Skip to content

Tetracycline

    Brands

    DEA Class; Rx

    Common Brand Names; Sumycin, Actisite, Achromycin V

    • Tetracyclines

    Semisynthetic tetracycline agent produced from chlortetracycline; wide spectrum of activity vs. gram-negative and gram-positive organisms; inactive against viruses and fungi.

    Indicated for the treatment of necrotizing ulcerative gingivitis (Fusospirochetosis or Vincent’s infection) and listeriosis (Listeria monocytogenes) when penicillin is contraindicated.

    For the treatment of necrotizing ulcerative gingivitis (Fusospirochetosis or Vincent’s infection) and listeriosis (Listeria monocytogenes) when penicillin is contraindicated.

    For the treatment of yaws when penicillin is contraindicated.

    Brucellosis

    500 mg PO q6hr for 3 weeks accompanied by streptomycin, 1 g IM BID for the first week, THEN qDay the second week

    Indicated for Syphilis, Gonorrhea, Uncomplicated urethral, endocervical or rectal infections

    Documented hypersensitivity

    Severe hepatic dysfunction

    Pregnancy 2nd and 3rd trimesters

    • Gastrointestinal: anorexia, nausea, epigastric distress, vomiting, diarrhea, glossitis, esophagitis, esophageal ulceration, black hairy tongue, dysphagia, enterocolitis, and inflammatory lesions (with Candida overgrowth) in the anogenital region
    • Teeth: Permanent discoloration of teeth, enamel hypoplasia
    • Skin: Maculopapular and erythematous rashes, exfoliative dermatitis, onycholysis and discoloration of the nails, photosensitivity
    • Renal toxicity: Increased BUN (dose-related)
    • Liver: Hepatotoxicity, liver failure
    • Hypersensitivity reactions: Urticaria, angioneurotic edema, anaphylaxis, anaphylactoid purpura, pericarditis, exacerbation of systemic lupus erythematosus, and serum sickness-like reactions, as fever, rash, and arthralgia
    • Blood: Hemolytic anemia, thrombocytopenia, thrombocytopenic purpura, neutropenia and eosinophilia have been reported

    Photosensitivity may occur with prolonged exposure to sunlight or tanning equipment

    Reduce dose in renal impairment

    Consider drug serum level determinations in prolonged therapy

    Tetracycline use during tooth development (last half of pregnancy through age 8 years) can cause permanent discoloration of teeth

    Antianabolic action of the tetracyclines may cause an increase in BUN; in patients with significantly impaired renal function, higher serum levels of tetracycline may lead to azotemia, hyperphosphatemia and acidosis

    Fanconi-like syndrome may occur with outdated tetracyclines

    Intracranial hypertension (IH, pseudotumor cerebri) has been associated with the use of tetracyclines; although IH typically resolve after discontinuing treatment, the possibility for permanent visual loss exists; if visual disturbance occurs during treatment, prompt ophthalmologic evaluation is warranted

    All tetracyclines form a stable calcium complex in any bone forming tissue; decrease in fibula growth rate has been observed in premature infants given oral tetracycline in doses of 25 mg/kg q6hr; reaction was shown to be reversible when discontinuing drug

    IV/IM no longer commercially available

    Pregnancy

    Avoid 1st trimester; contraindicated 2nd and 3rd trimesters

    Pregnant women with renal disease may be more prone to develop tetracycline-associated liver failure

    The effect of tetracyclines on labor and delivery is unknown

    Lactation

    Short-term use of tetracycline is acceptable in nursing mothers

    A number of reviews have stated that tetracycline is contraindicated during breastfeeding because of possible staining of infants’ dental enamel or bone deposition of tetracyclines; however, a close examination of available literature indicates that there is not likely to be harm in short-term use of tetracycline during lactation because milk levels are low and absorption by the infant is inhibited by the calcium in breast milk

    Adults

    2 g/day PO.

    Geriatric

    2 g/day PO.

    Adolescents

    50 mg/kg/day PO (Max: 2 g/day).

    Children

    9 to 12 years: 50 mg/kg/day (Max: 2 g/day) PO.
    1 to 8 years: Safety and efficacy have not been established; however, doses up to 40 mg/kg/day (Max: 2 g/day) PO have been used off-label.

    Infants

    Safety and efficacy have not been established; however, doses up to 40 mg/kg/day PO have been used off-label.

    Neonates

    Safety and efficacy have not been established.

    Tetracycline hydrochloride

    capsule/tablet

    • 250mg
    • 500mg