Doxycycline reaction

Doxycycline (Vibramycin) is an antibiotic belonging to die tetracycline group of antibiotics. The adverse reactions associated with this drug are discussed in Chapter 9 and include photosensitivity, anorexia, nausea, and vomiting. 

Dizziness, vertigo, nausea, and vomiting have been noted particularly with doxycycline at doses above 100 mg. With dosages of 200-400 mg/d of minocycline, 35-70% of patients will have these reactions. 

Supali T et al Doxycycline treatment of Brugia malayi-infected persons reduces microfilaremia and adverse reactions after diethylcarbamazine and albendazole treatment. Clin Infect Dis 2008 46 1385. [PMID 18419441]... 

The American Academy of Pediatrics recommends that doxycycline not be used in children less than 9 years of age because of retarded skeletal growth in infants and discolored teeth in infants and toddlers (Inglesby et al., 2002). Because of the serious nature of anthrax infection, however, Inglesby and colleagues (2002) recommend that doxycycline, instead of ciprofloxacin, be used in children if antibiotic susceptibility testing, exhaustion of drug supplies, or adverse reactions preclude the use of ciprofloxacin. 

A search for an association between doxycycline and polyneuropathy failed to identify any documented cases. An inquiry to the Swedish Adverse Drug Reactions Advisory Committee elicited information about three cases of paresthesia, two cases of sensitivity disturbance, and one case of neuropathy. The last was a man who had had pain and paresthesia in the feet, arms, and face after taking doxycycline 100 mg/day for 2 weeks for prostatitis. The sjmptoms began to wane 1 week after treatment was stopped, and disappeared completely 1 week later. 

A personally experienced case of likely tetracycline-induced liver injury after low-dose tetracycline has been reported (106). The patient took oral doxycycline 200 mg/ day for 8 days and had markedly altered liver function. The liver enzyme activities normalized only 109 days after withdrawal. The authors also reviewed all reports of liver damage to Swedish Adverse Drug Reactions Advisory... 

Rapid i.v. administration of tetracyclines can result in hypotension and collapse. This has been attributed to intravascular chelation of calcium and/or a decrease in blood pressure owing to the drug vehicle. The i.v. administration of doxycycline to horses causes tachycardia, systemic arterial hypertension, collapse and death. This reaction may be caused by the highly lipid-soluble doxycycline chelating intracellular calcium, resulting in cardiac neuromuscular blockade. 

A number of the tetracycline derivatives are phototoxic. In one study, chlortetracycline, doxycycline, and dimethylchlortetracycline treatment of normal human skin fibroblasts resulted in total cell death within 14 days when co-administered with UVA. A dimethylchlortetracycline and UVA cotreatment also showed a strong photosensitizing effect in a 7-day exposure study. These results, too, are consistent with clinically reported reactions in humans J15l... 

Cultured human urinary bladder carcinoma cells treated with doxycycline and UVA showed mitochondrial damage. Cell membrane integrity was maintained for several hours after mitochondrial damage appeared, indicating that the mitochondrion is an earlier target of doxycycline than the cell membrane when irradiated with UVA. The authors of the study opine that the photochemical reaction involves singlet oxygen J1 A... 

Minocycline has better gastrointestinal absorption than tetracycline and may be less photosensitizing than either tetracycline or doxycycline. Side effects of minocycline include dizziness and hyperpigmentation of the skin and mucosa, serum-sickness-like reactions, and drug-induced lupus erythematosus. With all the tetracyclines, vaginal candidiasis is a common complication that is readily treated with local administration of antifungal drugs. 

Structural susceptibilities and structure/activity studies have both inspired a large amount of semi-synthetic vrork to find more stable compounds without loss of antibacterial activity. The less active 6p methyl isomer of doxycycline (6) has been derived from oxytetracycline (3 R = OH) by catalytic reduction.. Treatment of (3) with N-chlorosuccinimide followed by hydrofluoric acid gave the chloro compound (X) which upon catalytic reduction afforded doxycycline (6), the 6a compound together with the less active 6p isomer (refs.250, 251) by saturation of the methylene group and removal of chlorine from (X). Reductive treatment of (X) with sodium hydrosulphite produced methacycline (5). The corresponding 5-deoxy analogues have likewise been derived by using tetracycline (3 R = H) in the same reaction sequences. 

Adverse effects. Adverse effects of quinine include abdominal pain, nausea, tinnitus, headache, blindne.ss and hypersen.siiiviiy reactions, icHu( uinc may cause neuropsychiatric reactions and Matarone or doxycycline are increasingly being used to provide prophylaxis in areas of chioroquinc-resistant P. falcipanim,... 

Any side effect that forces you not to take your medicine is serious enough that you should consult or see your doctor. Serious side effects of ciprofloxacin include seizures, mental confusion, rash that does not go away, or excessive diarrhea. If you have any of these effects, call your doctor. Serious side efl ecLs of doxycycline include jaundice (yellow eyes or skin), rash that does not go away, or excessive diarrhea. If you have any of these effects, call your doctor. Any reaction that cau.ses a rapid. swelling of the lips and face, shortness of breath, or hives is a medical emergency. You should call 911. These types of reactions are extremely rare. 

The ciprofloxacin, doxycycline, or amoxicillin gave me an allergic reaction and I stopped taking it. What should I do ... 

Twelve reports of pregnancies were attributed to the use of tetracyclines (unspecified) and an oral contraceptive (unspecified) in the adverse reactions register of the CSM in the UK for the years 1968 to 1984 (51 cases were attributed to other antibacterials). In an earlier report, the tetracyclines in 6 cases were named as tetracycline and oxytetracycline. A survey of oral contraceptive failure identified 7 failures due to doxycycline, lymecycline or minocycline (37 of a total of 163 cases were attributed to antibacterials), and a follow-up survey identified 3 further cases involving short courses of tetracycline. Similar surveys identified 5 contraceptive failures with tetracycline, " and 2 failures with doxycycline. Breakthrough bleeding was attributed to doxycycline or oxytetracycline in 3 other cases."... 

Skin A 59-year-old woman of African origin took doxycycline as malarial prophylaxis for 3 weeks and developed a drug reaction with eosinophilia and systemic symptoms (DRESS), but patch tests with doxycycline were negative [60 ]. Her HLA phenotype was A3/A30 and B39/B42. 

Mailhol C, Tremeau-Martinage C, Paul C, Godel A, Lamant L, Giordano-Labadie F. Severe drug hypersensitivity reaction (DRESS syndrome) to doxycycline. Ann Dermatol Venereol 2010 137(1) 40-3. 

Immunologic A Jarisch-Herxheimer reaction occurred four times in a 36-year-old man with Q fever pneumonia after treatment with doxycycline, with an acute rise in temperature, tachycardia, tachypnea, hypoxia, hypotension, and temporary deterioration of the chest x-ray on each occasion the reaction lasted for 6 hours [124 ]. 

Shapiro LE, Knowles SR, Shear NH. Comparative safety of tetracycline, minocycline, and doxycycline. Arch Dermatol 1997 133 1224-1230. de Paz S, Perez A, Gomez M, et al. Severe hypersensitivity reaction to minocycline. J Investig Allergol Clin Immunol 1999 9 403-404. 

A rare side effect of tetracycline is photoonycholysis. This reaction was observed in a woman treated for 40 days with doxycycline (200 mg/daUy) (59 ). Contact dermatitis is also a rare complication of tetracycline therapy. Three cases of eczematous contact allergy to oxytetracycline have been reported. Cross-sensitivity to tetracycline and metha-cycline could be demonstrated by patchtesting in these cases (60 ). 

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