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Doxycycline

Antibiotic, Bacteriostatic, Tetracycline derivative, Protein bound drug

Brand Names

Bio-Tab®, Doryx®, Doxirobe™, Doxy Caps®, Doxychel®, Monodox®, Vibramycin®

Drug Information

Pharmacology

Semi synthetic tetracycline bacteriostatic antibiotic.

Contraindications

General
  • Contraindicated in patients with known sensitivity to this type of drug.
  • Use only when benefit outweighs the risk during last half of pregnancy this can retard fetal skeletal development and discolor deciduous teeth even though this risk is less with doxycycline than with other tetracyclines.
  • Avoid in young animals.
  • Use with caution and at reduced dose in animals with severe liver disease.
Horse
  • IV route is considered contraindicated in horses.
Dog
  • Doxirobe Oral Gel – Clients should be advised to suspend brushing treated teeth for approximately 2 weeks following treatment.

Adverse Effects

General
  • Nausea and vomiting are most common. This can be minimized if given with food.
  • If given long tern may cause overgrowth of nonsusceptible organisms.
  • Humans have reported photosensitivity, and rarely hepatotoxicity and blood dyscrasia.
Horse
  • IV use in horses have been associated with arrhythmias, collapse and death.
Cat
  • Has been implicated in esophageal stricture formation in cats. Follow pill with at least 6 mL water.

Interactions

Category Interactions
Antacid
  • Oral antacids that contain aluminum, calcium, magnesium, zinc or bismuth cations may be chelated and cause decreased absorption of doxycycline. Separate dose by 1-2 hours.
Anticoagulant
  • Patients on anticoagulant therapy may need to have their dose adjusted.
Bactericidal
  • May interfere with bactericidal antibiotics although this is controversial.
Barbiturates
  • Barbiturates may decrease half life of doxycycline.
Cathartic
  • Saline cathartics that contain aluminum, calcium, magnesium, zinc or bismuth cations may be chelated and cause decreased absorption of doxycycline. Separate dose by 1-2 hours.
GI protectant
  • GI products that contain aluminum, calcium, magnesium, zinc or bismuth cations may be chelated and cause decreased absorption of doxycycline. Separate dose by 1-2 hours.
Drug Interactions
Aminophylline
  • Theophylline may increase risk for GI side effects.
Ampicillin sodium / sulbactam sodium
  • May predispose to treatment failure
CarBAMazepine
  • Carbamazepine may decrease the effect of this drug by lowering serum concentrations
Insulin
  • May possibly reduce the insulin requirements of diabetics.
Iron dextran
  • Oral iron may decrease absorption and should also be separated by a few hours from doxycycline.
Kaolin/Pectin
  • Kaolin and pectin may decrease absorption and should also be separated by a few hours from doxycycline.
PENTobarbital
  • Doxycycline may prolong effects.
PHENobarbital
  • May decrease the effect of doxycycline.
Phenytoin sodium
  • May decrease the effect of doxycycline.
Sodium bicarbonate
  • Sodium bicarbonate may decrease absorption and should also be separated by a few hours from doxycycline.
Sucralfate
  • Sucralfate may decrease efficacy.
Theophylline
  • Theophylline may increase risk for GI side effects.

Comments

After reconstitution monohydrate oral solution is stable for 14 days at room temperature.
Hyclate injection when reconstituted to a 0.1 – 1 mg/mL concentration may be stored for 72 hours if refrigerated.
For information regarding compatibility in solution or combination with other drugs, refer to specialized reference material.
Give oral form with food if GI signs occur.
Doxirobe Oral Gel – Store unreconstituted product in refrigerator. Once reconstituted, unused product should be stored at room temperature and used within 3 days.

Available Forms

Human
  • Tablet and capsule- 50 and 100 mg; Vibramycin®, Doxychel® Hyclate, DoxyCaps®, generic. Powder for oral suspension- 5 mg/mL, 25 mg/5 mL in 60 mL bottles. Syrup- 10 mg/mL in 50 mL bottles; Vibramycin®. Powder for injection- 100 and 200 mg vials; Vibramycin® IV, Doxychel®, generic.
Veterinary – General
  • Doxycycline gel 8.5% – applied topically for periodontal use in dogs in package containing syringe A (polymer delivery system) and syringe B (doxycycline), which when mixed result in approximately 0.5 mL of doxycycline solution. Available as a 3-unit carton (containing 1 additional blunt cannula),; Doxirobe™.