Doxycycline - instructions for use, dose, side effects, contraindications

Description:Hard gelatin capsules of cylindrical shape with hemispherical ends, yellow. The contents of the capsules are a yellow powder with white impregnations.

Pharmacotherapeutic group:Antibiotic, tetracycline

ATX: & nbsp

J.01.A.A.02 Doxycycline

Pharmacodynamics:

Semisynthetic tetracycline, a bacteriostatic broad-spectrum antibiotic obtained from metacycline.Penetrating into the cell, acts on intracellularly located pathogens. Ilinnonpyei synthesis of prophylaxis and microbial cells, disrupting the transport of aminoacyl-PPK with 30S subuninations of the ribosomal membrane. Ps influences the synthesis of the bacterial cell wall.

To it are highly sensitive: gram-positive microorganisms Staphylococcus spp. (including Slaphvlococcus aureus, Staphylococcus albus). Streptococcus spp. (including Streptococcus pneumoniae). Clostridium spp. Listeria spp .; and Gram-negative microorganisms: Neisseria

H. coli. Shigella spp .; Enterobacter; Salmonella spp; Pasterella spp. Bacteroides spp .; Psyttacosis spp., Treponema spp. (including strains resistant to other antibiotics, for example, to modern nenicillins and cephalosporins). The most sensitive are Haemophilus influenzae (91-96%) and intracellular pathogens.

Pharmacokinetics:

Absorption is fast and high (about 100%). Has a high degree of solubility in lipids and low affinity for calcium binding.

After oral administration of 200 mg, the time to reach the maximum concentration is 2.5 hours. the maximum concentration is 2.5 μg / ml. after 24 hours after administration - 1.25 μg / ml. The connection with plasma proteins is 80-90%.

It penetrates well into organs and tissues: after 30-45 minutes after ingestion, it is found in therapeutic concentrations in the liver, kidneys, lungs, spleen, bones, teeth, prostate gland, eye tissues, pleural and ascitic fluids: bile, synovial exudate,exudate of the maxillary and frontal sinuses. Poor penetration into the cerebrospinal fluid (10-20% of the plasma level). Penetrates through the placental barrier, is determined in human milk. Metabolised in the liver 30-60%. The half-life is 16-24 hours. With repeated administration, the drug can accumulate. Accumulates in bone tissue. In bones and teeth forms insoluble complexes with calcium.

It is excreted with bile, where it is found in high concentration. It is subjected to intestinal hepatic recirculation, it is excreted with caloric masses (20-60%); 40% of the dose is given by the kidneys for 72 hours (of which 20-50% is unchanged), in severe chronic renal failure, only 1-5%. In patients with impaired renal function or azotemia, an important route of elimination is the gastrointestinal tract.

Indications:

Infectious-inflammatory diseases caused by sensitive microorganisms: respiratory tract infections (pharyngitis, acute and chronic bronchitis, tracheitis, bronchopneumonia, lobar pneumonia, lung abscess, pleural empyema);

infection of the ENT organs (otitis media, tonsillitis, sinusitis, etc.);

infections of the genitourinary system (cystitis, pyelonephritis, prostatitis, urethritis, urethrocystitis, urogenital mycoplasmosis, endometritis, endocervicitis, acute orchypididitis, gonorrhea);

infection of biliary tract and gastrointestinal tract (cholecystitis, cholangitis, gastroenterocolitis, bacterial dysentery, diarrhea of "travelers");

infections of the skin and soft tissues (phlegmon, abscess, furunculosis, panaritium, infected burns, wounds, etc.);

infectious diseases of the eye, syphilis, yaws, yersiniosis, legionellosis, rickettsiosis, chlamydia different localization (incl prostatitis, proctitis), Q fever, Rocky Mountain spotted fever, typhus (including typhus, tick-borne relapsing) borreliosis , bacillary and amoebic dysentery, tularemia, cholera, lyme disease (I stage), actinomycosis, malaria, leptospirosis, trachoma, psittacosis, ornithosis, granulocytic ehrlichiosis; whooping cough, brucellosis, osteomyelitis; sepsis, subacute septic endocarditis, peritonitis.

Prevention of postoperative purulent complications; malaria caused by Plasmodium falciparum, during short travel (less than 4 months) in the area where common strains resistant to chloroquine and / or pyrimethamine-sulfadoxine.

Contraindications:Hypersensitivity, porphyria, severe hepatic insufficiency, leukopenia, pregnancy II-III trimester, lactation period,Children's age (up to 8 years - the possibility of formation of insoluble complexes with calcium and deposition in the bone skeleton, enamel and dentin teeth).

Pregnancy and lactation:The use is contraindicated.

Dosing and Administration:

Inside, in adults and children with a body weight of more than 45 kg, the average daily dose is 0.2 g on the first day (divided into 2 doses - 0.1 g twice a day), then 0.1 g / day (1-2 doses). In severe infections, especially with chronic infections of the urinary system - 200 mg / day throughout the period of therapy.

In the treatment of gonorrhea, one of the following regimens is prescribed: acute uncomplicated urethritis - a course dose of 0.5 g (1 dose - 0.3 g, the next two - 0.1 g at intervals of 6 hours) or 0.1 g / day until complete cure (in women) or 0.1 g 2 times a day for 7 days (in males); with complicated forms of gonorrhea, the course dose is 0.8-0.9 g, which is divided into 6-7 receptions (0.3 g - 1 reception, then at an interval of 6 hours for 5-6 follow-up).

