Adult Dosing
Bacterial infections
- Mild to moderate infections: Start 100 mg PO bid, then 100 mg/day divided daily-bid
- Severe infections: 100 mg PO bid
Chlamydia infections; uncomplicated urethral, endocervical or rectal infections
Chlamydia infections, nongonococcal urethritis caused by C.trachomatis/U. urealyticum
Acne vulgaris, severe
- Start 100 mg PO bid x 1 day; then 100 mg PO daily
Lyme Disease, early localized w/o neurological symptoms
- 100 mg PO bid x 14-21 days; 100 mg PO bid for lyme arthritis
Epididymitis
Malaria prophylaxis
- 100 mg PO daily; begin 1-2 days before exposure & continue until 4 wks after exposure
Syphilis (primary, secondary, early latent)
- 100 mg PO bid x 14 days if penicillin allergic
Syphilis (>1 yr duration)
- 100 mg PO bid x 28 days if penicillin alergic
Inhalational anthrax (post exposure)
Cutaneous anthrax
- 100 mg PO bid x 7-10 days; give x 60 days total if bioterrorism suspected
Acne rosacea, inflammatory lesions (Oracea)
- 40 mg PO qam. Give 1 hr before or 2 hrs after meals
Periodontitis (Periostat)
- 20 mg PO bid as an adjunct to scaling and root planning
- Give 1 hr before or 2 hrs after meals; may continue up to 9 months
Pharyngitis (Acute)[Non-FDA Approved]
- 200 mg PO initially, then 100 mg PO daily
Malaria [Non FDA-Approved]
COPD exacerbation[Non-FDA Approved]
Pediatric Dosing
Bacterial infections
Child
- (>8 yrs; <45 kgs):
- Mild to moderate infections: Start 4.4 mg/kg/day PO divided bid on day 1; then 2.2 mg/kg PO daily. [Max: 100 mg/dose]
- Severe infections: 4.4 mg/kg/day PO divided bid. [Max: 100 mg/dose]
- (>8 yrs; >45 kgs):
- Mild to moderate infections: Start 100 mg PO bid, then 100 mg/day divided daily-bid
- Severe infections: 100 mg PO bid
Acne vulgaris, severe
- Child (>8 yrs): Start 4.4 mg/kg/day PO divided bid on day 1, then 2.2 mg/kg PO daily. [Max: 100 mg/dose]
Epididymitis
- Adolescents: 100 mg PO bid x 10 days
Lyme Disease, early localized w/o neurological symptoms
- Child (>8 yrs): 100 mg PO bid x 14-21 days; 100 mg PO bid for lyme arthritis
Malaria prophylaxis
- Child (>8 yrs): 2.2 mg/kg PO daily; begin 1-2 days before exposure & continue until 4 wks after exposure. [Max: 100 mg/day]
Inhalational anthrax (post exposure)
- Child: 4.4 mg/kg/day PO divided bid for 60 days. [Max: 100 mg/dose]
Cutaneous anthrax
- Child: 4.4 mg/kg/day PO divided bid x 7-10 days; give x 60 days total if bioterrorism suspected. [Max: 100 mg/dose]
Pharyngitis (Acute)[Non-FDA Approved]-Only for children>8yrs, use adult dosing if >45 kgs
- 2.2 mg/kg/dose PO given bid
Orbital cellulitis [Non-FDA Approved]
- >8 years,
45 kg: 4.4 mg/kg/day PO [Max 200 mg/day] - > 45 kg: 100 mg PO bid
Chlamydia [Non-FDA Approved]
- Contraindicated in children < 9yrs
- Children
9 yrs: 100 mg PO bid x 7 days
Malaria [Non FDA-Approved]
- 2.2 mg/kg/dose orally every 12 hrs x 7 days [Max 100 mg/dose]
[Outline]
See Supplemental Patient Information
- Doxycycline is not the drug of choice for any type of stapylococcal infections
- Culture and susceptibility tests should be performed to determine the causative organism and its susceptibility to the drug
- Use of tetracyclines, including doxycycline; during tooth development (last half of pregnancy, infancy and childhood till the age of 8 yrs) may cause permanent discoloration of teeth. Hence it should not be used in this age group, unless treating inhalation anthrax or if other drugs are not effective or are contraindicated
- Use of this drug may result in overgrowth of nonsusceptible organisms particularly fungi. Institute appropriate therapy if new infections develop
- Tetracyclines can cause photosensitivity and pseudotumor cerebri (avoid use with isotretinoin)
- Photosensitivity manifested by an exaggerated sunburn reaction has been observed in some individuals taking tetracyclines. Avoid exposure to sunlight or ultraviolet light
- Use with caution in preexisting hepatic impairment. Doses > 2 g/day associated with liver failure. Monitor LFTS and avoid other hepatotoxic drugs
- Prolonged IV use may result in thrombophlebitis. Institute oral therapy whenever reasonable
- Bulging fontanels in infants and benign intracranial hypertension in adults have been reported in individuals receiving tetracyclines
- Doxycycline may decrease efficacy of oral contraceptives
- Measure BUN, serum creatinine, CBC at baseline and LFTs if prolonged therapy
- Do not give antacids or calcium supplements within 2 hrs of doxycycline
- Clostridium difficile associated diarrhea has been reported with use of nearly all antibacterial agents
- Use with methoxyflurane reported to result in fatal renal toxicity
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- SLE
- Geriatric population
- Pediatric population < 8 yrs
- Lactation
Supplemental Patient Information
- Patients taking for malaria prophylaxis should be advised that it does not guarantee protection and other measures to prevent mosquito bites should be taken. Patients should be advised on when and how long to take prophylaxis
- All patients should be advised on the potential effects, proper administration, not to take additional medications unless advised by provider and counseled that antibacterial drugs should only be used to treat bacterial infections
Adoxa, Doryx, Monodox, Oracea, Periostat, Vibramycin, Vibra-Tabs interacts with :
Pregnancy Category:D
Breastfeeding: Most sources consider that tetracyclines are contraindicated during breastfeeding due to possible staining of infants dental enamel or bone deposition. However short term use of tetracyclines would not adversely affect the breastfed infant. Avoid prolonged or repeated courses of therapy during nursing. Monitor the infant for adverse events such as rash, diarrhea or candidiasis. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 20 July 2010).
