Chemical formula: C₂₂H₂₄N₂O₈ Molecular mass: 444.435 g/mol PubChem compound: 54675776
Tetracycline interacts in the following cases:
Tetracyclines should be used with caution in patients receiving drugs which may have hepatotoxic effects; high doses should be avoided.
Antidiarrhoeal preparations such as kaolin-pectin and bismuth subsalicylate hinder absorption of tetracyclines.
Tetracyclines depress plasma prothrombin activity; therefore reduced dosages of concurrent anticoagulants may be required.
Combination of tetracyclines with diuretics may be detrimental to renal function and may aggravate nephrotoxicity by volume depletion.
A few cases of pregnancy or breakthrough bleeding have been attributed to the concurrent use of tetracycline with oral contraceptives and alternative contraceptive advice should be sought where necessary.
Since bacteriostatic drugs may interfere with the bactericidal action of penicillin, it is advisable to avoid giving tetracycline in conjunction with penicillin.
Plasma-atovaquone concentration is reduced by tetracycline.
The absorption of tetracycline from the gastrointestinal tract is impaired by the concomitant administration of di and trivalent cations such as iron, calcium, aluminium, magnesium, bismuth and zinc salts. Administration of medicinal products containing these cations and tetracycline should be maximally separated by at least two to three hours. The following should be avoided when taking tetracycline: antacids, bismuth containing ulcer-healing drugs, drugs such as quinapril tablets which contain magnesium carbonate and didanosine which contains calcium and magnesium excipients.
There have been reports of nephrotoxicity (increased blood urea nitrogen and serum creatinine) and death in some cases when tetracycline therapy has been combined with methoxyflurane.
The absorption of tetracycline may be reduced by the concomitant administration of sucralfate. Separating administration should be considered.
There is a possible increased risk of benign intracranial hypertension with tetracyclines and retinoids (acitretin, isotretinoin, tretinoin). Concomitant use should be avoided.
Absorption of tetracycline is impaired by food, milk, and milk products.
Tetracycline may increase the hypoglycaemic effects of insulin and sulfonylureas in patients with diabetes mellitus.
Care is advised when administered to patients with myasthenia gravis.
Tetracycline may be deposited in deciduous and permanent teeth giving permanent discolouration. It should not be used during pregnancy.
Not to be used in pregnancy unless essential to the patient’s welfare.
Tetracyclines cross the placenta and may have toxic effects on foetal tissues, particularly on skeletal development.
The use of tetracycline compounds during pregnancy has been associated with reports of maternal liver toxicity.
If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be appraised of the potential hazard to the foetus.
Tetracyclines are excreted in breast milk and are therefore contraindicated in nursing mothers.
All tetracyclines form a stable calcium complex in any bone-forming tissue.
A decrease in fibula growth rate has been observed in premature infants given oral tetracycline in doses of 25mg/kg every 6 hours. This reaction was reversed when drug was discontinued.
None known.
The following convention has been utilised for the classification of frequency. Very common (≥1/10); common (≥1/100 and <1/10); uncommon (≥1/1000 and <1/100); rare (≥1/10,000 and <1/1000); very rare (<1/10,000); Frequency not known (cannot be estimated from the available data).
Not known: overgrowth of resistant organisms (Candida albicans, in particular); this may cause glossitis, stomatitis, pseudomembranous colitis (Clostridium difficile overgrowth), enterocolitis (caused by resistant staphylococci), rectal and vaginal irritation, inflammatory lesions (with candidial overgrowth) in the anogenital regions
Rare: haemolytic anaemia, thrombocytopenia, neutropenia, eosinophilia, agranulocytosis, aplastic anaemia.
Not known: hypersensitivity reactions including Stevens-Johnson syndrome, angioedema, toxic epidermal necrolysis, urticaria, anaphylaxis, anaphylactoid purpura, pericarditis, and exacerbation of systemic lupus erythematosus, fixed drug eruptions, exfoliative dermatitis.
Not known: brown-black microscopic discolouration of thyroid tissue. No abnormalities of thyroid function are known to occur.
Not known: headache.
Not known: visual disturbances, permanent visual loss.
Not known: bulging fontanelles in infants; benign intracranial hypertension in juveniles and adults. Presenting features were headache, dizziness, tinnitus and visual disturbances including blurring of vision, scotomata and diplopia. Treatment should cease if evidence of raised intracranial pressure develops.
Rare: dysphagia, oesophagitis and oesophageal ulceration (most of these patients took medication immediately before going to bed)
Not known: gastrointestinal irritations, nausea, abdominal discomfort, vomiting, diarrhoea, anorexia, pancreatitis, permanent tooth discolouration and enamel hypoplasia in children. Tooth discolouration has also been seen in adults. If gastric irritation occurs, tablets should be taken with food.
Rare: transient increases in liver function tests, hepatitis, jaundice, hepatic failure.
Not known: hepatotoxicity associated with fatty liver.
Not known: erythematous and maculo-papular rashes, photosensitivity (Patients exposed to direct sunlight or ultraviolet light should be advised to discontinue treatment if any skin reaction occurs), pruritis, bullous dermatoses, skin discolouration.
Not known: increased muscle weakness in patients with myasthenia gravis.
Rare: acute renal failure, nephritis.
Not known: raised serum urea, renal dysfunction, especially in patients with pre-existing renal impairment.
© All content on this website, including data entry, data processing, decision support tools, "RxReasoner" logo and graphics, is the intellectual property of RxReasoner and is protected by copyright laws. Unauthorized reproduction or distribution of any part of this content without explicit written permission from RxReasoner is strictly prohibited. Any third-party content used on this site is acknowledged and utilized under fair use principles.
