sarecycline

Contraindicated in:

Hypersensitivity to sarecycline or other tetracycline antibiotics;
OB: Pregnancy (may lead to permanent staining of teeth and inhibition of bone growth in fetus if used during 2nd or 3rd trimester);
Lactation: Lactation;
Pedi: Children ≤8 yr (may lead to permanent staining of teeth and ↓ growth).

Use Cautiously in:

Rep: Women of reproductive potential who are overweight (↑ risk of intracranial hypertension).

Adv. Reactions/Side Effects ⬆ ⬇

Derm: photosensitivity

GI: CLOSTRIDIOIDES DIFFICILE-ASSOCIATED DIARRHEA (CDAD), nausea

GU: ↓fertility (males), vulvovaginal candidiasis

Neuro: dizziness, intracranial hypertension, vertigo

Interactions ⬆ ⬇

Drug-drug:

Isotretinoin may ↑ risk of intracranial hypertension; avoid concurrent use.
Antacids containing aluminum, calcium, or magnesium; bismuth subsalicylate; or iron supplements may ↓ absorption.
May interfere with the bactericidal effects of penicillin; avoid concurrent use.
May ↑ effect of and risk of bleeding with warfarin.
May ↑ levels and risk of toxicity of P-glycoprotein substrates, including digoxin.

Drug-Food:

Calcium in foods or dairy products may ↓ absorption.

Availability ⬆ ⬇

Tablets: 60 mg; 100 mg; 150 mg

Route/Dosage ⬆ ⬇

PO (Adults and Children ≥9 yr and 85–136 kg): 150 mg once weekly. Reassess treatment if no improvement after 12 wk.
PO (Adults and Children ≥9 yr and 55–84 kg): 100 mg once weekly. Reassess treatment if no improvement after 12 wk.
PO (Adults and Children ≥9 yr and 33–54 kg): 60 mg once weekly. Reassess treatment if no improvement after 12 wk.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Inhibits bacterial protein synthesis by binding to the 30S bacterial ribosome.

Therapeutic effects:

Reduction in inflammatory lesions.

Spectrum:

Active against Propionibacterium acnes.

Classifications ⬆ ⬇

Therapeutic Classification: anti-infectives

Pharmacologic Classification: tetracyclines

Pharmacokinetics ⬆ ⬇

Absorption: Unknown. Rate and extent of absorption reduced by high-fat, high-calorie food.

Distribution: Widely distributed to tissues.

Metabolism/Excretion: Minimally metabolized by liver. 43% excreted in feces (15% as unchanged drug), 44% in urine (25% as unchanged drug).

Half-Life: 21–22 hr.

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	1.5–2 hr	24 hr

Patient/Family Teaching ⬆ ⬇

Instruct patient to take sarecycline as directed. Advise patient to read Patient Information before starting therapy and with each Rx refill in case of changes.
May cause dizziness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
Instruct patient to notify health care professional immediately if rash, diarrhea, abdominal cramping, fever, or bloody stools occur, and not to treat with antidiarrheals without consulting health care professionals.
Caution patient to use sunscreen and protective clothing and minimize or avoid exposure to natural or artificial sunlight (tanning beds or UVA/B treatment) while using sarecycline to prevent photosensitivity reactions.
Advise patient to report the signs of superinfection (black, furry overgrowth on the tongue; vaginal itching or discharge; loose or foul-smelling stools) or intracranial hypertension (headache, blurred vision, diplopia, vision loss). Women of reproductive potential who are overweight are at greater risk for developing intracranial hypertension.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
Rep: May cause fetal harm. May permanently turn a baby or child's teeth yellow-gray-brown during tooth development during the 2nd and 3rd trimesters of pregnancy, and from birth to 8 yr. May also slow bone growth in infants and children. Advise females of reproductive potential to use a nonhormonal method of contraception and avoid breastfeeding during therapy. Advise patient to notify health care professional promptly if pregnancy is suspected. May reduce fertility in males; avoid use in males attempting to conceive a child.

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Indications ⬇

Contraind./Precautions ⬆ ⬇