877-944-6131 Email Us

Clinician’s Corner: Tetracycline family antibiotic prescriptions

Chlortetracycline was the first member of the tetracycline family, discovered in 1948. Aureomycin ophthalmic ointment was FDA approved in 1950. Tetracycline was first approved by the FDA in 1953, the patent given to Lederle Labs for the brand name of Achromycin-V. Doxycycline was approved by the FDA in 1967 with the brand name of Vibramycin. Minocycline (Minocin) was approved by the FDA in 1971 was the last tetracycline to be approved.

TETRACYCLINES

Mechanism: they slow the bacteria’s growth by affecting their protein synthesis.

Indications for use:

Drug of choice: acne, Rocky Mountain Spotted Fever, Lyme disease

Doxycyline does not affect kidney function, almost entirely excreted through the feces.

TETRACYCLINES 

Warnings/Precautions:

  • do not give with antacids, calcium, iron. will not get absorbed
  • increased sunburn
  • dental staining :not to be used in prepubertal children—however Doxycycline is OK
  • do not use in pregnant women or if breast feeding.

Drug Interactions:  magnesium, calcium, iron block absorption out of the gut

  • Decreases effectiveness of bactericidal antibiotic
  • May decrease effectiveness of oral contraceptives
  • Warfarin: increases effect.

Patient Education:

  • Avoid dairy products if using tetracycline. Does not seem to affect doxycycline.
  • May take with food to decrease GI upset
  • Wear sunscreen

Most common Drugs & dosage of this class

Tetracycline

Available as capsules 250mg &500mg

Dosage 250-500mg QID

Doxycycline hyclate  (Vibramycin®)  Doxycycline monohydrate, Monodox®)

Available as capsule=50mg &100mg   & 100mg tablets

Dosage: 200mg first day, then 100mg daily for 10days.  May use 100mg BID for 10days.

Minimal food drug interaction with doxycycline. Absorption is delayed.

Common uses:

Doxy: acne, Lyme disease, Upper Respiratory Infection, Community Acquired Pneumonia, Chlamydia, Community Acquired Methicillin Resistant Staph Aureus (CA-MRSA) Rocky Mountain Spotted Fever (RMSF)

Smile and take your DOXYCYCLINE: Doctors often avoid prescribing doxycycline to young children because of a warning that tooth staining may occur when used in children less than 8 years old. In a recent study, experts at the CDC and Indian Health Service (IHS) found that short courses of the antibiotic doxycycline can be used in children without causing tooth staining or weakening of tooth enamel.

https://www.cdc.gov/rmsf/doxycycline/index.html#:~:text=Despite%20the%20current%20label%20warning,severe%20illness%20and%20save%20lives.

Doxycycline monohydrate (Monodox)

Available as tablets and capsules.  Were believed to cause less GI upset. Not really proven.

Minocycline (Minocin®)

Available as capsules 50mg, 75mg & 100mg

Dosage: 200mg stat; then 100mg BID q12h

Minocycline can cause dizziness.

Minocycline can cause pigmentation of skin & mucus membranes.

Your Thompson Pharmacist wants you to get the MOST of your tetracycline family antibiotic prescriptions.  Always use sunscreen and avoid taking tetracyclines with calcium, iron, and other minerals.  Most of all, finish the entire prescription to completely clear up the infection. Feel free to ask your Thompson Pharmacist about your antibiotic therapy, Go Ahead and ASK, at Thompson Pharmacy it’s ALL for YOU!