Doxycycline Monohyd 25mg/5ml Susp

Doxycycline is a broad-spectrum tetracycline antibiotic that inhibits bacterial protein synthesis by reversibly binding to the 30S ribosomal subunit, thereby preventing the attachment of aminoacyl-tRNA to the ribosomal acceptor site. This action prevents the addition of amino acids to the growing peptide chain, leading to bacteriostatic effects.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of liver problems, including:
+ Dark urine
+ Tiredness
+ Decreased appetite
+ Upset stomach or stomach pain
+ Light-colored stools
+ Vomiting
+ Yellow skin or eyes
Signs of pancreatitis (pancreas problem), such as:
+ Severe stomach pain
+ Severe back pain
+ Severe upset stomach or vomiting
Chest pain or pressure
Fast heartbeat
Difficulty urinating or changes in urine output
Fever, chills, or sore throat
Unexplained bruising or bleeding
Feeling extremely tired or weak
Throat irritation
Trouble swallowing
Muscle or joint pain
Rapid breathing
Flushing
Severe dizziness or fainting
Changes in skin color
Vaginal itching or discharge

Important Antibiotic-Related Side Effect:

Diarrhea is a common side effect of antibiotics. However, in rare cases, a severe form of diarrhea called Clostridioides difficile-associated diarrhea (CDAD) may occur. This condition can lead to a life-threatening bowel problem. If you experience stomach pain, cramps, or loose, watery, or bloody stools, contact your doctor immediately. Before treating diarrhea, consult with your doctor.

Rare but Serious Side Effect:

Raised pressure in the brain has been reported with this medication. In most cases, this condition resolves after stopping the medication. However, in some instances, vision loss may occur and may be permanent. If you experience a headache or vision problems, such as blurred vision, double vision, or loss of vision, seek medical attention immediately.

Other Possible Side Effects:

Most people do not experience significant side effects or only have mild side effects. However, if you notice any of the following side effects or any other unusual symptoms, contact your doctor or seek medical attention:

Diarrhea
Upset stomach
Vomiting
* Decreased appetite

Reporting Side Effects:

If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced.
If you are currently taking any of the following medications: Acitretin, Isotretinoin, or a Penicillin.
* If you are breastfeeding or plan to breastfeed, as you may need to avoid breastfeeding while taking this medication.

This list is not exhaustive, and it is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. They will help you determine if it is safe to take this medication with your other medications and health conditions.

Remember, do not start, stop, or change the dose of any medication without first consulting your doctor to ensure your safety.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. If you are on long-term treatment with this drug, your doctor may recommend regular blood tests to monitor your condition.

This medication may interfere with certain laboratory tests, so it is crucial to notify all your healthcare providers and lab personnel that you are taking this drug. Do not exceed the prescribed duration of treatment, as this may increase the risk of a second infection.

You may be more susceptible to sunburn while taking this medication, so take necessary precautions when exposed to the sun. If you experience unusual sunburn or sensitivity, inform your doctor promptly.

There is a risk of severe skin reactions associated with this medication, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and other serious conditions that can affect internal organs. These reactions can be life-threatening. Seek immediate medical attention if you experience symptoms such as red, swollen, blistered, or peeling skin; red or irritated eyes; sores in your mouth, throat, nose, eyes, genitals, or skin; fever; chills; body aches; shortness of breath; or swollen glands.

If you are using birth control pills or other hormone-based contraception, note that this medication may reduce their effectiveness. Consider using an additional form of birth control, such as a condom, to prevent pregnancy.

In children under 8 years old, this medication may cause permanent tooth discoloration (yellow-gray brown) or affect tooth development. Additionally, bone growth may be impacted. If you have concerns, discuss them with your doctor. It is generally recommended to avoid using this medication in children under 8 years old, unless deemed necessary by a healthcare professional.

Tooth discoloration has also been reported in adults, but this condition may be reversible after stopping the medication and undergoing dental cleaning. Consult your doctor if you have any questions or concerns.

