Doxycycline - instructions for use, analogs, reviews and release forms (capsules 100 mg, injections in ampoules for injection (lyophilizate)) drugs for the treatment of syphilis, ureaplasma and other infections in adults, children and pregnancy

In this article, you can read the instructions for using the drug Doxycycline. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Doxycycline in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Doxycycline in the presence of existing structural analogues. Use for the treatment of syphilis, ureaplasma, borreliosis and other infectious diseases in adults, children, as well as during pregnancy and lactation.

Doxycycline - semisynthetic tetracycline, bacteriostatic broad-spectrum antibiotic. Penetrating into the cell, acts on intracellularly located pathogens. Suppresses the synthesis of proteins in a microbial cell, disrupts the binding of the transport aminoacyl RNA to the 30S subunit of the ribosomal membrane.

Hypersensitive: Gram positive and Gram negative microorganisms (including strains resistant to other antibiotics, such as penicillins and cephalosporins date).

The most sensitive are Haemophilus influenzae (91-96%) and intracellular pathogens. There is cross-resistance to other tetracyclines, as well as to penicillins.

Pharmacokinetics

Absorption is fast and high (about 100%). Has a high degree of lipid solubility and low affinity for calcium binding. It penetrates well into organs and tissues; 30-45 minutes after oral administration at therapeutic concentrations detected in the liver, kidney, lung, spleen, bones, teeth, prostate, eye tissues, pleural and ascitic fluids, bile, synovial exudate, the exudate maxillary and frontal sinuses, in the liquid gingival sulci.Poor penetration into the cerebrospinal fluid (10-20% of the plasma level). Penetrates through the placental barrier, is determined in human milk. Metabolised in the liver 30-60%. With repeated administration, the drug can accumulate. It accumulates in the reticuloendothelial system and bone tissue. In bones and teeth forms insoluble complexes with calcium. It is excreted with bile, where it is found in high concentration. It is subjected to intestinal-hepatic recirculation, it is excreted with caloric masses (20-60%); 40% of the dose taken is excreted by the kidneys for 72 hours (of which 20-50% is unchanged).

Indications

Infectious-inflammatory diseases caused by sensitive microorganisms:

• respiratory tract infections (pharyngitis, acute and chronic bronchitis, tracheitis, bronchopneumonia, lobar pneumonia, lung abscess, pleural empyema);
• infection of the ENT organs (otitis media, tonsillitis, sinusitis, etc.);
• infections of the genitourinary system (cystitis, pyelonephritis, prostatitis, urethritis, urethrocystitis, urogenital mycoplasmosis, endometritis, endocervicitis, acute orchypididitis, gonorrhea);
• infection of biliary tract and gastrointestinal tract (cholecystitis, cholangitis, gastroenterocolitis, bacterial dysentery, travelers' diarrhea);
• infections of the skin and soft tissues (phlegmon, abscess, furunculosis, panaritium, infected burns, wounds, etc.);
• infectious diseases of the eyes;
• syphilis;
• yaws;
• yersiniosis;
• legionellosis;
• rickettsiosis;
• Chlamydia of different localization (including prostatitis and proctitis);
• fever Ku;
• spotted fever in the Rocky Mountains;
• typhus (including rash, tick-borne recurrent);
• Lyme disease (borreliosis) I st .;
• bacillary and amoebic dysentery;
• Tularemia;
• cholera;
• actinomycosis;
• malaria;
• in the combination therapy - leptospirosis, trachoma, psittacosis, ornithosis, granulocyte erlichiosis; whooping cough, brucellosis, osteomyelitis; sepsis, subacute septic endocarditis, peritonitis.

Forms of release

Capsules 100 mg. Forms in the form of tablets or suspensions do not exist.

Lyophilizate for the preparation of a solution for intravenous administration (injections in ampoules for injection) 100 mg.

Instructions for use and dosage

Capsules

Inside, in adults and children with a body weight of more than 45 kg, the average daily dose - 0.2 g in the 1st day (divided into 2 doses - 0.1 g 2 times a day), then 0.1 g per day.

In chronic infections of the urinary system - 0.2 g per day during the entire period of therapy.

In the treatment of gonorrhea, one of the following regimens is prescribed: acute uncomplicated urethritis - a course dose of 0.5 g (1 dose - 0.3 g, the next 2 - 0.1 g at intervals of 6 hours) or 0.1 g per day until complete cure (in women) or 0.1 g 2 times a day for 7 days (in males); with complicated forms of gonorrhea, the course dose is 0.8 - 0.9 g, which is divided into 6 to 7 receptions (0.3 g - 1 reception, then with an interval of 6 hours for 5-6 follow-up).

In the treatment of syphilis - 0.3 g per day for at least 10 days.

In uncomplicated infections of the urethra, cervix and rectum caused by Chlamydia trachomatis, appoint 0.1 g 2 times a day for at least 7 days.

Infections of male genital organs - 0.1 g 2 times a day for 4 weeks.

Treatment of malaria resistant to chloroquine - 0.2 g per day for 7 days (in combination with shizontocidal drugs - quinine); malaria prophylaxis - 0.1 g once a day for 1 to 2 days before the trip, then daily during the trip and within 4 weeks after the return; children older than 8 years - 0.002 g / kg 1 time per day.

