Tetracycline hydrochloride

Tetracycline hydrochloride is an antibacterial medicinal substance for systemic use. It belongs to the subgroup of systemic tetracycline antibiotics.

The therapeutic drug mainly affects the body by inhibiting protein binding processes within the ribosomes of bacterial cells. The drug's effect covers a wide range of different microbes. At the same time, the medication demonstrates bacteriostatic activity (when using standard dosage portions of the drug). [ 1 ]

Indications Tetracycline hydrochloride

It is used for the treatment of the following inflammatory and infectious diseases:

• pneumonia with bronchitis, subacute endocarditis of a septic nature and purulent pleurisy;
• gonorrhea;
• dysentery of amoebic or bacterial type;
• tonsillitis, whooping cough or scarlet fever;
• tularemia, psittacosis, brucellosis and relapsing or typhus;
• infections in the area of the urinary and bile ducts;
• purulent meningitis;
• having a purulent form of damage to the subcutaneous layer with the epidermis;
• cholera.

In addition, it can be used to prevent the development of infections after surgery.

Release form

The drug is released in the form of tablets - 10 pieces inside a cell plate. Inside the box - 1 or 2 such plates.

Pharmacodynamics

Antibiotics from the tetracycline subgroup have a wide range of therapeutic effects. They act against gram-positive flora - streptococci, clostridia, staphylococci (also those that produce penicillinase), listeria with pneumococci and anthrax bacilli.

Among the gram-negative flora that are susceptible to the drug's influence are Escherichia coli, Klebsiella, Gonococcus, Shigella with Bordetella, Salmonella and Enterobacteria. In addition, the drug affects Rickettsia, Spirochetes with Leptospirosis and bacteria that cause ornithosis and trachoma. [ 2 ]

Tetracycline hydrochloride is inactive or has very weak activity against Serratia, Proteus, Pseudomonas aeruginosa, acid-fast bacteria, most strains of Bacteroides fragilis, influenza, measles and polio viruses, as well as mycotic bacteria.

There is data regarding the anti-cholera effect of drugs.

Pharmacokinetics

When taken orally, the drug is absorbed at high speed inside the gastrointestinal tract (by 75-77%). However, food reduces absorption. The drug is also well synthesized with plasma protein.

The drug is distributed at high speed within most fluids, including bile with pleural effusion, ascitic with synovial fluid and paranasal sinus secretions. It accumulates within neoplasms, spleen and liver cells, and teeth; crosses the placenta and is excreted with breast milk. It reaches therapeutic values after 2-3 days.

It is excreted through the kidneys with the help of CF, as well as with feces (through the kidneys and together with bile - 60%); synthesis with blood protein - 65%; the half-life in a normal state is 6-11 hours, and in individuals with anuria - 57-108 hours.

In case of renal secretion disorders, the blood level of tetracycline may increase.

Dosing and administration

The medication is taken 1 hour before or 2 hours after a meal; the tablets should be washed down with plain water.

The portion size and duration of the therapeutic cycle are selected by the attending physician, taking into account the clinical picture of the disease. The course should continue for at least another 3 days after the signs of pathology have passed.

Infectious infections associated with the action of β-hemolytic streptococcus require treatment for a period of at least 10 days.

The size of a single dose is 0.2 g (2 tablets) taken at 6-hour intervals. In case of severe infection, the dose can be increased to 0.5 g taken at 6-hour intervals. A maximum of 2000 mg of the drug can be used per day.

• Application for children

Tetracycline hydrochloride can be prescribed in pediatrics only to persons over 12 years of age.

Use Tetracycline hydrochloride during pregnancy

The medicine is not prescribed during pregnancy; it can be used only if there are vital indications determined by the attending physician.

If there is a need to take medications during breastfeeding, breastfeeding is discontinued for the duration of therapy.

Contraindications

Among the contraindications:

• severe personal intolerance to the components of the drug;
• SKV;
• diseases in the kidney/liver area, accompanied by severe functional insufficiency;
• use in combination with retinol or retinoids.