If you are pregnant or become pregnant while taking this medication, you should contact your doctor immediately, as it may harm the unborn baby.

• Antacids (containing aluminum, calcium, magnesium): Decreased doxycycline absorption.
• Iron preparations: Decreased doxycycline absorption.
• Bismuth subsalicylate: Decreased doxycycline absorption.
• Oral retinoids (e.g., isotretinoin, acitretin): Increased risk of pseudotumor cerebri (benign intracranial hypertension).
• Penicillins: Tetracyclines may interfere with the bactericidal action of penicillins.
• Warfarin: May potentiate anticoagulant effects (monitor INR).

• Barbiturates (e.g., phenobarbital): Decreased doxycycline half-life.
• Carbamazepine: Decreased doxycycline half-life.
• Phenytoin: Decreased doxycycline half-life.
• Oral contraceptives: May decrease efficacy of oral contraceptives (advise backup method).
• Methotrexate: May increase methotrexate toxicity (tetracyclines can reduce renal clearance of methotrexate).
• Ergot alkaloids: Possible increased risk of ergotism.

• Dairy products: While less significant than with other tetracyclines, large amounts may slightly reduce absorption if taken concurrently.

• Diarrhea (especially severe or persistent)
• Abdominal pain
• Nausea/vomiting
• Esophageal irritation/dysphagia (less common with suspension)
• Skin rash/hives
• Sunburn-like reaction (photosensitivity)
• Headache
• Blurred vision or double vision (signs of intracranial hypertension)
• Yellowing of skin or eyes (jaundice)
• Dark urine
• Unusual tiredness or weakness

Contraindicated during pregnancy, especially during the second and third trimesters, due to the risk of permanent tooth discoloration (yellow-gray-brown) and inhibition of bone growth in the fetus. Use only if the potential benefit justifies the potential risk to the fetus in severe or life-threatening conditions where safer alternatives are not available.

Doxycycline is excreted into breast milk. While the amount is generally low and calcium in milk may chelate the drug, there is a theoretical risk of tooth discoloration and inhibition of bone growth in the nursing infant. The American Academy of Pediatrics considers tetracyclines to be compatible with breastfeeding with caution. However, it is generally recommended to avoid or use with caution, or consider an alternative, especially for long-term use. Monitor infant for diarrhea, candidiasis, and tooth discoloration.

Contraindicated in children under 8 years of age due to the risk of permanent tooth discoloration (yellow-gray-brown) and inhibition of bone growth. In severe or life-threatening infections (e.g., anthrax, Rocky Mountain spotted fever) where the benefits outweigh the risks, it may be used under strict medical supervision.

No specific dose adjustment is generally needed based on age alone. However, elderly patients may be more susceptible to adverse effects such as gastrointestinal disturbances or photosensitivity. Monitor for renal and hepatic function, although doxycycline is largely eliminated non-renally.

• Doxycycline is unique among tetracyclines for its relatively good absorption even with food/dairy, though it's still best to avoid co-administration with antacids/iron.
• Always advise patients to take with plenty of water and remain upright to prevent esophageal irritation and ulceration.
• The 25mg/5ml suspension is particularly useful for pediatric dosing (in children ≥8 years) or for lower adult doses where precise titration is needed.
• It has anti-inflammatory properties at sub-antimicrobial doses (e.g., 20 mg BID or 40 mg once daily modified-release) used for acne and rosacea.
• Photosensitivity is a common side effect; emphasize sun protection.
• Despite its broad spectrum, it is not effective against all bacteria and should be used judiciously to prevent resistance.

• Azithromycin (for some respiratory/skin infections, STIs)
• Amoxicillin (for some respiratory/skin infections)
• Ciprofloxacin (for some UTIs, respiratory infections)
• Clindamycin (for some skin/soft tissue infections)
• Minocycline (another tetracycline, often used for acne)
• Tigecycline (glycylcycline, for complicated infections)

If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure safe and effective treatment, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the overdose, including the medication taken, the amount, and the time it occurred.