Demeclocycline

DEA Class; Rx

Common Brand Names; Declomycin

  • Tetracyclines

Tetracycline antibiotic with activity similar to the other tetracyclines. Main clinical use is for inappropriate secretion of ADH due to its ability to produce nephrogenic diabetes insipidus. Photosensitivity is more frequent and more severe with demeclocycline than with other tetracyclines.

Indicated for the treatment of cholera caused by Vibrio cholerae.

For the treatment of Campylobacter fetus infections.
For the treatment of clostridial diseases caused by Clostridium sp..
For the treatment of acute intestinal amebiasis as an adjunct to amebicides.
For the treatment of severe acne (i.e. acne vulgaris) as adjunctive therapy.
For the treatment of necrotizing ulcerative gingivitis (Fusospirochetosis or Vincent’s infection).
For the treatment of syphilis (Treponema pallidum) or yaws (Treponema pertenue) when other more effective agents are contraindicated.
For the treatment of upper respiratory tract infections and lower respiratory tract infections.
For the treatment of bacterial urinary tract infection (UTI) caused by Klebsiella sp., E. coli, Enterobacter aerogenes, or Proteus sp.

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)

Documented hypersensitivity

  • 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

All tetracyclines form a stable calcium complex in any bone-forming tissue; a decrease in fibula growth rate has been observed in premature human infants given in doses of 25 mg/kg/ every six hr; this reaction was shown to be reversible when the drug was discontinued

Results of animal studies indicate that tetracyclines cross the placenta, are found in fetal tissues, and can have toxic effects on the developing fetus (often related to retardation of skeletal development); evidence of embryotoxicity has been noted in animals treated early in pregnancy

The anti-anabolic action of the tetracyclines may cause an increase in BUN; while this is not a problem in those with normal renal function, in patients with significantly impaired function, higher serum levels of tetracycline may lead to azotemia, hyperphosphatemia, and acidosis; if renal impairment exists, even usual oral or parenteral doses may lead to excessive systemic accumulation of the drug and possible liver toxicity; under such conditions, lower than usual total doses are indicated and, if therapy is prolonged, serum level determinations of the drug may be advisable

Photosensitivity manifested by exaggerated sunburn reaction has been observed in some individuals taking tetracyclines; phototoxic reactions can occur in individuals taking demeclocycline, and are characterized by severe burns or exposed surfaces resulting from direct exposure of patients to sunlight during therapy with moderate or large doses of demeclocycline; patients that may be exposed to direct sunlight or ultraviolet light should be advised that this reaction can occur and treatment should be discontinued at first evidence of erythema of skin

Administration of demeclocycline hydrochloride has resulted in appearance of the diabetes insipidus syndrome (polyuria, polydipsia, and weakness) in some patients on long-term therapy; the syndrome has been shown to be nephrogenic, dose-dependent, and reversible on discontinuance of therapy; patients, who are experiencing central nervous system symptoms associated with this therapy, should be cautioned about driving vehicles or using hazardous machinery while on demeclocycline therapy

Pseudotumor cerebri (benign intracranial hypertension) in adults has been associated with use of this medication; the usual clinical manifestations are headache and blurred vision; bulging fontanels have been associated with use of tetracyclines in infants; while both of these conditions and related symptoms usually resolve soon after discontinuation of tetracycline, the possibility for permanent sequelae exists

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

Tetracyclines are excreted in breastmilk

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

Adults

1.2 g/day PO for SIADH.

Geriatric

1.2 g/day PO for SIADH.

Adolescents

13 mg/kg/day (Max: 600 mg/day) PO.

Children

8 to 12 years: 13 mg/kg/day (Max: 600 mg/day) PO.
1 to 7 years: Safety and efficacy have not been established.

Infants

Safety and efficacy have not been established.

Neonates

Safety and efficacy have not been established.

Demeclocycline Hydrochloride

tablet

  • 150mg
  • 300mg

About the Author

You may also like these

0