Demeclocycline hydrochloride

CLINICAL USE

Antibacterial agent:Treatment of syndrome of inappropriate antidiuretic hormone secretion

DOSE IN NORMAL RENAL FUNCTION

150 mg 4 times a day or 300 mg twice daily Syndrome of inappropriate antidiuretic hormone: 900–1200 mg daily in divided dosesMaintenance: 600–900 mg daily in divided doses

PHARMACOKINETICS

Molecular weight :501.3

%Protein binding :41–90

%Excreted unchanged in urine : 42

Volume of distribution (L/kg) :1.7

half-life – normal/ESRD (hrs) :10–15/ 42–68

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : 600 mg every 24–48 hours

<10 : 600 mg every 24–48 hours

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. 600 mg every 48 hours

HD :Dialysed. 600 mg post dialysis

HDF/high flux :Dialysed. 600 mg post dialysis

CAV/VVHD :Unknown dialysability. Dose as in GFR 10 to 20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAnticoagulants: possibly enhanced anticoagulant effect of coumarins and phenindioneOestrogens: possibly reduced contraceptive effects of oestrogens (risk probably small)Retinoids: possible increased risk of benign intracranial hypertension, avoid concomitant use

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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OTHER INFORMATION

Avoid if possible in renal impairment due to its potential nephrotoxicityMay be administered to anuric patients every 3–4 days

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