lupus-erythematosus-like syndrome. Minocycline
sometimes causes irreversible pigmentation.
Tetracyclines have a role in the management of meticillin-
resistantStaphylococcus aureus(MRSA) infections.Tetracyclines f
lCONTRA-INDICATIONSChildren under 12 years (deposition
in growing bone and teeth, by binding to calcium, causes
staining and occasionally dental hypoplasia)
lCAUTIONSMyasthenia gravis (muscle weakness may be
increased).systemic lupus erythematosus (may be
exacerbated)
lSIDE-EFFECTS
▶Common or very commonAngioedema.diarrhoea.
headache.Henoch-Schönlein purpura.hypersensitivity.
nausea.pericarditis.photosensitivity reaction.skin
reactions.systemic lupus erythematosus exacerbated.
vomiting
▶Rare or very rareAppetite decreased.discolouration of
thyroid gland.dysphagia.eosinophilia.fontanelle
bulging (in infants).gastrointestinal disorders.
haemolytic anaemia.hepatic disorders.idiopathic
intracranial hypertension.increased risk of infection.
neutropenia.oral disorders.pancreatitis.
pseudomembranous enterocolitis.severe cutaneous
adverse reactions (SCARs).thrombocytopenia
▶Frequency not knownDizziness
SIDE-EFFECTS, FURTHER INFORMATIONHeadache and
visual disturbances may indicate benign intracranial
hypertension (discontinue treatment if raised intracranial
pressure develops).
lPREGNANCYShouldnotbe given to pregnant women;
effects on skeletal development have been documented in
thefirst trimester inanimalstudies. Administration during
the second or third trimester may cause discoloration of
the child’s teeth, and maternal hepatotoxicity has been
reported with large parenteral doses.
lBREAST FEEDINGShouldnotbe given to women who are
breast-feeding (although absorption and therefore
discoloration of teeth in the infant is probably usually
prevented by chelation with calcium in milk).
lHEPATIC IMPAIRMENTShould be avoided or used with
caution in patients with hepatic impairment.eiiiiFaboveDemeclocycline hydrochloride
lINDICATIONS AND DOSE
Susceptible infections (e.g. chlamydia, rickettsia and
mycoplasma)
▶BY MOUTH
▶Child 12–17 years: 150 mg 4 times a day, alternatively
300 mg twice dailylCAUTIONSPhotosensitivity more common than with other
tetracyclines
lINTERACTIONS→Appendix 1 : tetracyclines
lSIDE-EFFECTS
▶Rare or very rareAgranulocytosis.aplastic anaemia.
hearing impairment.nephritis.severe cutaneous adverse
reactions (SCARs)
▶Frequency not knownIntracranial pressure increased.
muscle weakness.nephrogenic diabetes insipidus.vision
disorders
lHEPATIC IMPAIRMENT
Dose adjustmentsMax. 1 g daily in divided doses.
lRENAL IMPAIRMENTMay exacerbate renal failure and
shouldnotbe given to patients with renal impairment.lPATIENT AND CARER ADVICEPatients should be advised to
avoid exposure to sunlight or sun lamps.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: tablet, oral suspension, oral solution
Tablet
▶Demeclocycline hydrochloride (Non-proprietary)
Demeclocycline hydrochloride 150 mgDemeclocycline 150 mg
tablets| 100 tabletPs
Capsule
CAUTIONARY AND ADVISORY LABELS7, 9, 11, 23
▶Demeclocycline hydrochloride (Non-proprietary)
Demeclocycline hydrochloride 150 mgDemeclocycline 150 mg
capsules| 28 capsuleP£ 176. 16 DT = £ 176. 16
eiiiiFaboveDoxycycline
lINDICATIONS AND DOSE
Susceptible infections (e.g. chlamydia, rickettsia and
mycoplasma)
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 12–17 years:Initially 200 mg daily for 1 dose, then
maintenance 100 mg once daily
Acute sinusitis
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 12–17 years:Initially 200 mg daily for 1 dose, then
maintenance 100 mg once daily for 4 days
Severe infections (including refractory urinary-tract
infections)
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 12–17 years: 200 mg daily
Acne
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 12–17 years: 100 mg once daily
Early syphilis
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 12–17 years: 100 mg twice daily for 14 days
Late latent syphilis
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 12–17 years: 100 mg twice daily for 28 days
Uncomplicated genital chlamydia|Non-gonococcal
urethritis
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 12–17 years: 100 mg twice daily for 7 days
Pelvic inflammatory disease
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 12–17 years: 100 mg twice daily for 14 days
Lyme disease (under expert supervision)
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 12–17 years: 100 mg twice daily for 10 – 14 days (for
28 days in Lyme arthritis)
Anthrax (treatment or post-exposure prophylaxis)
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 1 month–11 years: 2. 5 mg/kg twice daily (max. per
dose 100 mg twice daily), only to be used in children
under 12 years if alternative antibacterial cannot be
given
▶Child 12–17 years: 100 mg twice daily
Prophylaxis of malaria
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 12–17 years: 100 mg once daily, to be started
1 – 2 days before entering endemic area and continued
for 4 weeks after leaving, can be used for up to 2 years
Adjunct to quinine in treatment ofPlasmodium
falciparummalaria
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 12–17 years: 200 mg daily for 7 days352 Bacterial infection BNFC 2018 – 2019
Infection5