Periodontitis (as an adjunct to gingival scaling and root
planing)
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 12–17 years: 20 mg twice daily for 3 monthslUNLICENSED USEDoxycycline doses in BNF Publications
may differ from those in product literature. Not licensed
for severe recurrent aphthous ulceration. Not licensed for
malaria prophylaxis during pregnancy. Not licensed for
treatment or post-exposure prophylaxis of anthrax.g
Duration of treatment for acute sinusitis adheres to
national guidelines.hSee Sinusitis (acute) p. 697 for
further information.
Not licensed for use in children under 12 years.
lCAUTIONSAlcohol dependence
lINTERACTIONS→Appendix 1 : tetracyclines
lSIDE-EFFECTS
▶Common or very commonDyspnoea.hypotension.
peripheral oedema.serum sickness.tachycardia
▶UncommonGastritis.gastrointestinal discomfort
▶Rare or very rareAntibiotic associated colitis.arthralgia.
flushing.hepatic function abnormal.myalgia.
photoonycholysis.severe cutaneous adverse reactions
(SCARs).tinnitus.vision disorders
lPREGNANCYWhen travel to malarious areas is
unavoidable during pregnancy, doxycycline can be used
for malaria prophylaxis if other regimens are unsuitable,
and if the entire course of doxycycline can be completed
before 15 weeks’gestation.
lRENAL IMPAIRMENTUse with caution (avoid excessive
doses).
lMONITORING REQUIREMENTSWhen used for periodontitis,
monitor for superficial fungal infection, particularly if
predisposition to oral candidiasis.
lDIRECTIONS FOR ADMINISTRATIONCapsules and Tablets
should be swallowed whole with plenty offluid, while
sitting or standing. Capsules should be taken during meals.
lPATIENT AND CARER ADVICECounselling on
administration advised.
PhotosensitivityPatients should be advised to avoid
exposure to sunlight or sun lamps.
lPROFESSION SPECIFIC INFORMATION
Dental practitioners’formulary
Doxycycline Capsules 100 mg may be prescribed.
Dispersible tablets may be prescribed as Dispersible
Doxycycline Tablets. Tablets may be prescribed as
Doxycycline Tablets 20 mg.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral suspension, oral solution
Tablet
CAUTIONARY AND ADVISORY LABELS6, 11, 27
▶Periostat(Alliance Pharmaceuticals Ltd)
Doxycycline (as Doxycycline hyclate) 20 mgPeriostat 20 mg tablets
| 56 tabletP£ 17. 30 DT = £ 17. 30
Dispersible tablet
CAUTIONARY AND ADVISORY LABELS6, 9, 11, 13
▶Vibramycin-D(Pfizer Ltd)
Doxycycline (as Doxycycline monohydrate) 100 mgVibramycin-D
100 mg dispersible tablets sugar-free| 8 tabletP£ 4. 91 DT = £ 4. 91
Capsule
CAUTIONARY AND ADVISORY LABELS6, 9, 11, 27
▶Doxycycline (Non-proprietary)
Doxycycline (as Doxycycline hyclate) 50 mgDoxycycline 50 mg
capsules| 28 capsuleP£ 4. 00 DT = £ 1. 08
Doxycycline (as Doxycycline hyclate) 100 mgDoxycycline 100 mg
capsules| 8 capsuleP£ 3. 00 DT = £ 0. 51 | 14 capsuleP£ 5. 25
| 50 capsuleP£ 3. 19 – £ 19. 00
eiiiiF 352Lymecycline
lINDICATIONS AND DOSE
Susceptible infections (e.g. chlamydia, rickettsia and
mycoplasma)
▶BY MOUTH
▶Child 12–17 years: 408 mg twice daily, increased to
1. 224 – 1. 632 g daily, (in severe infection)
Acne
▶BY MOUTH
▶Child 12–17 years: 408 mg daily for at least 8 weekslINTERACTIONS→Appendix 1 : tetracyclines
lSIDE-EFFECTS
▶Common or very commonGastrointestinal discomfort
▶Frequency not knownVisual impairment
lRENAL IMPAIRMENTMay exacerbate renal failure and
shouldnotbe given to patients with renal impairment.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Capsule
CAUTIONARY AND ADVISORY LABELS6, 9
▶Lymecycline (Non-proprietary)
Lymecycline 408 mgLymecycline 408 mg capsules|
28 capsuleP£ 6. 95 DT = £ 4. 59 | 56 capsuleP£ 9. 18 – £ 11. 66
▶Tetralysal(Galderma (UK) Ltd)
Lymecycline 408 mgTetralysal 300 capsules| 28 capsuleP
£ 6. 95 DT = £ 4. 59 | 56 capsuleP£ 11. 53eiiiiF 352Minocycline
lINDICATIONS AND DOSE
Susceptible infections (e.g. chlamydia, rickettsia and
mycoplasma)
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 12–17 years: 100 mg twice daily
Acne
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 12–17 years: 100 mg once daily, alternatively 50 mg
twice daily
▶BY MOUTH USING MODIFIED-RELEASE MEDICINES
▶Child 12–17 years: 100 mg dailylCAUTIONSSystemic lupus erythematosus
lINTERACTIONS→Appendix 1 : tetracyclines
lSIDE-EFFECTS
▶Rare or very rareAcute kidney injury.hearing impairment
.respiratory disorders
▶Frequency not knownAlopecia.antibiotic associated
colitis.arthralgia.ataxia.breast secretion.conjunctival
discolouration.drug reaction with eosinophilia and
systemic symptoms (DRESS).dyspepsia.
hyperbilirubinaemia.hyperhidrosis.polyarteritis nodosa.
sensation abnormal.tear discolouration.vertigo
lRENAL IMPAIRMENTUse with caution (avoid excessive
doses).
lMONITORING REQUIREMENTSIf treatment continued for
longer than 6 months, monitor every 3 months for
hepatotoxicity, pigmentation and for systemic lupus
erythematosus—discontinue if these develop or if pre-
existing systemic lupus erythematosus worsens.
lDIRECTIONS FOR ADMINISTRATIONTablets or capsules
should be swallowed whole with plenty offluid while
sitting or standing.
lPATIENT AND CARER ADVICECounselling on
administration advised (posture).BNFC 2018 – 2019 Bacterial infection 353
Infection5