Doxycycline (When ATH J01AA02)

When ATH:
J01AA02

Characteristic.

A derivative of tetracycline, synthetically derived from oxytetracycline. Doxycycline - light yellow crystalline powder. Doxycycline monogidrat - Very slightly soluble in water, molecular weight 462,46. Doxycycline giklat (gemietanolat hydrochloride hemihydrate) - Soluble in water.

Pharmacological action.
Broad-spectrum antibacterial, bacteriostatic.

Application.

Infection, caused by susceptible, incl. intracellular, microorganisms: Q fever, Rocky Mountain spotted fever, typhus (incl. typhus, returnable), Brucellosis, iersinioz, batsillyarnaya and dysentery amebnaya, tulyaremiya, cholera, Lyme disease (Stage I), actinomycosis, malaria; in a combination therapy - leptospirosis, trachoma, ornithosis, granulotsitarnyi erlikhioz; ENT diseases and lower respiratory tract (sinusitis, otitis, tonsillitis, acute bronchitis, exacerbation of chronic bronchitis, pneumonia, pleurisy), biliary tract infections, and gastrointestinal tract (cholecystitis, kholangit, gastroenterocolitis, proctitis), periodontitis, peritonitis, urinary tract infection (incl. cystitis, pyelonephritis, uretrit, urogenital mycoplasmosis), inflammatory diseases of the pelvic organs in the acute phase in women (endometritis), acute prostatitis, epididymitis, gonorrhea, syphilis (if you are allergic to penicillin), purulent infections of the skin and soft tissues (flegmona, abscess, furunculosis, panaris, infected burns, wounds, acne), Eye infections, incl. Ulcerative keratitis. Prevention of postoperative septic complications after surgical infections, incl. after medical abortion, operations on the colon. Prevention of Malaria, caused by Plasmodium falciparum, For short stays (less 4 Months) in the territory, which marked the resistance of Plasmodium to chloroquine and / or pyrimethamine-sulfadoxine.

Contraindications.

Hypersensitivity, porphyria, severe liver failure, leukopenia, pregnancy (especially II-III trimester), lactation, Children up to age 8 years (because of the possible formation of insoluble complexes with calcium and deposits them in the skeleton, enamel and dentin of the teeth); for / in the introduction - myasthenia gravis.

Pregnancy and breast-feeding.

Contraindicated in pregnancy (may form insoluble complexes with calcium and deposition doxycycline skeleton) and breastfeeding.

Category actions result in FDA - D. (There is evidence of the risk of adverse effects of drugs on the human fetus, obtained in research or practice, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk, if the drug is needed in life-threatening situations or severe disease, when safer agents should not be used or are ineffective.)

Side effects.

From the nervous system and sensory organs: benign intracranial hypertension (adults - anorexia, headache, vomiting, papilledema, vision changes, children - a diverticulum of fontanels), toxic effect on the CNS (dizziness or unsteadiness).

Cardio-vascular system and blood (hematopoiesis, hemostasis): gemoliticheskaya anemia, thrombocytopenia, eozinofilija, neutropenia, decrease in prothrombin activity.

From the digestive tract: nausea, diarrhea, constipation, dysphagia, glossitis, esophagitis (incl erosive), gastritis, ulceration of the stomach and duodenum, enterocolitis (due to the proliferation of drug-resistant strains of staphylococci); liver damage during prolonged use or in patients with renal or hepatic insufficiency.

Allergic reactions: maculopapular rash, itching, dermahemia, angioedema, anaphylactoid reactions, exacerbation of systemic lupus erythematosus.

Other: dysbiosis, fungal infections (vaginitis, glossitis, stomatitis, proctitis), reinfection resistant strains, inflammation in the anogenital area perineum, photosensitivity, sustainable change in color of tooth enamel; in contact with the solution under the skin - phlebitis and periphlebitis.

Cooperation.

Absorption reduces simultaneous reception of iron preparations, sodium bicarbonate, aluminum, calcium or magnesium antacids, magnesium-containing laxatives, cholestyramine and colestipol. Barbiturates, Carbamazepine, phenytoin, rifampicin - it reduces the concentration of plasma and reducing T_1/2 doxycycline (induction of monooxygenases and acceleration of biotransformation), which can lead to a reduction of antibacterial effect. While the use of antibacterial drugs (incl. penicillins, cephalosporins) reduced effect (simultaneous use should be avoided). Doxycycline reduces the reliability of contraception and increases the frequency of "breakthrough" bleeding on oral contraceptives background estrogensoderjath. Potentiates the effect of indirect anticoagulants.

Overdose.

Treatment: discontinuation, symptomatic and supportive therapy. Hemodialysis nyeeffyektivyen.

Dosing and Administration.

Inside, I /. The dosage regimen depends on the indication, exciter, tolerability and set individually. Inside, after meal. In / in the introduction, preferably in severe forms of septic diseases, when you want to prompt the creation of a high concentration of drug in the blood, and in cases, when oral administration is hampered. It should move to ingestion, as soon as possible. B / drip (solution is prepared ex tempore), duration of infusion in a dose dependent manner (0,1 or 0,2 g) 1-2 hours at the rate of administration of 60-80 drops / min. The initial daily dose for adults 0.1-0.2 g (It can be 2 admission), further 0,1 g. Children 9-12 years - 4 mg / kg / day on the first day and 2 mg / kg - to further, in severe infections - for 4 mg / kg.

In the case of severe liver disease should decrease the daily dose of doxycycline due to the gradual accumulation in the body (the risk of hepatotoxicity).

Precautions.

To avoid irritation to the gastrointestinal tract is recommended to take the drug in the daytime, with a large amount of liquid.

For the prevention of candidiasis simultaneously with doxycycline hydrochloride recommend taking nystatin. With the development of superinfection should discontinue the use of doxycycline.

During treatment with doxycycline and for 4-5 days after it is contraindicated direct exposure to sunlight or UV rays (photosensitivity). With long-term use should be regularly monitored cellular composition of peripheral blood, carry out liver function tests, determine the content of serum urea. When using estrogensoderjath oral contraceptives should use additional means of contraception or change the method of contraception. Perhaps falsely elevated levels of catecholamines in the urine when determining the fluorescence method. When biopsy of thyroid patients, receiving long-term doxycycline, should consider the possibility of dark brown staining tissue micropreparations.

Cooperation