Adox Pak 2 / 100

Name: Adox Pak 2 / 100

What do I need to tell my doctor BEFORE I take Adox Pak 2/100?

  • If you have an allergy to doxycycline or any other part of Adox Pak 2/100 (doxycycline tablets and capsules).
  • If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
  • If you are taking any of these drugs: Acitretin, isotretinoin, or a penicillin.
  • If you are breast-feeding or plan to breast-feed.

This is not a list of all drugs or health problems that interact with this medicine.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take Adox Pak 2/100 with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

How is this medicine (Adox Pak 2/100) best taken?

Use this medicine as ordered by your doctor. Read all information given to you. Follow all instructions closely.

  • To gain the most benefit, do not miss doses.
  • Keep taking Adox Pak 2/100 (doxycycline tablets and capsules) as you have been told by your doctor or other health care provider, even if you feel well.
  • Some drugs may need to be taken with food or on an empty stomach. For some drugs it does not matter. Check with your pharmacist about how to take this medicine.
  • Drink lots of noncaffeine liquids unless told to drink less liquid by your doctor.
  • Do not take bismuth (Pepto-BismolĀ®), calcium, iron, magnesium, zinc, multivitamins with minerals, colestipol, cholestyramine, didanosine, or antacids within 2 hours of Adox Pak 2/100.
  • Take with a full glass of water.
  • Do not lie down for at least 30 minutes after taking this medicine.

What do I do if I miss a dose?

  • Take a missed dose as soon as you think about it.
  • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.

What should I avoid while taking doxycycline?

Do not take iron supplements, multivitamins, calcium supplements, antacids, or laxatives within 2 hours before or after taking doxycycline.

Avoid taking any other antibiotics with doxycycline unless your doctor has told you to.

Avoid exposure to sunlight or tanning beds. Doxycycline can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

For the Consumer

Applies to doxycycline: oral capsule, oral capsule delayed release, oral capsule extended release, oral powder for suspension, oral syrup, oral tablet, oral tablet delayed release

Along with its needed effects, doxycycline may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking doxycycline:

Incidence not known
  • Bloating
  • chills
  • clay-colored stools
  • constipation
  • cough
  • dark urine
  • decreased appetite
  • diarrhea
  • diarrhea, watery and severe, which may also be bloody
  • difficulty with swallowing
  • dizziness
  • fast heartbeat
  • feeling of discomfort
  • fever
  • headache
  • hives, itching, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • hives or welts, itching, or rash
  • increased thirst
  • indigestion
  • inflammation of the joints
  • joint or muscle pain
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • loss of appetite
  • nausea and vomiting
  • numbness or tingling of the face, hands, or feet
  • pain in the stomach, side, or abdomen, possibly radiating to the back
  • redness and soreness of the eyes
  • redness of the skin
  • severe stomach pain
  • sore throat
  • sores in the mouth
  • stomach cramps
  • stomach pain or tenderness
  • swelling of the feet or lower legs
  • swollen lymph glands
  • tightness in the chest
  • unusual tiredness or weakness
  • unusual weight loss
  • yellow eyes or skin

Some side effects of doxycycline may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known
  • Back, leg, or stomach pains
  • bleeding gums
  • blood in the urine or stools
  • blurred vision
  • bulging soft spot on the head of an infant
  • change in the ability to see colors, especially blue or yellow
  • chest pain, discomfort, or burning
  • cracks in the skin
  • decrease in vision
  • difficulty breathing
  • discoloration of the thyroid glands
  • double vision
  • general body swelling
  • heartburn
  • increased sensitivity of the skin to sunlight
  • loss of heat from the body
  • lower back or side pain
  • nosebleeds
  • pain or burning in the throat
  • pain with swallowing
  • painful or difficult urination
  • pale skin
  • pinpoint red spots on the skin
  • rash with flat lesions or small raised lesions on the skin
  • red, swollen skin
  • redness or other discoloration of the skin
  • redness, swelling, or soreness of the tongue
  • scaly skin
  • severe nausea
  • severe sunburn
  • sores, ulcers, or white spots on the lips or tongue or inside the mouth
  • unusual bleeding or bruising
  • vomiting blood

Usual Adult Dose for Chlamydia Infection

Uncomplicated urethral, endocervical, or rectal infection:
-Most products: 100 mg orally twice a day
---Alternatively, Doryx(R) MPC: 120 mg orally twice a day

Alternative regimen for uncomplicated urethral or endocervical infection:
-Delayed-release tablets: 200 mg orally once a day

Duration of therapy: 7 days

Comments:
-These regimens (100 mg orally twice a day and 200 mg orally once a day) have been recommended by the US CDC for the treatment of chlamydial infections; current guidelines should be consulted for additional information.
-The patient's sexual partner(s) should also be evaluated/treated.

