Doxycycline Monohydrate 50mg Caps

Doxycycline is a bacteriostatic 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, ultimately inhibiting bacterial growth and replication. It also exhibits anti-inflammatory properties at sub-antimicrobial doses.

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 immediate medical attention:

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
+ Difficulty breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of liver problems, including:
+ Dark urine
+ Fatigue
+ 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
Rapid heartbeat
Difficulty urinating or changes in urine output
Fever, chills, or sore throat
Unexplained bruising or bleeding
Feeling extremely tired or weak
Throat irritation
Difficulty swallowing
Muscle or joint pain
Rapid breathing
Flushing
Severe dizziness or fainting
Changes in skin color
Vaginal itching or discharge
Diarrhea (common with antibiotics), especially if severe or accompanied by:
+ Stomach pain
+ Cramps
+ Watery, bloody, or loose stools
+ Note: Rarely, a severe form of diarrhea called C. diff-associated diarrhea (CDAD) may occur, which can lead to a life-threatening bowel problem. If you experience any of these symptoms, contact your doctor immediately.

Other Possible Side Effects

Most people experience no side effects or only mild ones. However, if you notice any of the following side effects or if they persist or bother you, contact your doctor:

Diarrhea
Upset stomach
Vomiting
Decreased appetite

Reporting Side Effects

This is not an exhaustive list of potential 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, over-the-counter, natural products, and vitamins) and health issues with your doctor and pharmacist. They will help 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.

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 laboratory 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.

Be aware that this medication can increase your sensitivity to the sun, making you more prone to sunburn. Take necessary precautions when exposed to sunlight, and inform your doctor if you experience any unusual sunburn or sensitivity.

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. These reactions can be life-threatening and may also affect internal organs. Seek immediate medical attention if you experience any 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 can cause permanent tooth discoloration, turning teeth yellow-gray brown. Similarly, if taken during certain stages of pregnancy, it can affect the unborn baby's teeth. This tooth discoloration is irreversible. Additionally, this medication may lead to other tooth problems and affect bone growth in these individuals. If you have concerns, discuss them with your doctor.

Generally, this medication is not recommended for children under 8 years old, except in specific circumstances. Consult with your doctor to determine the best course of treatment.

In some cases, adults have also experienced tooth discoloration, which has been reported to reverse after stopping the medication and undergoing dental cleaning. If you have concerns, discuss them with your doctor.

If you are pregnant or become pregnant while taking this medication, it is essential to inform your doctor immediately, as it may harm the unborn baby.

• Antacids (containing aluminum, calcium, magnesium): Decreased doxycycline absorption.
• Iron preparations (oral): Decreased doxycycline absorption.
• Bismuth subsalicylate: Decreased doxycycline absorption.
• Oral retinoids (e.g., Isotretinoin, Acitretin): Increased risk of pseudotumor cerebri (benign intracranial hypertension).
• Penicillins: May antagonize the bactericidal effect of penicillin (due to bacteriostatic action of doxycycline).
• Live bacterial vaccines (e.g., Typhoid, Cholera): May decrease vaccine efficacy.

• Oral Contraceptives: May decrease efficacy of oral contraceptives (though evidence is weak and controversial).
• Warfarin: May enhance anticoagulant effect (monitor INR).
• Methotrexate: May increase methotrexate toxicity.
• Ergot alkaloids: Increased risk of ergotism.
• Barbiturates, Carbamazepine, Phenytoin: May decrease doxycycline half-life due to enzyme induction.

• Digoxin: May increase digoxin levels in some patients (rare).

• Nausea
• Vomiting
• Diarrhea
• Abdominal pain
• Heartburn/Esophageal irritation
• Photosensitivity (severe sunburn-like reaction)
• Rash
• Headache
• Blurred vision or visual disturbances (signs of pseudotumor cerebri)
• Vaginal yeast infection (candidiasis)
• Oral thrush

Doxycycline is classified as Pregnancy Category D. It should be avoided 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.

Doxycycline is excreted into breast milk. While generally considered compatible with breastfeeding for short-term use (L3), caution is advised. Long-term or repeated use should be avoided due to theoretical concerns of tooth discoloration and bone growth effects in the infant.

Contraindicated in children under 8 years of age due to the risk of permanent tooth discoloration (yellow-gray-brown) and inhibition of bone growth. Use in children 8 years and older should be carefully weighed against potential risks.

No specific dose adjustment is generally required for elderly patients. However, caution should be exercised in patients with pre-existing hepatic impairment. Elderly patients may be more susceptible to adverse effects like esophageal irritation or photosensitivity.

• Always advise patients to take doxycycline with a full glass of water and to remain upright for at least 30 minutes to minimize the risk of esophageal irritation and ulceration.
• Educate patients thoroughly about photosensitivity and the importance of sun protection (sunscreen, protective clothing, avoiding peak sun hours).
• Remind patients to avoid dairy products, antacids, and iron supplements for several hours before and after taking doxycycline to ensure optimal absorption.
• For acne/rosacea, emphasize that the effects are often anti-inflammatory rather than purely antimicrobial at lower doses, and it may take weeks to see improvement.
• Doxycycline is a good option for patients with renal impairment as it is primarily eliminated non-renally.

• Other tetracyclines (e.g., Minocycline, Tetracycline)
• Macrolide antibiotics (e.g., Azithromycin, Erythromycin, Clarithromycin) for susceptible infections
• Fluoroquinolone antibiotics (e.g., Ciprofloxacin, Levofloxacin) for susceptible infections
• Beta-lactam antibiotics (e.g., Penicillins, Cephalosporins) for susceptible infections
• For acne: Topical retinoids, topical antibiotics (e.g., clindamycin, erythromycin), benzoyl peroxide, oral isotretinoin (for severe acne).
• For rosacea: Topical metronidazole, azelaic acid, ivermectin cream.

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