doxycycline

CLINICAL USE

Antibacterial agentProphylaxis/treatment of malaria

DOSE IN NORMAL RENAL FUNCTION

200 mg on day 1, then 100 mg daily; severe infections 200 mg dailyLate latent syphilis: 200 mg twice daily Malaria: treatment: 200 mg once daily; prophylaxis: 100 mg daily

PHARMACOKINETICS

Molecular weight :462.4

%Protein binding :>90

%Excreted unchanged in urine : 33–45

Volume of distribution (L/kg) :0.7

half-life – normal/ESRD (hrs) :18/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Dose as in normal renal function

HD :Not dialysed. Dose as in normal renal function

HDF/high flux :Unknown dialysability. Dose as in normal renal function

CAV/VVHD :Not dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Anticoagulants: possibly enhanced anticoagulant effect of coumarins and phenindione

Ciclosporin: possibly increases plasma- ciclosporin concentration

Oestrogens: 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

Do not take iron preparations, indigestion remedies or phosphate binders at the same time of day as doxycycline.

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