Demeclocycline Hydrochloride
Indications
Demeclocycline Hydrochloride is used for:
Atypical pneumonia, Hyponatraemia
Adult Dose
Oral
Susceptible infections
Adult: 600 mg daily in 2 or 4 divided doses.
Atypical pneumonia
Adult: 900 mg daily in 3 divided doses for 6 days.
Chronic hyponatraemia associated with syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Adult: Initially, 900-1,200 mg daily in divided doses. Maintenance: 600-900 mg daily in divided doses.
Hepatic impairment: Max: 1 g daily.
Child Dose
Child: Not recommended for childn <12 yr.
Renal Dose
Administration
Should be taken on an empty stomach. Take w/ a full glass of water on an empty stomach at least 1 hr before or 2 hr after meals.
Contra Indications
Hypersensitivity. Pregnancy and lactation.
Precautions
Children <12 yr; SLE; renal or hepatic disease.
Lactation: enters breast milk/not recommended by manufacturer
Pregnancy-Lactation
Pregnancy
Avoid during pregnancy; use alternant antibiotics
Tetracycline use during tooth development (last one-half of pregnancy through age 8 y) can cause permanent discoloration of teeth
Lactation
Tetracyclines are excreted in breastmilk
Avoided in breastfeeding women due to theoretical concerns that they may permanently stain the teeth of the breastfed infants
Interactions
Reduced absorption w/ antacids containing Al, Mg, or Ca, Fe-containing preparations, zinc, kaolin, quinapril, strontium ranelate, sucralfate, tripotassium dicitratobismuthate. May reduce the efficacy of oral contraceptives and penicillins. Increased risk of benign intracranial HTN w/ retinoids (e.g. acitretin, isotretinoin, tretinoin). Increased risk of ergotism w/ ergotamine and methysergide. May inactivate oral typhoid vaccine. May potentiate the effect of anticoagulants.
Potentially Fatal: Concurrent use w/ methoxyflurane may result to fatal renal toxicity.
Adverse Effects
Side effects of Demeclocycline Hydrochloride :
Photosensitivity. Reversible nephrogenic diabetes insipidus. Permanent staining of teeth; nausea; rash; GI upsets; dysphagia; enterocolitis; anogenital inflammation (moniliasis). Hypersensitivity; haemolytic anaemia, thrombocytopenia, neutropenia and eosinophilia; raised blood urea and liver enzymes.
Potentially Fatal: Anaphylaxis (rare).
Mechanism of Action
Demeclocycline inhibits protein synthesis by binding w/ the 30S and possibly the 50S ribosomal subunits of susceptible bacteria. It may also cause alterations in the cytoplasmic membrane. It inhibits the action of antidiuretic hormone (ADH) in patients w/ chronic syndrome of inappropriate antidiuretic hormone secretion (SIADH).