or twice daily, depending on the infection. For severe infections, initial dose may be 200 mg, followed by 100 mg daily.
Elderly
No specific dose adjustment is generally required for elderly patients, but caution is advised due to potential comorbidities and polypharmacy.
Renal_impairment
No dosage adjustment is usually necessary for patients with renal impairment, as doxycycline is primarily excreted non-renally.
How to Take
Take orally with a full glass of water, preferably during a meal or with food to reduce gastrointestinal irritation. Avoid lying down for at least 30 minutes to 1 hour after taking to prevent esophageal irritation. Do not take with antacids, iron supplements, or dairy products.
Mechanism of Action
Doxycycline inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit, preventing the attachment of aminoacyl-tRNA to the ribosomal acceptor site. This action is bacteriostatic, meaning it stops the growth and multiplication of bacteria.
Pharmacokinetics
Onset
Therapeutic concentrations are generally reached within 2-4 hours after oral administration.
Excretion
Primarily excreted in the feces via the intestine and, to a lesser extent, in the urine. Minimal accumulation occurs in patients with renal impairment.
Half life
Approximately 16-22 hours, allowing for once or twice daily dosing.
Absorption
Well absorbed orally, approximately 90-100% absorption, even in the presence of food and milk, though absorption may be slightly reduced by dairy products, calcium, aluminum, magnesium, or iron supplements.
Metabolism
Minimally metabolized in the liver; largely excreted in the active form.
Side Effects
Contraindications
- Hypersensitivity to doxycycline or other tetracyclines
- Pregnancy (especially second and third trimesters) due to potential for permanent tooth discoloration and bone growth inhibition in the fetus
- Children under 8 years of age (risk of permanent tooth discoloration)
- Severe liver impairment
Drug Interactions
Warfarin
May potentiate the anticoagulant effect of warfarin; monitor INR closely.
Penicillins
Tetracyclines may interfere with the bactericidal action of penicillins; avoid concomitant use.
Iron preparations
May decrease doxycycline absorption. Separate administration by at least 2-3 hours.
Oral contraceptives
Doxycycline may reduce the effectiveness of oral contraceptives; advise additional birth control methods.
Antacids (containing aluminum, calcium, magnesium)
May decrease doxycycline absorption. Separate administration by at least 2-3 hours.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include severe nausea, vomiting, and diarrhea. Management typically involves gastric lavage if recent ingestion, symptomatic and supportive care. Doxycycline is not effectively removed by hemodialysis.
Pregnancy & Lactation
Pregnancy Category D: Doxycycline can cause permanent tooth discoloration and bone growth inhibition in the fetus. Not recommended during pregnancy, especially during the second and third trimesters. Not recommended during breastfeeding as it is excreted into breast milk and may affect the infant's tooth development.
Side Effects
Contraindications
- Hypersensitivity to doxycycline or other tetracyclines
- Pregnancy (especially second and third trimesters) due to potential for permanent tooth discoloration and bone growth inhibition in the fetus
- Children under 8 years of age (risk of permanent tooth discoloration)
- Severe liver impairment
Drug Interactions
Warfarin
May potentiate the anticoagulant effect of warfarin; monitor INR closely.
Penicillins
Tetracyclines may interfere with the bactericidal action of penicillins; avoid concomitant use.
Iron preparations
May decrease doxycycline absorption. Separate administration by at least 2-3 hours.
Oral contraceptives
Doxycycline may reduce the effectiveness of oral contraceptives; advise additional birth control methods.
Antacids (containing aluminum, calcium, magnesium)
May decrease doxycycline absorption. Separate administration by at least 2-3 hours.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include severe nausea, vomiting, and diarrhea. Management typically involves gastric lavage if recent ingestion, symptomatic and supportive care. Doxycycline is not effectively removed by hemodialysis.
Pregnancy & Lactation
Pregnancy Category D: Doxycycline can cause permanent tooth discoloration and bone growth inhibition in the fetus. Not recommended during pregnancy, especially during the second and third trimesters. Not recommended during breastfeeding as it is excreted into breast milk and may affect the infant's tooth development.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture when stored correctly.
Availability
Pharmacies, Hospitals
Approval Status
Approved by regulatory authorities worldwide
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Doxycycline has been extensively studied in numerous clinical trials for its various indications, including ongoing research for its anti-inflammatory and immunomodulatory effects in conditions like rosacea and certain autoimmune diseases.
Lab Monitoring
- Liver function tests (for long-term therapy)
- Kidney function tests (for long-term therapy)
- Complete blood count (if prolonged use)
Doctor Notes
- Counsel patients on strict adherence to administration instructions, especially taking with ample water and remaining upright to prevent esophageal irritation.
- Emphasize sun protection due to photosensitivity. Review potential drug interactions, particularly with antacids, iron, and oral contraceptives.
- Avoid in pregnant women and children under 8 due to developmental risks.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor and complete the full course of treatment, even if you feel better.
- Avoid direct sunlight and use protective clothing and sunscreen while taking this medication.
- Take with plenty of water to prevent esophageal irritation. Do not lie down for at least 30 minutes after taking.
- Avoid dairy products, antacids, and iron supplements within 2 hours of taking doxycycline.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Doxycycline may cause dizziness or blurred vision in some individuals. Exercise caution when driving or operating machinery until you know how the medication affects you.
Lifestyle Advice
- Maintain good hydration by drinking plenty of fluids.
- Practice sun safety by seeking shade, wearing protective clothing, and using sunscreen due to photosensitivity.
- Avoid alcohol consumption as it may reduce the effectiveness of some antibiotics.
Alternative Medicines in Bangladesh
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.