demedocydine hydrochloride

HOW SUPPLIED



Tablets (film-coated): 150mg, 300 mg



Capsules: 150 mg

ACTION



Unknown. Thought to exert bacteriostatic effect by binding to the 30S and possibly 50S ribosomal subunits of micro-organisms, thus inhibiting protein synthesis. May also alter the cytoplasmic membrane of susceptible microorganisms.

INDICATIONS & DOSAGE



Infections due to susceptible gram­positive and gram-negative organisms (including Haemophilus ducreyi, Yersinia pestis, and Campylobacter fetus), Rickettsiae, Mycoplasma pneumoniae, Chlamydia trachomatis; psittacosis; granuloma inguinale -



Adults: 150 mg P.O. q 6 hours or 300 mg P.O. q 12 hours.



Children over age 8: 6.6 to 13.2 mg/kg P.O. daily, in divided doses q 6 to 12 hours.



Gonorrhea-



Adults: initially, 600 mg P.O.; then 300 mg P.O. q 12 hours for 4 days (for total of 3 g).



ADVERSE REACTIONS



CNS: intracranial hypertension, dizziness.



CV: pericarditis.



EENT: dysphagia, tinnitus, visual disturbances.



GI: anorexia, nausea, vomiting, diarrhea, enterocolitis, glossitis, anogenital inflam-mation, pancreatitis.



GU: elevated serum BUN levels.



Hematologic: neutropenia, eosinophilia, thrombocytopenw, hemolytic anemw.



Hepatic: elevated liver enzymes.



Metabolic: diabetes insipidus syndrome.



Skin: maculopapular and erythematous rashes, photosensitivity, increased pigmentation, urticaria.



Other: hypersensitivity reactions, anaphylaxis, permanent tooth discoloration, bone growth retardation if used in children under age 9.

INTERACTIONS



Drug-drug. Antacids (including sodium bicarbonate) and laxatives containing aluminum, magnesium, or calcium; antidiarrheals: decreased antibiotic absorption. Antibiotic is given 1 hour before or 2 hours after any of these drugs.



Ferrous sulfate and other iron products, zinc: decreased antibiotic absorption. Antibiotic is given 2 hours before or 3 hours after iron administration.



Methoxyflurane: may cause nephrotoxic­ity with tetracyclines. Avoid concurrent use.



Oral anticoagulants: increased anticoagulant effect. PT and INR must be monitored, and dosage adjusted as needed. Oral contraceptives: decreased contraceptive effectiveness and increased risk of breakthrough bleeding. A nonhormonal birth control method should be recommended.



Penicillins: may interfere with bactericidal action of penicillins. Avoid use together.



Drug-food. Milk, dairy products, other foods: decreased antibiotic absorption. Antibiotic is given 1 hour before or 2 hours after any of the above.



Drug-lifestyle. Sun exposure: photosen­sitivity reactions may occur. Take precautions.

EFFECTS ON DIAGNOSTIC TESTS



Demeclocycline causes false-negative results in urine glucose tests using glucose oxidase reagent (Diastix or Chemstrip uG). Drug also causes false elevations in fluorometric tests for urine catecholamines.

CONTRAINDICATIONS



Contraindicated in patients with hyper­sensitivity to drug or other tetracyclines.

SPECIAL CONSIDERATIONS



* Use cautiously in patients with impaired renal or hepatic function.

* Use of these drugs during last half of pregnancy and in children under age 9 may cause permanent discoloration of teeth, enamel defects, and bone growth retardation.

* Signs and symptoms of diabetes insipidus syndrome include polyuria, polydipsia, and weakness.

* Renal and liver function test results must be monitored.

* Fluid balance and daily weights are monitored in patients with impaired kidney and liver function.

* A specimen for culture and sensitivity tests should be obtained before giving first dose. Therapy may begin pending test results.

* Alert: Expiration date needs to be checked. Outdated or deteriorated tetracyclines have been associated with reversible nephrotoxicity (Fanconi's syndrome).

* Drug should not be exposed to light or heat; store in tightly capped container.

* With large doses or prolonged therapy, superinfection is possible, especially in high-risk patients.

* Patient's tongue should be checked for signs of candidal infection. Stress good oral hygiene.



Patient teathing



* Take entire amount of drug, exactly as prescribed, even after feeling better.

* The drug's effectiveness is reduced when taken with milk or other dairy products, food, antacids, or iron products. Take each dose with a full glass of water on an empty stomach, at least 1 hour before or 2 hours after meals. Also, take drug at least 1 hour before bedtime to prevent esophageal irritation or ulceration.

* Avoid direct sunlight and ultraviolet light, wear protective clothing, and use sunscreen. Photosensitivity reactions may occur within a few minutes to several hours after sun exposure. Photosensitivity persists for some time after discontinuation of drug.

* Report signs and symptoms of superinfection.





Description about drugs and medicines with information on their interactions, and guidelines for using these drugs. For more articles by this author, visit his site at: http://www.drug-facts.net.