Demeclocycline

BRANDS OF DEMECLOCYCLINE IN KENYA

NB: No brand of Demeclocycline in Kenya


 Demeclocycline in Kenya
Demeclocycline structure:

MODE OF ACTION OF DEMECLOCYCLINE:

Tetracyclines have a broad spectrum of anti-microbial activity and act by interfering with bacterial protein synthesis. They are active against a large number of gram positive and gram negative pathogenic bacteria, including some which are resistant to penicillin.

INDICATIONS

Demeclocycline is indicated in the treatment of infections caused by susceptible strains of the designated microorganisms in the conditions below:

Rocky Mountain spotted fever, typhus fever and the typhus group, Q fever, rickettsialpox and tick fevers caused by rickettsiae;
Respiratory tract infections caused by Mycoplasma pneumoniae
Lymphogranuloma venereum due to Chlamydia trachomatis
Psittacosis (Ornithosis) due to Chlamydia psittaci
Trachoma due to Chlamydia trachomatis, although the infectious agent is not always eliminated as judged by immunofluorescence
Inclusion conjunctivitis caused by Chlamydia trachomatis
Nongonococcal urethritis in adults caused by Ureaplasma urealyticum or Chlamydia trachomatis
Relapsing fever due to Borrelia recurrentis
Chancroid caused by Haemophilus ducreyi
Plague due to Yersinia pestis
Tularemia due to Francisella tularensis
Cholera caused by Vibrio cholerae
Campylobacter fetus infections cause by Campylobacter fetus
Brucellosis due to Brucella species (in conjunction with streptomycin);
Bartonellosis due to Bartonella bacilliformis
Granuloma inguinale caused by Calymmatobacterium granulomatis
Demeclocycline  is indicated for treatment of infections by the following gram-negative microorganisms, when bacteriologic testing indicates appropriate susceptibility to the drug:
Escherichia coli
Enterobacter aerogenes
Shigella species
Acinetobacter species
Respiratory tract infections caused by Haemophilus influenzae
Respiratory tract and urinary tract infections caused by Klebsiella species
Demeclocycline is indicated for treatment of infections caused by the following gram-positive microorganisms, when bacteriologic testing indicates appropriate susceptibility to the drug:
Upper respiratory infections caused by Streptococcus pneumoniae
Skin and skin structure infections caused by Staphylococcus aureus. (Note: Tetracyclines, including demeclocycline, are not the drugs of choice in the treatment of any type of staphylococcal infection).
When penicillin is contraindicated, tetracyclines, including demeclocycline HCl, are alternative drugs in the treatment of the following infections:
Uncomplicated urethritis in men due to Neisseria gonorrhoeae, and for the treatment of other uncomplicated gonococcal infections
Infections in women caused by Neisseria gonorrhoeae
Syphilis caused by Treponema pallidum subspecies pallidum
Yaws caused by Treponema pallidum subspecies pertenue
Listeriosis due to Listeria monocytogenes
Anthrax due to Bacillus anthracis
Vincent’s infection caused by Fusobacterium fusiforme
Actinomycosis caused by Actinomyces israelii
Clostridial diseases caused by Clostridium species
In acute intestinal amebiasis, demeclocycline HCl may be a useful adjunct to amebicides.
In severe acne, demeclocycline HCl may be a useful adjunctive therapy.

CONTRAINDICATIONS:

Hypersensitivity to Demeclocycline.
The use of Demeclocycline is contraindicated in patients with acute porphyria, patients who are pregnant or breast-feeding, children under 12 years of age, patients with a history of hypersensitivity to tetracyclines and patients with renal impairment.

DRUG INTERACTIONS:

