Dosing and uses of Declomycin (demeclocycline)
Adult dosage forms and strengths
tablet
- 150mg
- 300mg
600 mg/day divided BID/TID PO
Administration
1 hour before or 2 hours after meals
Other Indications & Uses
Rickettsial fevers (Rocky mountain spotten fever, typhus, Q fever), various infections caused by Mycoplasma pneumoniae, Chlamydia trachomatis, Chlamydia psittacci, Ureaplasma. urealyticum, Borrelia recurrentis, Haemophilus ducreyi, Yersinia pestis, Francisella tularensis, Vibrio cholerae, Campylobacter fetus, Brucella sp., Bartonella bacilliformis, E. coli, Enterobacter aerogenes, Acinetobacter sp., H. influenzae, Shigella sp., Klebsiella sp., Sterptococcus pneumoniae, skin infections caused by Staphylococcus aureus (not the drug of choice)
When penicillin is contraindicated: N. gonorrheae (infections in women), Treponema pallidum, Lsiteria monocytogenes, Bacillus anthracis, Fusobacteriunm fusiforme, Actinomyces israelii, Clostridium sp.
Off-label: SIADH
Pediatric dosage forms and strengths
tablet
- 150mg
- 300mg
>8 Years Old
6.6-13.2 mg/kg/day divided BID/TID PO
Alternatively, 300 mg/sq.meter/day divided BID/TID PO
Administration
1 hour before or 2 hours after meals
Declomycin (demeclocycline) adverse (side) effects
Frequency not defined
Photosensitivity rxn (more frequent & severe than other tetracyclines), reversible
Dose-related diabetes insipidus (does not occur with other tetracyclines)
Discoloration of teeth
Superinfection, moniliaL
Dysphagia
Glossitis
Nausea
Vomiting
Diarrhea
Hepatotoxicity
Warnings
Contraindications
Documented hypersensitivity
Cautions
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 one-half of pregnancy through age 8 y) can cause permanent discoloration of teeth
Fanconilike syndrome may occur with outdated tetracyclines
Pregnancy and lactation
Pregnancy category: d
Lactation: enters breast milk/not recommended by manufacturer
Tetracyclines bind to calcium. The amount of demeclocycline absorbed by the infant is significantly decreased by the calcium in breast milk.
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Declomycin (demeclocycline)
Absorption: 60-80% in fasting adults, reduced by 50% or more by food or milk
Peak Plasma: (150 mg x1): 0.9-1.2 mcg/mL; (300 mg x1) 1.5-1.7 mcg/mL
Half-Life: 11-17 hr; severe renal impairment: 42-68 hr
Metabolism: N/A
Excretion
Urine: 44%
Feces: 31%
Mechanism of action
Inhibits bacterial protein synthesis by binding with 30S and possibly 50S ribosomal subunit(s).
