Interactions with supplements
Calcium
Iron
Magnesium
Zinc
Look Up > Drugs > Oxytetracycline
Oxytetracycline
Pronunciation
U.S. Brand Names
Generic Available
Synonyms
Pharmacological Index
Use
Pregnancy Risk Factor
Contraindications
Warnings/Precautions
Adverse Reactions
Overdosage/Toxicology
Drug Interactions
Mechanism of Action
Pharmacodynamics/Kinetics
Usual Dosage
Mental Health: Effects on Mental Status
Mental Health: Effects on Psychiatric Treatment
Dental Health: Local Anesthetic/Vasoconstrictor Precautions
Dental Health: Effects on Dental Treatment
Patient Information
Nursing Implications
Dosage Forms

Pronunciation
(oks i tet ra SYE kleen)

U.S. Brand Names
Terramycin® I.M. Injection; Terramycin® Oral

Generic Available

Yes


Synonyms
Oxytetracycline Hydrochloride

Pharmacological Index

Antibiotic, Tetracycline Derivative


Use

Treatment of susceptible bacterial infections; both gram-positive and gram-negative, as well as, Rickettsia and Mycoplasma organisms


Pregnancy Risk Factor

D


Contraindications

Hypersensitivity to tetracycline or any component


Warnings/Precautions

Avoid in children less than or equal to 8 years of age, pregnant and nursing women; photosensitivity can occur with oxytetracycline


Adverse Reactions

>10%: Miscellaneous: Discoloration of teeth and enamel hypoplasia (infants)

1% to 10%:

Dermatologic: Photosensitivity

Gastrointestinal: Nausea, diarrhea

<1%: Pericarditis, increased intracranial pressure, bulging fontanels in infants, pseudotumor cerebri, pruritus, exfoliative dermatitis, dermatologic effects, diabetes insipidus syndrome, vomiting, esophagitis, anorexia, abdominal cramps, antibiotic-associated pseudomembranous colitis, staphylococcal enterocolitis, hepatotoxicity, thrombophlebitis, paresthesia, renal damage, acute renal failure, azotemia, superinfections, anaphylaxis, pigmentation of nails, hypersensitivity reactions, candidal superinfection


Overdosage/Toxicology

Symptoms of overdose include nausea, anorexia, diarrhea

Following GI decontamination, supportive care only


Drug Interactions

Decreased effect with antacids containing aluminum, calcium or magnesium

Iron and bismuth subsalicylate may decrease doxycycline bioavailability

Barbiturates, phenytoin, and carbamazepine decrease doxycycline's half-life

Increased effect of warfarin


Mechanism of Action

Inhibits bacterial protein synthesis by binding with the 30S and possibly the 50S ribosomal subunit(s) of susceptible bacteria, cell wall synthesis is not affected


Pharmacodynamics/Kinetics

Absorption: Oral: Adequate (~75%); I.M.: Poor

Distribution: Crosses the placenta

Metabolism: Small amounts in the liver

Half-life: 8.5-9.6 hours (increases with renal impairment)

Time to peak serum concentration: Within 2-4 hours

Elimination: In urine, while much higher amounts can be found in bile


Usual Dosage

Oral:

Children >8 years: 40-50 mg/kg/day in divided doses every 6 hours (maximum: 2 g/24 hours)

Adults: 250-500 mg/dose every 6-12 hours depending on severity of the infection

I.M.:

Children >8 years: 15-25 mg/kg/day (maximum: 250 mg/dose) in divided doses every 8-12 hours

Adults: 250 mg every 24 hours or 300 mg/day divided every 8-12 hours

Syphilis: 30-40 g in divided doses over 10-15 days

Gonorrhea: 1.5 g, then 500 mg every 6 hours for total of 9 g

Uncomplicated chlamydial infections: 500 mg every 6 hours for 7 days

Severe acne: 1 g/day then decrease to 125-500 mg/day

Dosing interval in renal impairment:

Clcr <10 mL/minute: Administer every 24 hours or avoid use if possible

Dosing adjustment/comments in hepatic impairment: Avoid use in patients with severe liver disease


Mental Health: Effects on Mental Status

Case reports of tetracyclines report memory disturbances, mood stabilizing and antidepressant effects


Mental Health: Effects on Psychiatric Treatment

Barbiturates and carbamazepine may decrease the effects of oxytetracycline; may decrease lithium clearance resulting in an increase in serum lithium levels and potential lithium toxicity; monitor serum lithium levels


Dental Health: Local Anesthetic/Vasoconstrictor Precautions

No information available to require special precautions


Dental Health: Effects on Dental Treatment

Tetracyclines are not recommended for use during pregnancy or in children less than or equal to 8 years of age since they have been reported to cause enamel hypoplasia and permanent teeth discoloration. Tetracyclines should only be used in these patients if other agents are contraindicated or alternative antimicrobials will not eradicate the organism. Long-term use associated with oral candidiasis.


Patient Information

Take as directed, around-the-clock. Finish all doses; do not skip doses. May take with food to reduce GI upset. Do not take with antacids, iron products, or dairy products. You may be sensitive to sunlight; use sunblock, wear protective clothing, or avoid direct sun. If diabetic, drug may cause false tests with Clinitest® urine glucose monitoring; use of glucose oxidase methods (Clinistix®) or serum glucose monitoring is preferable. Report rash, difficulty breathing, yellowing of skin or eyes, change in color of urine or stool, easy bruising or bleeding, fever, chills, perianal itching, purulent vaginal discharge, white plaques in mouth, or persistent diarrhea. Pregnancy/breast-feeding precautions: Do not get pregnant while taking this medication - Oral contraceptives effectiveness may be reduced; use appropriate barrier contraceptive measures. Breast-feeding is not recommended.


Nursing Implications

Injection for intramuscular use only; reduce dose in renal insufficiency


Dosage Forms

Capsule, as hydrochloride: 250 mg

Injection, as hydrochloride, with lidocaine 2%: 5% [50 mg/mL] (2 mL, 10 mL); 12.5% [125 mg/mL] (2 mL)


Copyright © 1978-2000 Lexi-Comp Inc. All Rights Reserved