Doxycycline Monohydrate 75mg Caps

Doxycycline is a broad-spectrum tetracycline antibiotic that inhibits bacterial protein synthesis by reversibly binding to the 30S ribosomal subunit, thereby preventing the binding of aminoacyl tRNA to the mRNA-ribosome complex. This action prevents the addition of new amino acids to the growing peptide chain, leading to bacteriostasis. At sub-antimicrobial doses (e.g., for rosacea), it exhibits anti-inflammatory properties by inhibiting matrix metalloproteinases (MMPs) and other inflammatory mediators.

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: 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, or swelling of the mouth, face, lips, tongue, or throat
Signs of liver problems: dark urine, fatigue, decreased appetite, stomach pain or upset, light-colored stools, vomiting, or yellow skin or eyes
Signs of pancreatitis (pancreas problem): severe stomach pain, severe back pain, or severe stomach upset or vomiting
Chest pain or pressure, or a rapid heartbeat
Difficulty urinating or changes in urine output
Fever, chills, sore throat, unexplained bruising or bleeding, or feeling extremely tired or weak
Throat irritation or 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 it's severe, bloody, or watery (may be a sign of C. diff-associated diarrhea, a potentially life-threatening condition)

If you experience any of these symptoms, contact your doctor right away.

Additional Important Warnings

C. diff-associated diarrhea (CDAD) may occur during or after antibiotic treatment, which can lead to a life-threatening bowel condition. If you experience stomach pain, cramps, or severe diarrhea, contact your doctor immediately.
Raised pressure in the brain has been reported with this medication, which may cause headaches or vision problems (such as blurred vision, double vision, or loss of vision). If you experience any of these symptoms, contact your doctor right away.

Other Possible Side Effects

Not everyone will experience side effects, and many people may only have mild symptoms. However, if you notice any of the following side effects or if they bother you or persist, contact your doctor:

Diarrhea, stomach upset, or 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 doing so 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. Never start, stop, or adjust the dosage 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 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.

Be aware that this medication can make you more susceptible to sunburn. Take necessary precautions when exposed to the sun, and consult your doctor if you experience 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 reactions. These reactions can be life-threatening and may also affect internal organs. 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 birth control methods, 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. This effect can also occur in unborn babies if the mother takes the medication during certain stages of pregnancy. Additionally, this medication may affect tooth development and 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, but there may be exceptions. Consult 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, consult your doctor.

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

• Isotretinoin (increased risk of pseudotumor cerebri)
• Acitretin (increased risk of pseudotumor cerebri)

• Antacids (containing aluminum, calcium, magnesium): Decreased doxycycline absorption
• Iron preparations (oral): Decreased doxycycline absorption
• Bismuth subsalicylate: Decreased doxycycline absorption
• Warfarin: Potentiation of anticoagulant effect (monitor INR)
• Penicillins: May interfere with the bactericidal action of penicillin (avoid concomitant use if possible)
• Live bacterial vaccines (e.g., oral typhoid vaccine): May reduce vaccine efficacy

• Oral contraceptives: Theoretical reduction in efficacy (evidence is weak, but advise backup contraception)
• Barbiturates (e.g., phenobarbital): Decreased doxycycline half-life
• Carbamazepine: Decreased doxycycline half-life
• Phenytoin: Decreased doxycycline half-life
• Methoxyflurane: Increased risk of nephrotoxicity

• Severe diarrhea (may indicate C. difficile infection)
• New or worsening headache, blurred vision, or diplopia (may indicate pseudotumor cerebri)
• Severe skin rash or blistering (may indicate severe cutaneous adverse reactions)
• Yellowing of skin or eyes, dark urine, persistent nausea/vomiting (signs of liver dysfunction)
• Increased sensitivity to sunlight (photosensitivity)

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 the amount transferred is generally low and binding to calcium in milk may limit absorption by the infant, the potential for tooth discoloration and inhibition of bone growth in the nursing infant remains a concern, especially with long-term or repeated use. The American Academy of Pediatrics considers tetracyclines compatible with breastfeeding with caution. LactMed rates it L3 (moderate risk).

Contraindicated in children under 8 years of age due to the risk of permanent tooth discoloration (yellow-gray-brown) and reversible inhibition of bone growth. Use in children < 8 years only when other drugs are contraindicated or ineffective, such as for anthrax or Rocky Mountain spotted fever. For children > 8 years, dosing is weight-based.

Generally well-tolerated in geriatric patients. No specific dose adjustment is typically required based on age alone, but monitor for age-related decreases in renal or hepatic function and potential for increased photosensitivity or gastrointestinal upset.

• Always advise patients to take doxycycline with a full glass of water and to remain upright for at least 30-60 minutes to prevent esophageal irritation and ulceration.
• Emphasize strict sun protection due to significant photosensitivity risk.
• Doxycycline monohydrate is generally better tolerated gastrointestinally than doxycycline hyclate and its absorption is less affected by food/dairy.
• Unlike other tetracyclines, doxycycline does not accumulate significantly in patients with renal impairment, making it a preferred tetracycline in this population.
• For acne and rosacea, the anti-inflammatory effects at sub-antimicrobial doses are key, not just the antibacterial action.

• Other tetracyclines (e.g., minocycline, tetracycline)
• Macrolides (e.g., azithromycin, erythromycin - for certain infections)
• Beta-lactam antibiotics (e.g., penicillins, cephalosporins - for susceptible infections)
• Topical antibiotics (e.g., clindamycin, erythromycin - for acne/rosacea)
• Topical anti-inflammatory agents (e.g., metronidazole, azelaic acid - for rosacea)
• Oral retinoids (e.g., isotretinoin - for severe acne, but contraindicated with doxycycline)

If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. 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 it is a good idea to consult with your pharmacist. If you have any questions or concerns about this medication, do not 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 detailed information about the overdose, including the medication taken, the amount, and the time it occurred.