Uses: For the treatment of uncomplicated urethral, endocervical, or rectal infections due to C trachomatis

Usual Adult Dose for Epididymitis - Sexually Transmitted

Most products: 100 mg orally twice a day
-Alternatively, Doryx(R) MPC: 120 mg orally twice a day
Duration of therapy: At least 10 days

Use: For the treatment of acute epididymo-orchitis due to C trachomatis or Neisseria gonorrhoeae

US CDC Recommendations: 100 mg orally twice a day for 10 days

Comments:
-With ceftriaxone, the recommended regimen for acute epididymitis most likely due to sexually transmitted chlamydia and gonorrhea
-The patient's sexual partner(s) should also be evaluated/treated.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Plague

IV:
-Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
-Maintenance dose: 100 to 200 mg/day IV

ORAL:
Most Products:
-Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
-Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
---More severe infections: 100 mg orally every 12 hours

Doryx(R) MPC:
-Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
-Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
---More severe infections: 120 mg orally every 12 hours

Comments:
-The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
-If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).

Use: For the treatment of plague due to Yersinia pestis

US CDC Recommendations: 100 mg orally or IV twice a day or 200 mg orally or IV once a day
Duration of therapy: 10 to 14 days (or until 2 days after fever subsides)

Comments:
-In general, recommended as an alternative regimen for the treatment of plague
-IV therapy should be started as soon as plague suspected; may switch to oral therapy once patient improves
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Plague Prophylaxis

US CDC Recommendations: 100 mg orally twice a day for 7 days

Comments:
-Recommended as a preferred agent for postexposure prophylaxis in patients with known exposure to plague (e.g., close contact with pneumonic plague patient, direct contact with infected body fluids/tissues)
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Skin or Soft Tissue Infection

Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
Maintenance dose: 100 to 200 mg/day IV

Comments:
-Not the drug of choice for any type of staphylococcal infection
-The maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.

Use: For the treatment of skin and soft tissue infections due to Staphylococcus aureus when bacteriological testing shows suitable susceptibility to this drug

IDSA Recommendations: 100 mg orally or IV every 12 hours

Comments:
-Recommended as oral therapy for skin and soft tissue infections due to methicillin-susceptible and methicillin-resistant S aureus, bacillary angiomatosis, bubonic plague, tularemia, and infections after human bites
-Recommended as oral therapy for purulent cellulitis (cellulitis associated with purulent drainage/exudate without a drainable abscess) due to methicillin-resistant S aureus
-With other agents, recommended as a part of an IV regimen for necrotizing infections of the skin, fascia, and muscle due to Aeromonas hydrophila or V vulnificus
-Recommended oral or IV therapy for infections after animal bites
-Recommended duration of therapy for bacillary angiomatosis is 2 weeks to 2 months
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Syphilis - Early

Early:
-Most products: 100 mg orally twice a day
---Alternatively, Doryx(R) MPC: 120 mg orally twice a day
Duration of therapy: 2 weeks

More than 1-year duration:
-Most products: 100 mg orally twice a day
---Alternatively, Doryx(R) MPC: 120 mg orally twice a day
Duration of therapy: 4 weeks

For the treatment of primary or secondary syphilis, some manufacturers recommend: 300 mg/day orally (in divided doses) or IV for at least 10 days

Comments:
-Penicillin is the drug of choice.
-The patient's sexual partner(s) should also be evaluated/treated.

Use: When penicillin is contraindicated, as alternative therapy for syphilis due to T pallidum

US CDC Recommendations:
-Primary or secondary syphilis: 100 mg orally twice a day for 14 days
-Latent syphilis: 100 mg orally twice a day for 28 days

Comments:
-Recommended for nonpregnant penicillin-allergic patients
-Penicillin-allergic pregnant patients or penicillin-allergic patients whose compliance cannot be ensured should be desensitized and treated with benzathine penicillin.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Syphilis - Latent

Early:
-Most products: 100 mg orally twice a day
---Alternatively, Doryx(R) MPC: 120 mg orally twice a day
Duration of therapy: 2 weeks

More than 1-year duration:
-Most products: 100 mg orally twice a day
---Alternatively, Doryx(R) MPC: 120 mg orally twice a day
Duration of therapy: 4 weeks

For the treatment of primary or secondary syphilis, some manufacturers recommend: 300 mg/day orally (in divided doses) or IV for at least 10 days

Comments:
-Penicillin is the drug of choice.
-The patient's sexual partner(s) should also be evaluated/treated.

