Doxycycline Alcohol

Drugs that may affect barbiturates include alcohol, charcoal, chloramphenicol, MAO inhibitors, rifampin, and valproic acid. Drugs that may be affected by barbiturates include acetaminophen, anticoagulants, beta blockers, carbamazepine, chloramphenicol, clonazepam, oral contraceptives, corticosteroids, digitoxin, doxorubicin, doxycycline, felodipine, fenoprofen, griseofulvin, hydantoins, methoxyflurane, metronidazole, narcotics, phenmetrazine, phenylbutazone, quinidine, theophylline, and verapamil. 

The alcohol 5 was the common intermediate for both syntheses. For the deoxy series, 5 was carried on to the enone 6. Conjugate addition of the anion 7 proceeded with remarkable diastereoselectivity, to give, after intramolecular acylation and deprotection, doxycycline 9. 

HA, mild pain Action Nonnarco tic analgesic w/ barbiturate Dose 1—2 tabs or caps PO q4-6h PRN i in renal/hepatic impair 4 g/24 h APAP max Caution [C, D, +] Alcoholic liver Dz Contra G6PD deficiency Disp Caps, Liq, tabs SE Drowsiness, dizziness, hangover effect Interactions T Effects OF benzodiazepines, opiate analgesics, sedatives/hypnotics, EtOH, methylphenidate hydrochloride i effects OF MAOIs, TCAs, corticosteroids, theophylline, OCPs, BBs, doxycycline EMS See Acetaminophen may impair coordination, monitor for depression concurrent EtOH use T CNS depression butalbital is habit forming... 

Can I drink alcohol if I am taking ciprofloxacin, doxycycline, or amoxicillin ... 

Doxycycline serum levels may fall below minimum therapeutic concentrations in alcoholic patients, but tetracycline is not affected. There is nothing to surest that moderate amounts of alcohol have a clinically relevant effect on the serum levels of any tetracycline in non-alcoholic subjects. 

A study into the effects of alcohol on doxycycline and tetracycline pharmacokinetics found that the half-life of doxycycline was 10.5 hours in 6 alcoholics (with normal liver function) compared with 14.7 hours in 6 healthy subjects. The serum doxycycline levels of 3 of the alcoholic patients fell below the generally accepted minimum inhibitory concentration at 24 hours. The half-life of tetracycline was the same in both groups. All of the subjects were given doxycycline 100 mg daily after a200-mg loading dose, and tetracycline 500 mg twice daily after an initial 750-mg loading dose. ... 

Another study in healthy subjects found that cheap red wine, but not whisky (both 1 g/kg) delayed the absorption of doxycycline, probably because of the presence of acetic acid, which slows gastric emptying. However, the total absorption was not affected. The authors concluded that acute intake of alcoholic beverages has no clinically relevant effects on the pharmacokinetics of doxycycline. ... 

Heavy drinkers can metabolise some drugs much more quickly than non-drinkers due to the enzyme-inducing effects of alcohol. The interaction with doxycycline would seem to be due to this effect, possibly allied with some reduction in absorption from the gut. 

Information is limited, but the interaction between doxycycline and alcohol appears to be established and of clinical significance in alcoholics but not in non-alcoholic individuals. One possible solution to the problem of enzyme induction is to give alcoholic subjects double the dose of doxycy-cline. Alternatively tetracycline may be a suitable non-interacting alternative. There is nothing to suggest that moderate or even occasional heavy drinking has a clinically relevant effect on any of the tetracyclines in non-alcoholic subjects. 

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