Tetracycline

CLINICAL USE

Antibacterial agent

DOSE IN NORMAL RENAL FUNCTION

250–500 mg 4 times a day Acne: 500 mg twice daily

PHARMACOKINETICS

Molecular weight : 444.44

%Protein binding : 20–65

%Excreted unchanged in urine : 55–60

Volume of distribution (L/kg) : >0.7

half-life – normal/ESRD (hrs) : 6–12/57–120

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 : 250 mg 4 times a day

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD : Not dialysed. Dose as in GFR <10 mL/min

HD : Not dialysed. Dose as in GFR <10 mL/min

HDF/high flux : Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD : Unlikely to be dialysed. Dose as in GFR 10 to 20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Anticoagulants: possibly enhance anticoagulant effect of coumarins and phenindione

Oestrogens: possibly reduce contraceptive effects of oestrogens (risk probably small)

Retinoids: possible increased risk of benign intracranial hypertension with retinoids – 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

10% is removed by haemodialysis and 7% by peritoneal dialysis Avoid if possible in renal impairment due to its potential nephrotoxicity and increased risk of azotaemia, hyperphosphataemia and acidosis May cause an increase in blood urea which is dose related Avoid in SLE .

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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