Product Name: Doxycycline
Common Brand Names: Periostat; Vibramycin; Doryx
Pharmaceutical Category: Antibiotics / Anti-Infectives
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There is an additional general information about this medication active ingredient doxycycline:
Doxycycline is an semisynthetic tetracycline group's antibiotic of broad-spectrum. This medication has bacteriostatic action due to suppression of protein synthesis of pathogens. It active against aerobic gram-positive bacteria: Staphylococcus spp. (including strains producing penicillinase), Streptococcus spp. (including Streptococcus pneumoniae), Bacillus anthracis, Listeria monocytogenes; anaerobic bacteria: Clostridium spp.
Doxycycline is also active against aerobic gram-negative bacteria: Neisseria gonorrhoeae, Escherichia coli, Shigella spp., Salmonella spp., Enterobacter spp., Klebsiella spp., Bordetella pertussis, as well as against Rickettsia spp., Treponema spp., Mycoplasma spp. and Chlamydia spp.
Pseudomonas aeruginosa, Proteus spp., Serratia spp., most strains of Bacteroides fragilis are resistant to doxycycline.
After oral administration Doxycycline is quickly and almost completely absorbed from the gastrointestinal tract. Ingestion has very little effect on the absorption of doxycycline. This medication is widely distributed in tissues and body fluids. Plasma protein binding is 80-95%. T1/2 is 12-22 h. Doxycycline excreted in the urine as unchanged (40%) but the main part of the dose excreted unchanged in the feces through bile secretion.
Why is Doxycycline prescribed?
Infectious-inflammatory diseases caused by microorganisms sensitive to doxycycline including infections of the respiratory and ENT organs; gastrointestinal tract infections; purulent infections of skin and soft tissues (including acne); infection of the genitourinary system (including gonorrhea, primary and secondary syphilis); typhus, brucellosis, rickettsiosis, osteomyelitis, trachoma, chlamydia.
Dosage and administration
Doxycycline is indicated for adults orally or IV (infusions) in 200 mg / day dosess on the first day of treatment, in the coming days at 100-200 mg / day. Multiplicity of admission (or IV infusion) is 1-2 times / day. For children older than 8 years of age and weighing over 50 kg the daily Doxycycline dose for oral administration or IV (infusion) in the first day of treatment is 4 mg / kg. In next days ir is 2-4 mg / kg depending on the severity of the clinical course of disease. Multiplicity of admission (or intravenous infusion) is 1-2 times / day. The recommended minimum time for IV infusion 100 mg of doxycycline (a concentration of infusion solution is 0.5 mg / ml) is 1 hour.
Maximum doses: for adults for oral administration is 300 mg / day or 600 mg / day (depending on the etiology of the agent); for iv injection it is 300 mg / day.
Doxycycline side effects, adverse reactions
Digestive system: nausea, vomiting, anorexia, abdominal pain, diarrhea, constipation, dysphagia, glossitis, esophagitis, transient increase in the blood of hepatic transaminases, alkaline phosphatase, bilirubin.
Hematopoietic system: neutropenia, thrombocytopenia, hemolytic anemia.
Allergic reactions: skin rash, itching, eosinophilia, rarely - angioedema, photosensitivity.
Other: increased residual nitrogen, candidiasis, intestinal dysbiosis, discoloration of teeth in children.
Pregnancy, children age up to 8 years (possibility of forming insoluble complexes with calcium in the skeleton, enamel and dentin of the teeth), hypersensitivity to tetracyclines, porphyria, severe liver insufficiency, leukopenia, lactation period, myasthenia (for IV administration).
Using during pregnancy and breastfeeding
Doxycycline is contraindicated during pregnancy and lactation. Doxycycline crosses the placental barrier. This medication may cause long-term discoloration of the teeth, enamel hypoplasia, inhibition of growth of bones of the fetus and also the development of fatty liver.
If necessary using during lactation patients should stop breastfeeding.
With careful use of Doxycycline with impaired liver function. If a patient has renal impairment the dose adjustment is not required.
To prevent local irritating action (esophagitis, gastritis, gastrointestinal ultseratsiya) Doxycycline should be taken during the day with plenty of fluids, food or milk. Due to possible development of photosensitivity it is necessary the restriction of insolation during treatment and for 4-5 days thereafter.
Doxycycline is not used in children younger than 8 years because tetracyclines (including doxycycline) are causing long-term discoloration of the teeth, enamel hypoplasia and retardation of longitudinal growth of bones in these patients.
Doxycycline solution for IV administration should be used no later than 72 hours after its preparation.
Doxycycline drug interactions
Medications containing metal ions (antacids, products containing iron, magnesium, calcium) form inactive chelates with doxycycline, in connection with what it is necessary to avoid their simultaneous use.
It needed to avoid combination with penicillins, cephalosporins, bactericidal action and is an antagonist of bacteriostatic antibiotics (including doxycycline).
Absorption of doxycycline is reduced by cholestyramine and colestipol (observe the interval between the reception of at least 3 h).
Due to suppression of intestinal microflora doxycycline reduces prothrombin index which requires dose adjustment of indirect anticoagulants.
Doxycycline reduces the reliability of contraception and increases the frequency of breakthrough bleeding while taking estrogen-containing oral contraceptives.
Simultaneous administration of Doxycycline with:
barbiturates, carbamazepine, phenytoin concentrations of doxycycline in plasma decreases due to the induction of liver enzymes, which may be responsible for the decrease of its antibacterial action.
retinol improves intracranial pressure.
Doxycycline in case of emergency / overdose
Treatment: discontinuation, symptomatic and supportive therapy. Hemodialysis is ineffective.