Side effects Tetracycline hydrochloride

The drug is usually tolerated without complications (when administered in recommended doses). The main side effects are:

• pericarditis;
• nausea, constipation, anorexia, xerostomia, discomfort or pain in the abdominal area, heartburn, vomiting, glossitis or stomatitis;
• ulcers in the gastrointestinal tract, dysphagia, esophagitis, proctitis, gastritis, intestinal dysbacteriosis, hepatotoxic effect, pseudomembranous colitis and staphylococcal enterocolitis;
• hoarse voice and pain in the throat;
• unsteadiness of gait, photophobia, headaches and dizziness; prolonged use causes an increase in intracranial pressure (vomiting, visual changes, headaches and swelling in the optic nerve), hearing impairment and transient vision loss;
• thrombocyto- or neutropenia, eosinophilia, hemolytic anemia, agranulocytosis and Moszkowitz disease;
• nephritis, acute renal failure, azotemia, vaginitis and hypercreatininemia;
• Quincke's edema, TEN, maculopapular rash, anaphylactoid symptoms, epidermal hyperemia, photosensitivity, urticaria and anaphylaxis;
• bronchial spasm.

Overdose

Signs of poisoning include vomiting with nausea. The use of extremely high doses of the drug causes hematuria and crystalluria. The severity of the above-mentioned side effects (for example, manifestations of intolerance) may be potentiated.

Tetracycline hydrochloride has no antidote. Symptomatic actions are performed.

Interactions with other drugs

Fe salts, orally administered substances of Zn, Ca, Mg, Al, bismuth (including bismuth subsalicylate) and other drugs containing the above cations (including antacids, magnesium-containing laxatives and sucralfate), Na bicarbonate, colestipol with cholestyramine and kaolin-pectin form chelates (inactive) when combined with tetracycline. Also, the combination with these drugs reduces the absorption of tetracycline.

Therefore, it is necessary to refuse to use the medicine with the described drugs, didanosine (the composition contains additional components containing Mg and Ca) and quinapril (the composition contains Mg carbonate). If such a combination is necessary, tetracycline should be used with the longest possible time interval (2 hours before or 4-6 hours after the administration of the specified drugs).

Strontium ranelate may decrease serum tetracycline levels, so this combination should be avoided. Strontium ranelate should be discontinued during treatment with Tetracycline hydrochloride.

When administered together with tetracycline, serum levels of lithium and digoxin may increase.

When used with methysergide and ergotamine, the risk of ergotism increases.

Being a bacteriostatic antibiotic, the drug may interfere with the bactericidal effect of other antibiotics (cephalosporins, penicillins and β-lactam antibiotics). For this reason, such a combination is not used.

The combined use of the drug with erythromycin or oleandomycin causes a synergistic effect.

Indirect anticoagulants, including phenindione with warfarin and antithrombotic agents.

Tetracycline can potentiate the activity of these drugs, slowing down their intrahepatic metabolic processes, and reduce the plasma prothrombin index - it is necessary to carefully monitor the PT values and, if necessary, reduce the dosage of anticoagulants.

Use with atovaquone results in a decrease in its plasma values.

Administration with methoxyflurane may cause nephrotoxic effects (eg, increased serum creatinine and blood urea nitrogen) and acute renal failure (sometimes fatal).

When administered with methotrexate, its toxic activity may increase; therefore, this combination should be used with caution. If such a combination is necessary, the level of toxicity should be constantly monitored.

Retinoids (isotrethionine, acitretin, and tretinoin (acne therapy)) with retinol can cause a benign increase in ICP, which is why they should not be used together with tetracycline. To prevent this disorder from developing during acne therapy with retinoids, a time interval should be observed after using tetracycline.

The introduction of the drug while using hormonal contraception causes a weakening of their effect (unplanned conception) and an increase in the number of breakthrough bleeding. Because of this, during the period of using the drug and for another 7 days from the end of the treatment cycle, non-hormonal contraception should be used.

Use with diuretics should be done with caution, since dehydration increases the risk of nephrotoxicity.

When combined with hypoglycemic agents (insulin and sulfonylurea derivatives, including gliclazide with glibenclamide), their antidiabetic activity is potentiated.

Chymotrypsin increases the circulation duration and blood levels of tetracycline.

The drug should be used with caution in combination with hepatotoxic drugs.

Antibacterial drugs, including tetracycline, can weaken the medicinal effect of BCG and the orally administered typhoid vaccine. For this reason, vaccination cannot be carried out during the period of antibiotic use.

If the medicine is taken with food, dairy products and milk, the absorption of tetracycline is disrupted.

Storage conditions

Tetracycline hydrochloride must be stored at a temperature not exceeding 25°C.

Shelf life

Tetracycline hydrochloride can be used during the 36-month period from the date of manufacture of the medicinal substance.

Analogues

Analogues of the drug are Tetracycline with Polcortolone TS and Oletetrin with Tetracycline ointment.