  • Because tetracyclines have shown to depress plasma prothrombin activity, patients who are on anticoagulant therapy may require downward adjustment of their anticoagulant dosage.
  • Since bacteriostatic drugs may interfere with the bactericidal action of penicillins, it is advisable to avoid giving tetracycline-class drugs in conjunction with penicillin.
  • Concurrent use of tetracyclines with oral contraceptives may render oral contraceptives less effective.
  • The concurrent use of tetracyclines and methoxyflurane has been reported to result in fatal renal toxicity.
  • Absorption of Demeclocycline is impaired by the concomitant administration of milk and dairy products, food, iron, calcium, zinc, magnesium and particularly aluminium salts commonly used as antacids.
  • Absorption of tetracyclines is possibly reduced by kaolin, quinapril tablets (quinapril tablets contain magnesium carbonate), strontium ranelate, sucralfate, tripotassium dicitratobismuthate.
  • There is a possible increased risk of benign intracranial hypertension with concomitant use of tetracyclines and retinoids, e.g. acitretin, isotretinoin, tretinoin. There is increased risk of ergotism when tetracyclines given with ergotamine and methysergide.
  • Typhoid Vaccine (oral): A in Kenyantibacterials inactivate oral typhoid vaccine and therefore Demeclocycline should be avoided for 3 days before and after oral typhoid vaccine.

ADVERSE DRUG REACTIONS:

The following reactions have been reported in patients receiving tetracyclines:
Gastrointestinal: Anorexia, nausea, vomiting, diarrhea, glossitis, dysphagia, enterocolitis, pancreatitis and inflammatory lesions (with monilial overgrowth) in the anogenital region, increases in liver enzymes, and hepatic toxicity has been reported rarely.
Rarely, hepatitis and liver failure have been reported. These reactions have been caused by both the oral and parenteral administration of tetracyclines.
Instances of esophageal ulcerations have been reported in patients receiving oral tetracyclines. Most of the patients were reported to have taken the medication immediately before lying down
Skin: Maculopapular and erythematous rashes, erythema multiforme. Exfoliative dermatitis has been reported but is uncommon. Fixed drug eruptions and Stevens-Johnson syndrome have been reported rarely. Lesions occurring on the glans penis have caused balanitis. Pigmentation of the skin and mucous membranes has also been reported. Photosensitivity is discussed above .
Renal toxicity: Acute renal failure, rise in BUN has been reported and is apparently dose related, nephrogenic diabetes insipidus
Hypersensitivity reactions: Urticaria, angioneurotic edema, polyarthralgia, anaphylaxis, anaphylactoid purpura, pericarditis exacerbation of systemic lupus erythematosus, lupus-like syndrome, pulmonary infiltrates with eosinophilia.
Hematologic: Hemolytic anemia, thrombocytopenia, neutropenia and eosinophilia have been reported.
CNS: Pseudotumor cerebri (benign intracranial hypertension) in adults and bulging fontanels in infants . Dizziness, headache, tinnitus and visual disturbances have been reported. Myasthenic syndrome has been reported rarely.
Other: When given over prolonged periods, tetracyclines have been reported to produce brown-black microscopic discoloration of thyroid glands. No abnormalities of thyroid function studies are known to occur. Very rare cases of abnormal thyroid function have been reported.
Tooth discoloration has occurred in pediatric patients less than 8 years of age (see WARNINGS), and has been reported rarely in adults.

Reporting of suspected adverse reactions:

The PPB Department of Pharmacovigilance was set up with a vision to develop, implement and continuously upgrade an appropriate system for detecting, reporting, and monitoring adverse drug reactions (ADRs) and other relevant problems with medicines in Kenya. The department strives to ensure the safety and efficacy of pharmaceutical products in Kenya.
Reporting suspected adverse reactions after authorization of the medicinal product are important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals/ Patients are encouraged to report any suspected adverse reactions via Pharmacovigilance Yellow Form, pv@pharmacyboardkenya.org or clicking below button:


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Clinical | Pharmacokinetic data


Pregnancy Category:
Routes of Administration: Oral
Bioavailability: 60–80%
Protein Binding: 41–50%
Metabolosim: Liver
Onset of Action:
Elimination Half life: 10–17 hours
Excretion: Renal

Legal Status | Dosage forms & Strengths


Prescription Category:
Prescription only Medicine (POM) , ℞-only
Narcotic Drugs and Psychotropic Substances (Control ) Act Schedule:
This drug is not a controlled substance under Narcotic Drugs and Psychotropic Substances (Control ) Act
Dosage Forms | Strengths:
Tablets

Drug Indentifiers:

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Drug Images

References/ Citation:

  • Chopra, I.; Hawkey, P. M.; Hinton, M. (1992). “Tetracyclines, molecular and clinical aspects”. J. Antimicrob. Chemother. 29 (3): 245–277.



What was the patient being treated for
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