Adult Dosing
Bacterial Infections
- 300 mg PO bid; alt: 150 mg PO qid
Gonorrhea patients sensitive to penicillin
- Start 600 mg PO x 1, followed by 300 mg PO q12 hrs for 4 days
Syndrome of inappropriate antidiuretic hormone secretion (not FDA Approved)
- 600-1200 mg/day PO divided bid-qid
Notes:- Administer at least 1 hour before or 2 hours after meals, Continue the treatment for at least 24 to 48 hours after symptoms and fever have subsided
- Duration of therapy varies according to clinical condition and indication being treated
Pediatric Dosing
- Safety and effectiveness in pediatric patients < 8yrs have not been established
Bacterial Infections
- >8 yrs: Primarily for UTI, 7-13 mg/kg/day PO divided bid-qid; Max: 600 mg/day
Notes:- Administer at least 1 hour before or 2 hours after meals, Continue the treatment for at least 24 to 48 hours after symptoms and fever have subsided
- Duration of therapy varies according to clinical condition and indication being treated
[Outline]
See Supplemental Patient Information
- Demeclocycline can cause fetal harm when administered to a pregnant woman; if administered during pregnancy or if patient becomes pregnant during treatment, apprise about the potential hazards to the fetus
- Use during last half of the pregnancy, infancy and during the first 8 yrs of life may cause permanent discoloration of teeth
- Tetracyclines administered to premature infants, in the doses of 25 mg/kg PO qid, have caused decrease in fibula growth rate
- Concurrent use of tetracyclines and methoxyflurane results in fatal renal toxicity
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- In pre-existing renal impairment, even usual oral/parenteral doses may cause hepatotoxicity; dose adjustments may be necessary. Monitor serum drug levels if prolonged therapy
- Photosensitivity manifested by an exaggerated sunburn reaction may occur, discontinue the treatment on first evidence of erythema of the skin
- Dose-dependent, reversible, nephrogenic diabetes insipidus syndrome may occur on prolonged use
- Clostridium difficile associated diarrhea which may vary in severity from mild to fatal colitis, has been reported with use of all antibiotics, including demeclocycline. Maintain appropriate fluid and electrolyte levels, protein supplementation, along with antibiotics for C. difficile as needed
- Pseudotumor cerebri in adults and bulging fontanels in infants may occur; possibility for permanent sequelae exists
- Development of drug-resistant bacteria may occur if it is used as a prophylactic indication for unproven or unsuspected bacterial infection; discontinue if superinfection occurs
- Increase in BUN may occur
- Perform darkfield examination before starting of treatment in venereal diseases when coexistent syphilis is suspected; blood serology qmo x 4
- Monitor creatinine/creatinine clearance at baseline and periodically if prolonged therapy; LFTs if long-term therapy
- For all patients with gonorrhea, perform serologic test for syphilis at the time of diagnosis and after 3 months
Cautions: Use cautiously in
- Renal impairment (dose reduction recommended)
- Hepatic impairment (dose reduction recommended)
- SLE
- Anticoagulants
- Oral Contraceptives
Supplemental Patient Information
- Demeclocycline should be taken with a full glass of water on an empty stomach at least 1 h before or 3 h after meals. Administer antacids containing aluminium, calcium or magnesium at least 2 hrs before or after demeclocycline administration.
- Skipping doses or not completing the full course of therapy may decrease the effectiveness of the immediate treatment
- Refrain from driving vehicles or using hazardous machinery during therapy
- Exaggerated sunburn reaction is possible. Avoid exposure to sunlight
Pregnancy Category:D
Breastfeeding: Possibly unsafe; staining of infants dental enamel or bone deposition occurs. Not indicated during pregnancy because of potential hazards to infants. It is not likely to harm on short term treatment as milk levels are low and absorption by the infant is inhibited by the calcium in breast milk. Avoid prolonged use. Monitor infant for rash and for possible effects on the gastrointestinal flora, such as diarrhea or candidiasis (thrush, diaper rash). This information is based upon LactMed database http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 20 October 2010). Manufacturer advises to discontinue nursing/drug because of potential serious adverse reactions in nursing infants. Decision should be based on importance of the drug to the mother
