Indicatios:

Doxycycline has been found clinically effective in the treatment of a variety of infections caused by susceptible strains of Gram-positive and Gram-negative bacteria and certain other micro-organisms.

Respiratory tract infections

Urinary tract infections

Sexually transmitted diseases

Skin infections

Since doxycycline is a member of the tetracycline series of antibiotics, it may be expected to be useful in the treatment of infections which respond to other tetracyclines, such as:

Ophthalmic infections

Rickettsial infections

Other infections

Doxycycline is an alternative drug in the treatment of leptospirosis, gas gangrene and tetanus.

Doxycycline Capsules are indicated for prophylaxis in the following conditions: Scrub typhus, travellers diarrhoea (enterotoxigenic Escherichia coli), leptospirosis and malaria. Prophylaxis of malaria should be used in accordance to current guidelines, as resistance is an ever changing problem.

Dosage and administration：

Posology

Adults and children aged 12 years to less than 18 years

The usual dose of Doxycycline Capsules for the treatment of acute infections in adults and children aged 12 years to less than 18 years is 200mg on the first day (as a single dose or divided doses), followed by a maintenance dose of 100mg/day. In the management of more severe infections, 200mg daily should be given throughout treatment.

Children aged 8 years to less than 12 years.

The use of doxycycline for the treatment of acute infections in children aged 8 years to less than 12 years should be carefully justified in situations where other drugs are not available, are not likely to be effective or are contraindicated.

Method of administration

Tablets should be swallowed whole with adequate fluids (at least 100ml of water) and should be taken in an upright sitting or standing position

Contraindications:

• Hypersensitivity to the active substance, any of the tetracyclines or to any of the excipients.

• Pregnancy

• Nursing mothers

Precautions:

Paediatric population

Use in patients with impaired hepatic function

Use in patients with renal impairment

Serious skin reactions

Photosensitivity

Benign intracranial hypertension

Microbiological overgrowth

Drug interactions:

The absorption of doxycycline may be impaired by concurrently administered antacids containing aluminium, calcium, magnesium or other drugs containing these cations;  oral zinc, iron salts or bismuth preparations.  Dosages should be maximally separated.

Since bacteriostatic drugs may interfere with the bactericidal action of penicillin, it is advisable to avoid giving doxycycline in conjunction with penicillin.

There have been reports of prolonged prothrombin time in patients taking warfarin and doxycycline.  Tetracyclines depress plasma prothrombin activity and reduced doses of concomitant anticoagulants may be necessary.

The serum half-life of doxycycline may be shortened when patients are concurrently receiving barbiturates, carbamazepine or phenytoin.  An increase in the daily dosage of Doxycycline should be considered.

Alcohol may decrease the half-life of doxycycline.

A few cases of pregnancy or breakthrough bleeding have been attributed to the concurrent use of tetracycline antibiotics with oral contraceptives.

Doxycycline may increase the plasma concentration of ciclosporin.  Co-administration should only be undertaken with appropriate monitoring.

The concurrent use of tetracyclines and methoxyflurane has been reported to result in fatal renal toxicity.

Concomitant use of isotretinoin or other systemic retinoids and doxycycline should be avoided.  Each of these agents used alone has been associated with benign intracranial hypertension (pseudotumor cerebri).  

Storage:

Store below 25°C in a dry place.