Use: When penicillin is contraindicated, as alternative therapy for syphilis due to T pallidum

US CDC Recommendations:
-Primary or secondary syphilis: 100 mg orally twice a day for 14 days
-Latent syphilis: 100 mg orally twice a day for 28 days

Comments:
-Recommended for nonpregnant penicillin-allergic patients
-Penicillin-allergic pregnant patients or penicillin-allergic patients whose compliance cannot be ensured should be desensitized and treated with benzathine penicillin.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Lyme Disease - Neurologic

IDSA Recommendations: 100 to 200 mg orally twice a day
Duration of therapy: 14 days (range: 10 to 28 days)

Comments:
-Recommended as the preferred regimen for the treatment of nervous system Lyme disease (including the following syndromes: meningitis, any neurologic syndrome with CSF pleocytosis, peripheral nerve [radiculopathy, diffuse neuropathy, mononeuropathy multiplex, cranial neuropathy; normal CSF])
-Recommended in early Lyme disease for patients intolerant of beta-lactam antibiotics with acute neurologic disease manifested by meningitis or radiculopathy
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Sinusitis

IDSA Recommendations: 100 mg orally twice a day or 200 mg orally once a day

Comments:
-Recommended as a second-line regimen for acute bacterial rhinosinusitis, as initial empirical therapy or for patients with beta-lactam allergy
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Actinomycosis

IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
-Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day

At least 45 kg:
-Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
-Maintenance dose: 100 to 200 mg/day IV

ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
-Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day

At least 45 kg:
-Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
-Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
---More severe infections: 100 mg orally every 12 hours

Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
-Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day

At least 45 kg:
-Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
-Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
---More severe infections: 120 mg orally every 12 hours

Comments:
-The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
-For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
-With trachoma, the infectious agent is not always eliminated (as assessed by immunofluorescence).
-Coadministration with streptomycin recommended for brucellosis.

Uses:
-For the treatment of the following infection: Psittacosis (ornithosis) due to C psittaci; chancroid due to H ducreyi; relapsing fever due to B recurrentis; C fetus infections; brucellosis due to Brucella species; bartonellosis due to B bacilliformis; trachoma or inclusion conjunctivitis due to C trachomatis
-For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: E coli; E aerogenes; Shigella species; Acinetobacter species; urinary tract infections due to Klebsiella species
-When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to T pallidum subspecies pertenue; listeriosis due to L monocytogenes; Vincent's infection due to F fusiforme; actinomycosis due to A israelii; infections due to Clostridium species
-As adjunctive therapy for: Acute intestinal amebiasis; severe acne

American Academy of Pediatrics (AAP) Recommendations:
1 month or older:
-Mild to moderate infections: 2 to 4 mg/kg/day orally or IV in 1 to 2 divided doses
-Severe infections: 2 mg/kg orally or IV every 12 hours
Maximum dose: 200 mg/day

Comments:
-Risk of dental staining in children younger than 8 years is unlikely at the dose and duration recommended to treat serious infections.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Trachoma

IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
-Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day

At least 45 kg:
-Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
-Maintenance dose: 100 to 200 mg/day IV

ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
-Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day

At least 45 kg:
-Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
-Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
---More severe infections: 100 mg orally every 12 hours

Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
-Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day

At least 45 kg:
-Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
-Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
---More severe infections: 120 mg orally every 12 hours

Comments:
-The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
-For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
-With trachoma, the infectious agent is not always eliminated (as assessed by immunofluorescence).
-Coadministration with streptomycin recommended for brucellosis.

Uses:
-For the treatment of the following infection: Psittacosis (ornithosis) due to C psittaci; chancroid due to H ducreyi; relapsing fever due to B recurrentis; C fetus infections; brucellosis due to Brucella species; bartonellosis due to B bacilliformis; trachoma or inclusion conjunctivitis due to C trachomatis
-For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: E coli; E aerogenes; Shigella species; Acinetobacter species; urinary tract infections due to Klebsiella species
-When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to T pallidum subspecies pertenue; listeriosis due to L monocytogenes; Vincent's infection due to F fusiforme; actinomycosis due to A israelii; infections due to Clostridium species
-As adjunctive therapy for: Acute intestinal amebiasis; severe acne

American Academy of Pediatrics (AAP) Recommendations:
1 month or older:
-Mild to moderate infections: 2 to 4 mg/kg/day orally or IV in 1 to 2 divided doses
-Severe infections: 2 mg/kg orally or IV every 12 hours
Maximum dose: 200 mg/day

Comments:
-Risk of dental staining in children younger than 8 years is unlikely at the dose and duration recommended to treat serious infections.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Upper Respiratory Tract Infection

IV:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg IV every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
-Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day

At least 45 kg:
-Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
-Maintenance dose: 100 to 200 mg/day IV

ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
-Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day

At least 45 kg:
-Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
-Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
---More severe infections: 100 mg orally every 12 hours

Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
-Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day

At least 45 kg:
-Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
-Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
---More severe infections: 120 mg orally every 12 hours

Comments:
-The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
-For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
-When used in streptococcal infections, duration of therapy should be 10 days.

