Tetracycline

Indications
 Oral
Susceptible infections
Adult: As hydrochloride: 250 or 500 mg every 6 hrs, increased to 4 g daily in severe infections.
Child: As hydrochloride: ≥12 yr: usual adult dose. Max: 2 g daily.
Renal impairment: Mild impairment: Avoid.
Hepatic impairment: Max: 1 g daily.
Oral
Acne
Adult: As hydrochloride: 500 mg-1 g daily in 4 divided doses for 1-2 wk or until clinical improvement occurs, then decreased slowly to maintenance dose of 125-500 mg daily until clinical improvement allows discontinuation of the drug.
Renal impairment: Mild: Avoid
Hepatic impairment: Max: 1g/day.
Intrapleural
Pleural effusions
Adult: As hydrochloride: 500 mg dissolved in 30-50 mL of 0.9% NaCl instilled into pleural spaces.
Contraindications
 Hypersensitivity; pregnancy, lactation, children; renal impairment.
Warnings / Precautions
 Hepatic impairment. Myasthenia gravis, SLE. Should be administered with plenty of water, while sitting or standing, and well before going to bed to avoid oesophageal ulceration. Avoid exposure to sunlight. Periodic evaluation of renal, hepatic and haematological system during prolonged therapy.
Adverse Reactions
 Oesophageal ulceration, nausea, vomiting, oral candidiasis, diarrhoea, epigastric burning, sore throat, black hairy tongue, pancreatitis, oncholysis, discolouration of tooth (children with developing teeth) and nails, tinnitus, visual disturbances, superinfections, photosensitivity, hypersensitivity,
Potentially Fatal: Anaphylaxis, hepatotoxicity, nephrotoxicity, blood dyscrasias.
Drug Interactions
 Absorption reduced by divalent and trivalent cations, Fe prep and antacids. Decreases effectiveness of oral contraceptives. Concurrent use may increase levels of lithium, digoxin, halofantrine and theophylline; decrease concentrations of atovaquone; increase anticoagulant effects with warfarin; increase risk of ergotism with ergot alkaloids.
Potentially Fatal: Nephrotoxic effects exacerbated by diuretics, methoxyflurane or other nephrotoxic drugs; avoid concurrent use with potentially hepatotoxic drugs. Increased incidence of benign intracranial hypertension with retinoids.
See Below for More tetracycline Drug Interactions
Lab Interactions
 Interferes with diagnostic tests eg, urinary determination of glucose, false increase in fluorometric determinations of urine catecholamines.
Food Interactions
 Absorption reduced by milk, milk products, antacids containing aluminum, magnesium iron preparations and food.
Mechanism of Actions
 Tetracycline exhibits its bacteriostatic action by reversible binding to the 30s subunits of the ribosome thus preventing protein synthesis and arresting cell growth. It has a broad spectrum of antimicrobial activity including Chlamydiaceae, Mycoplasma spp., Rickettsia spp., spirochaetes, many aerobic and anaerobic Gram-positive and Gram-negative pathogenic bacteria, and some protozoa.
Absorption: Absorbed incompletely from the GIT (oral) with oral bioavailability 60-80%; absorption affected by the presence of divalent ot trivalent metal ions, food and milk.
Distribution: Widely distributed to body tissues and fluids, CSF (low, may be increased in meningitis), saliva (small amounts), eye, lung, bone (newly formed), teeth (recently calcified and newly developed). Crosses the placenta into the foetal circulation and enters breast milk. Protein-binding: 20-65%. Half life: 6-12 hr.
Excretion: Via urine by glomerular filtration (as unchanged, 55% via oral and 60% via IV); may be increased in alkaline urine. Via bile; may undergo enterohepatic reabsorption.
Administration
 Should be taken on an empty stomach. (Take on an empty stomach 1 hr before or 2 hr after meals w/ a full glass of water, in upright position. May be taken w/ meals to reduce GI discomfort.)
ATC Classification
 D06AA04 - tetracycline ; Belongs to the class of topical tetracycline and derivatives agents used in the treatment of dermatological diseases.
A01AB13 - tetracycline ; Belongs to the class of local antiinfective and antiseptic preparations. Used in the treatment of diseases of the mouth.
J01AA07 - tetracycline ; Belongs to the class of tetracyclines. Used in the systemic treatment of infections.
S01AA09 - tetracycline ; Belongs to the class of antibiotics. Used in the treatment of eye infections.
S02AA08 - tetracycline ; Belongs to the class of antiinfectives used in the treatment of ear infections.
S03AA02 - tetracycline ; Belongs to the class of antiinfectives used in ophthalmologic and otologic preparations.
Available As
  • Tetracycline 1%
  • Tetracycline 1% w/w
  • Tetracycline 10 mg
  • Tetracycline 100 mg
  • Tetracycline 125 mg
  • Tetracycline 170 mg
  • Tetracycline 250 mg
  • Tetracycline 333 mg
  • Tetracycline 50 mg
  • Tetracycline 500 mg

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