In the treatment of syphilis - 0.3 g / day for at least 10 days (inside or in / in).

In uncomplicated infections of the urethra, cervix and rectum caused by Cl.trachomatis, appoint 0.1 g 2 times a day for at least 7 days.

Infections of male genital organs - 0.1 g 2 times a day for 4 weeks.

Treatment of malaria resistant to chloroquine - 0.2 g / day for 7 days (in combination with shizontocidal drugs - quinine); malaria prophylaxis - 0.1 g once a day 1-2 days before the trip, then daily during the trip and within 4 weeks after the return; children, over 8 years old - 0.002 g / kg once a day.

Traveler's diarrhea (prophylaxis) - 0.2 g on the first day of the trip (1 dose or 0.1 g 2 times a day), then 0.1 g once a day during the whole stay in the region (no more than 3 weeks).

Treatment of leptospirosis - O L g orally 2 times a day for 7 days; prophylaxis of leptospirosis - 0.2 g once a week during a stay in the dysfunctional region and 0.2 g at the end of the trip.

Prevention of infections after medical abortion - 0.1 g for 1 hour before abortion and 0.2 g - 30 minutes after.

Maximum daily doses for adults - up to 300 mg per day or up to 600 mg per day for 5 days with severe gonococcal infections.

In children 9-12 years old with a body weight of up to 45 kg, the average daily dose is 0.004 g / kg on the first day, then 0.002 g / kg per day (in 1-2 doses). In severe infections, every 12 hours, 0.004 g / kg is prescribed.

In the presence of severe hepatic insufficiency, a decrease in the daily dose of doxycycline is required, since this gradually accumulates in the body (the risk of hepatotoxic action).

Side effects:

From the nervous system:

increased intracranial pressure (anorexia, vomiting, headache, edema of the optic nerve), toxic effects on the central nervous system (dizziness or ataxia).

From the digestive system:

nausea, diarrhea, constipation, glossitis, dysphagia, esophagitis (including erosive), gastritis, gastric ulceration and duodenal ulcers, inflammation in the anogenital area crotch enterocolitis (due to proliferation of resistant strains of staphylococci).

Allergic reactions:

Maculopapular rash, skin itching, skin hyperemia,

angioedema, anaphylactoid reactions, drug lupus erythematosus.

From the side of the blood:

hemolytic anemia, thrombocytopenia, neutropenia, eosinophilia,

Other:

photosensitivity, superinfection; persistent discoloration of tooth enamel.

Fungal infections (vaginitis, glossitis, stomatitis, proctitis), dysbiosis.

Overdose:

Interaction:

Absorbance decrease antacids that contain aluminum, magnesium and calcium, food containing calcium (milk, cheese), iron preparations, sodium bicarbonate, magnesium-containing laxatives, colestramine and colestipol, therefore their use should be separated by an interval of 3 hours.

In connection with the suppression of the intestinal microflora reduces the prothrombin index, which requires correction of the dose of indirect anticoagulants.

When combined with bactericidal antibiotics that disrupt the synthesis of the cell wall (penicillins, cephalosporins), a decrease in the effectiveness of the latter.

Reduces the reliability of contraception and increases the frequency of bleeding "breakthrough" against the background of taking estrogen-containing oral contraceptives.

Ethanol, barbiturates, rifampicin, carbamazepine, phenytoin and other stimulators of microsomal oxidation accelerate the metabolism of doxycycline.

With the simultaneous use of methoxyflurane, the risk of developing fatal nephrotoxicity increases.

Simultaneous use of retinol helps increase intracranial pressure.

Special instructions:

To prevent locally irritating effect (esophagitis, gastritis, ulceration of the gastrointestinal tract) it is recommended to take in the daytime hours with a lot of liquid, food.

In connection with the possible development of photosensitization, it is necessary to limit the insolation during treatment and for 4-5 days after it.

With prolonged use, periodic monitoring of the function of the kidneys (KK), liver, hematopoiesis is necessary.

May mask the manifestations of syphilis, in connection with which, with the possibility of mixed infection, a monthly serological analysis is necessary for 4 months.

The appointment during the development of teeth can cause irreversible changes in their color.

Perhaps a false increase in the level of catecholamines in urine when determined by the fluorescent method. In the study of the thyroid biopsy,

long-term doxycycline, it is possible to dark brown staining of tissue in micropreparations without disturbing its function.

In the experiment it was established that doxycycline can cause toxic effects on the development of the fetus - the delay in the development of the skeleton.

Form release / dosage:

Capsules of 100 mg.

Packaging:

10 capsules per contour cell package. For 1, 2, 3, 4, 5 contour packs, together with the instructions for use are placed in a pack of cardboard.

For hospitals: 200 contour mesh packages together with 20 instructions for use in a cardboard box.

Storage conditions:List B. In a dry, the dark place at a temperature of no higher than 25 ° C, out of reach of children.

Shelf life:3 years. Do not use after the expiration date.

Terms of leave from pharmacies:On prescription

Registration number:П N010698

Date of registration:23.08.2010

The owner of the registration certificate:BORISOVSKIY FACTORY OF MEDPREPARATES, OJSC BORISOVSKIY FACTORY OF MEDPREPARATES, OJSC Republic of Belarus

Manufacturer: & nbsp

BORISOVSKIY FACTORY OF MEDPREPARATES, OJSC Republic of Belarus

Information update date: & nbsp10.02.2016

Illustrated instructions

Instructions

Doxycycline (Doxycycline)