Diarrhea of ​​travelers (prophylaxis) - 0.2 g per 1 day trip (for 1 dose or 0.1 g 2), then 0.1 g once a day during the whole stay in the region (no more than 3 weeks).

Treatment of leptospirosis - 0.1 g inside 2 times a day for 7 days; prophylaxis of leptospirosis - 0.2 g once a week during a stay in the dysfunctional region and 0.2 g at the end of the trip.

Prevention of infections after medical abortion - 0.1 g for 1 hour before abortion and 0.2 g - 30 minutes after.

Maximum daily doses for adults - up to 0.3 g per day or up to 0.6 g per day for 5 days with severe gonococcal infections.

In children 9-12 years with a body weight of 45 kg, the mean daily dose - 0.004 g / kg on day 1, further - 0.002 g / kg per day (1-2 doses). In severe infections, every 12 hours, 0.004 g / kg is prescribed.

Ampoules

Adults injected intravenously (drip) 200 mg per day on the first day of treatment, in the following days - 100-200 mg per day. Multiplicity of admission (or intravenous infusions) - 1-2 times a day. For children over 8 years of age and weighing more than 50 kg the daily dose for oral administration or in / in (drip) is the first day of treatment of 4 mg / kg. In the following days - 2-4 mg / kg per day, depending on the severity of the clinical course of the disease. The multiplicity of intravenous infusions is 1-2 times a day. The recommended minimum time / v infusion of 100 mg of doxycycline (infusion solution at a concentration of 0.5 mg / ml) was 1 hour.

The maximum dose for intravenous administration is 300 mg per day.

Side effect

• benign increase in intracranial pressure (decreased appetite, vomiting, headache, edema of the optic disc);
• toxic effects on the central nervous system (dizziness or instability);
• nausea;
• constipation or diarrhea;
• glossitis;
• dysphagia;
• esophagitis (including erosive);
• ulceration of the stomach and duodenum;
• Enterocolitis (due to the proliferation of resistant strains of staphylococci);
• itching;
• hyperemia of the skin;
• angioedema;
• anaphylactoid reactions;
• Hemolytic anemia, thrombocytopenia, neutropenia, eosinophilia;
• photosensitization;
• superinfection;
• persistent discoloration of tooth enamel.

Contraindications

• porphyria;
• severe hepatic impairment;
• leukopenia;
• pregnancy (2-3 trimesters);
• lactation period;
• infancy (up to 8 years - the possibility of forming insoluble complexes with calcium and deposition in bone skeleton, tooth enamel and dentin);
• hypersensitivity.

Application in pregnancy and lactation

In the experiment it was established that doxycycline can have a toxic effect on the development of the fetus - a delay in the development of the skeleton.

Contraindicated in pregnancy and lactation.

special instructions

To prevent locally irritating effects (esophagitis, gastritis,ulceration of the mucous membrane of the gastrointestinal tract) it is recommended to take in the afternoon hours with a lot of liquid, food.

In connection with the possible development of photosensitization, it is necessary to limit the insolation during treatment and for 4-5 days after it.

With prolonged use, periodic monitoring of the function of the kidneys, liver, and hematopoiesis is necessary.

May mask the manifestations of syphilis, and therefore with the possibility of mikstinfektsii need a monthly serological analysis for 4 months.

The appointment during the development of teeth can cause irreversible changes in their color.

Perhaps a false increase in the level of catecholamines in urine when determined by the fluorescent method. In the study of the thyroid biopsy in patients who have been receiving doxycycline for a long time, it is possible to dark brown staining of the tissue in micropreparations without disturbing its function.

Drug Interactions

Absorption is reduced by antacids containing aluminum, magnesium, calcium, food containing calcium (milk, cottage cheese), iron preparations, sodium bicarbonate, magnesium-containing laxatives, colestyramine and colestipol, so their use should be separated by an interval of 3 hours.

In connection with the suppression of the intestinal microflora reduces the prothrombin index, which requires correction of the dose of indirect anticoagulants.

When combined with bactericidal antibiotics that disrupt the synthesis of the cell wall (penicillins, cephalosporins), the effectiveness of the latter is reduced.

Reduces the reliability of contraception and increases the frequency of bleeding from a breakthrough in the course of taking estrogen-containing oral contraceptives.

Ethanol (alcohol), barbiturates, rifampicin, carbamazepine, phenytoin and other stimulants of microsomal oxidation, accelerating the metabolism of doxycycline, reduce its concentration in the plasma.

With the simultaneous use of methoxyflurane, the risk of developing fatal nephrotoxicity increases.

Simultaneous use of Retinol helps increase intracranial pressure.

Analogues of the drug Doxycycline

Structural analogs for the active substance:

• Bassado;
• Vibramycin;
• Widokcin;
• Dovitsin;
• Doxal;
• Doksybeene;
• Doksybeene M;
• Doxilan;
• Doxycycline Nycomed;
• Stox's doxycycline;
• Doxycycline-AKOS;
• Doxycycline-Ferein;
• Doxycycline hydrochloride;
• Xedocine;
• Monoclin;
• Yunidox Solutab.

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