Uses:
-For the treatment of respiratory tract infections due to M pneumoniae
-For the treatment of respiratory tract infections due to H influenzae or Klebsiella species and upper respiratory infections due to S pneumoniae when bacteriological testing shows suitable susceptibility to this drug

Pediatric Infectious Diseases Society (PIDS) and IDSA Recommendations:
-Older than 7 years: 1 to 2 mg/kg orally twice a day

Comments:
-Recommended as an alternative for step-down therapy or mild infection due to M pneumoniae, C trachomatis, or C pneumoniae
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Tularemia

IV:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg IV every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
-Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day

At least 45 kg:
-Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
-Maintenance dose: 100 to 200 mg/day IV

ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
-Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day

At least 45 kg:
-Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
-Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
---More severe infections: 100 mg orally every 12 hours

Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
-Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day

At least 45 kg:
-Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
-Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
---More severe infections: 120 mg orally every 12 hours

Comments:
-The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
-For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).

Use: For the treatment of tularemia due to F tularensis

Working Group on Civilian Biodefense Recommendations:
-Less than 45 kg: 2.2 mg/kg orally or IV twice a day
-At least 45 kg: 100 mg orally or IV twice a day

Duration of Therapy:
-Postexposure prophylaxis: 14 days
-Treatment in a contained casualty setting: At least 14 days
-Treatment in a mass casualty setting: 14 to 21 days

Comments:
-Recommended as an alternative IV regimen for the treatment of tularemia in a contained casualty setting and for postexposure prophylaxis
-Recommended as a preferred oral regimen for the treatment of tularemia in a mass casualty setting and for postexposure prophylaxis
-If parenteral therapy is used initially, may switch to oral therapy when clinically indicated
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Nongonococcal Urethritis

AAP Recommendations:
-Adolescents and children 8 years or older weighing at least 45 kg: 100 mg orally twice a day for 7 days

Comments:
-Recommended in combination with ceftriaxone
-The patient's sexual partner(s) should also be evaluated/treated.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Epididymitis - Sexually Transmitted

AAP and US CDC Recommendations:
-Adolescents: 100 mg orally twice a day for 10 days

Comments:
-With ceftriaxone, the recommended regimen for acute epididymitis most likely due to sexually transmitted chlamydia and gonorrhea
-The patient's sexual partner(s) should also be evaluated/treated.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Lyme Disease - Arthritis

IDSA Recommendations:
8 years or older: 2 mg/kg orally twice a day
Maximum dose: 100 mg/dose

Duration of Therapy:
-Acrodermatitis chronica atrophicans: 21 days
-Cardiac disease: 14 to 21 days
-Erythema migrans: 10 to 21 days
-Lyme arthritis: 28 days

Comments:
-Recommended for the treatment of early localized or early disseminated Lyme disease associated with erythema migrans when specific neurologic manifestations or advanced atrioventricular heart block absent, uncomplicated Lyme arthritis in patients without clinical evidence of neurologic disease, patients with atrioventricular heart block and/or myopericarditis associated with early Lyme disease, and acrodermatitis chronica atrophicans
-A parenteral antibiotic (e.g., ceftriaxone) is recommended as initial treatment of patients hospitalized for cardiac monitoring; an oral regimen may be used for completion of therapy and for ambulatory patients.
-Current guidelines should be consulted for additional information.

Precautions

Consult WARNINGS section for additional precautions.

Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • A headache, nausea, dyspepsia, joint or back pain, nasal and sinus congestion, a rash, are the more commonly reported side effects.
  • Some people may find they are more sensitive to the sun while taking doxycycline.
  • Tetracyclines, including doxycycline, form a stable calcium complex in bone-forming tissue. This can affect the growth rate of the fibula in young children and skeletal development in the fetus.
  • Can cause permanent tooth discoloration (typically a yellow-gray-brown staining) or enamel hypoplasia (underdeveloped tooth enamel) if used during critical periods of tooth development, such as the last half of pregnancy or in children aged less than eight years. The risk is greater with long-term use but has been noted after short-term use.
  • Clostridium difficile-associated diarrhea, a severe, persistent diarrhea has been associated with most antibiotics, including doxycycline. Seek medical advice if persistent diarrhea occurs within two months of antibiotic use.
  • Use of antibiotics, such as doxycycline, has been associated with an increased risk of vaginal candidiasis (thrush).
  • Cross-resistance is common - this means that if bacteria are resistant to another type of tetracycline, they will likely be resistant to doxycycline.
  • May not be suitable for some people including pregnant or lactating women and children aged less than eight years.
  • May interact with some drugs including anticoagulants, penicillins, antacids or iron-containing preparations, antiepileptics, and oral contraceptives.

Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.

Bottom Line

Doxycycline is an effective antibiotic that treats a wide variety of infections; however, it is not usually recommended for children aged less than eight nor in pregnant women in the last half of pregnancy.

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