Known brand names include Vibramycin, Doryx, Acticlate, Monodox, Adoxa, Oracea, Periostat, and Targadox.
A tetracycline antibiotic taken by mouth for many infections, including Rocky Mountain spotted fever and other tick-borne illnesses, chlamydia, some pneumonias, and anthrax exposure, and to prevent malaria. It can stain developing teeth, make skin burn easily in the sun, and irritate the esophagus, so it is taken with plenty of water and not right before lying down.
Labeled use. Uncomplicated urethral, endocervical, or rectal infection in adults.
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Drug of choice for Rocky Mountain spotted fever and other rickettsial infections at any age, and for early Lyme disease; first-line for chlamydia and an outpatient option for community-acquired pneumonia. It is also used for MRSA skin infections and acne. Avoid in pregnancy, and in young children unless the infection is severe.
A bacteriostatic tetracycline that inhibits protein synthesis by binding the 30S ribosomal subunit, with a broad gram-positive and gram-negative spectrum plus rickettsiae, chlamydiae, mycoplasma, and spirochetes. Cross-resistance with other tetracyclines is common. It is nearly completely absorbed, has a half-life of about 18 to 22 hours, is not removed by hemodialysis, and does not accumulate in renal impairment.
The label does not describe a narrow therapeutic index or direct dosing by measured blood levels of the drug.
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Doses come from the FDA label. Study tool, not for clinical decisions.
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No adjustment; it does not accumulate in renal impairment, and the half-life is unchanged. Hemodialysis does not remove it.
No specific antidote. For overdose, stop the drug and give symptomatic and supportive care; dialysis does not help.
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Tetracyclines cross the placenta, can stain the teeth of a developing baby when used in the last half of pregnancy, and harmed fetal skeletal development in animals. An expert review judged usual doses unlikely to pose a substantial risk of birth defects, but data are insufficient to rule out risk. Patients should be told of the possible hazard.
Tetracyclines pass into milk; short-term use is not necessarily contraindicated, but effects of prolonged exposure are unknown. Decide whether to stop nursing or the drug.
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In children 8 and younger, use only for severe or life-threatening infections (such as anthrax or Rocky Mountain spotted fever) because of tooth staining. Under 45 kg with severe infection: 2.2 mg/kg every 12 hours; 45 kg or more: adult dose.