Classes
DEA Class; Rx
Common Brand Names; Sumycin, Actisite, Achromycin V
- Tetracyclines
Description
Semisynthetic tetracycline agent produced from chlortetracycline; wide spectrum of activity vs. gram-negative and gram-positive organisms; inactive against viruses and fungi.
Indications
Indicated for the treatment of necrotizing ulcerative gingivitis (Fusospirochetosis or Vincent’s infection) and listeriosis (Listeria monocytogenes) when penicillin is contraindicated.
For the treatment of necrotizing ulcerative gingivitis (Fusospirochetosis or Vincent’s infection) and listeriosis (Listeria monocytogenes) when penicillin is contraindicated.
For the treatment of yaws when penicillin is contraindicated.
Brucellosis
500 mg PO q6hr for 3 weeks accompanied by streptomycin, 1 g IM BID for the first week, THEN qDay the second week
Indicated for Syphilis, Gonorrhea, Uncomplicated urethral, endocervical or rectal infections
Contraindications
Documented hypersensitivity
Severe hepatic dysfunction
Pregnancy 2nd and 3rd trimesters
Adverse Effects
- Gastrointestinal: anorexia, nausea, epigastric distress, vomiting, diarrhea, glossitis, esophagitis, esophageal ulceration, black hairy tongue, dysphagia, enterocolitis, and inflammatory lesions (with Candida overgrowth) in the anogenital region
- Teeth: Permanent discoloration of teeth, enamel hypoplasia
- Skin: Maculopapular and erythematous rashes, exfoliative dermatitis, onycholysis and discoloration of the nails, photosensitivity
- Renal toxicity: Increased BUN (dose-related)
- Liver: Hepatotoxicity, liver failure
- Hypersensitivity reactions: Urticaria, angioneurotic edema, anaphylaxis, anaphylactoid purpura, pericarditis, exacerbation of systemic lupus erythematosus, and serum sickness-like reactions, as fever, rash, and arthralgia
- Blood: Hemolytic anemia, thrombocytopenia, thrombocytopenic purpura, neutropenia and eosinophilia have been reported
Warnings
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 half of pregnancy through age 8 years) can cause permanent discoloration of teeth
Antianabolic action of the tetracyclines may cause an increase in BUN; in patients with significantly impaired renal function, higher serum levels of tetracycline may lead to azotemia, hyperphosphatemia and acidosis
Fanconi-like syndrome may occur with outdated tetracyclines
Intracranial hypertension (IH, pseudotumor cerebri) has been associated with the use of tetracyclines; although IH typically resolve after discontinuing treatment, the possibility for permanent visual loss exists; if visual disturbance occurs during treatment, prompt ophthalmologic evaluation is warranted
All tetracyclines form a stable calcium complex in any bone forming tissue; decrease in fibula growth rate has been observed in premature infants given oral tetracycline in doses of 25 mg/kg q6hr; reaction was shown to be reversible when discontinuing drug
IV/IM no longer commercially available
Pregnancy and Lactation
Pregnancy
Avoid 1st trimester; contraindicated 2nd and 3rd trimesters
Pregnant women with renal disease may be more prone to develop tetracycline-associated liver failure
The effect of tetracyclines on labor and delivery is unknown
Lactation
Short-term use of tetracycline is acceptable in nursing mothers
A number of reviews have stated that tetracycline is contraindicated during breastfeeding because of possible staining of infants’ dental enamel or bone deposition of tetracyclines; however, a close examination of available literature indicates that there is not likely to be harm in short-term use of tetracycline during lactation because milk levels are low and absorption by the infant is inhibited by the calcium in breast milk
Maximum Dosage
2 g/day PO.
2 g/day PO.
50 mg/kg/day PO (Max: 2 g/day).
9 to 12 years: 50 mg/kg/day (Max: 2 g/day) PO.
1 to 8 years: Safety and efficacy have not been established; however, doses up to 40 mg/kg/day (Max: 2 g/day) PO have been used off-label.
Safety and efficacy have not been established; however, doses up to 40 mg/kg/day PO have been used off-label.
Safety and efficacy have not been established.
How supplied
Tetracycline hydrochloride
capsule/tablet
- 250mg
- 500mg