US Trade Name(s)
- Adoxa
- Doryx
- Monodox
- Oracea
- Periostat
- Vibramycin
- Vibra-Tabs (Discontinued)
US Availability
doxycycline (generic)
- TABS: 20, 50, 75, 100, 150 mg
- CAPS: 20, 50, 75, 100, 150 mg
- Delayed release TABS: 75, 100, 150 mg
- SUSP: 25 mg/5 mL (susp)
Adoxa
- TABS: 50, 75, 100, 150 mg
- CAPS: 150 mg
Doryx
- Delayed release TABS: 75, 80, 100, 150, 200 mg
Monodox
Oracea
Periostat
Vibramycin
- CAPS: 50, 100 mg
- SUSP: 25 mg/5 mL (60 mL)
- SOLN: 50 mg/5 mL (437 mL)
Vibra-Tabs
Canadian Trade Name(s)
- Apo-Doxy
- Doxycin
- Doxytab
- Novo-Doxylin
- Periostat
- Vibra-Tabs
- Vibramycin
Canadian Availability
doxycycline (generic)
Apo-Doxy, Doxycin, Novo-Doxylin
Doxytab, Vibra-Tabs
Periostat
Vibramycin
UK Trade Name(s)
- Efracea
- Periostat
- Vibramycin
- Vibramycin-D
UK Availability
doxycycline (generic)
Efracea
Periostat
Vibramycin
Vibramycin-D
Australian Trade Name(s)
- Doryx
- Doxsig
- Doxy
- Doxyhexal
- Doxylin
- Frakas
- Vibramycin
Australian Availability
doxycycline (generic)
- CAPS: 50, 100 mg
- TABS: 50, 100 mg
Doryx
Doxsig
Doxy, Doxylin, Doxyhexal, Vibramycin
Frakas
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Vibramycin 25 MG/5ML SUSR [Bottle] (PFIZER U.S.)
60 5ml = $35.99
180 5ml = $84.97 - Adoxa 150 MG CAPS [Bottle] (PHARMADERM)
60 mg = $1706.29
180 mg = $4962.34 - Monodox 75 MG CAPS [Bottle] (AQUA PHARMACEUTICALS)
100 mg = $1402.56
300 mg = $4207.68 - Doryx 100 MG TBEC [Bottle] (WARNER CHILCOTT PROF PROD DIV)
30 mg = $317.98
90 mg = $902.99 - Doryx 75 MG TBEC [Bottle] (WARNER CHILCOTT PROF PROD DIV)
30 mg = $244.72
90 mg = $689.95 - Vibramycin 50 MG/5ML SYRP [Bottle] (PFIZER U.S.)
480 5ml = $277.17
960 5ml = $538.95 - Adoxa 75 MG TABS [Bottle] (DOAK DERMATOLOGICS)
30 mg = $381.99
90 mg = $1105.96 - Vibramycin 100 MG CAPS [Bottle] (PFIZER U.S.)
20 mg = $129.99
60 mg = $379.98 - Vibra-Tabs 100 MG TABS [Bottle] (PFIZER U.S.)
20 mg = $129.99
60 mg = $379.98 - Adoxa 100 MG TABS [Bottle] (DOAK DERMATOLOGICS)
30 mg = $407.97
90 mg = $1169.97 - Doryx 150 MG TBEC [Bottle] (WARNER CHILCOTT PROF PROD DIV)
60 mg = $1039.99
180 mg = $3019.9 - Monodox 100 MG CAPS [Bottle] (AQUA PHARMACEUTICALS)
50 mg = $782.02
150 mg = $2293.08 - Oracea 40 MG CPDR [Bottle] (GALDERMA)
30 mg = $430.01
90 mg = $1244.93
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
