Drug reference

Demeclocycline

Tetracycline · Antibiotic

Also known as Demeclocycline hydrochloride, Demethylchlortetracycline, Ledermycin

TetracyclineAntibiotic

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

8 major

SEVERE in our sources

PREGNANCY

Should not be given to pregnant women. Effects on skeletal development have been documented in the first trimester in animal studies. Administration during the second or third trimester may cause discoloration of the child’s teeth, and maternal hepatotoxicity has been reported with large parenteral doses.

FDA category + note

Top interactionssee all 9 →

AcitretinSevereDatabaseDDInter
Aminolevulinic AcidSevereDatabaseDDInter
IsotretinoinSevereDatabaseDDInter
LomitapideSevereDatabaseDDInter

Mechanism

Demeclocycline is a tetracycline antimicrobial drug. As an antibiotic, it is presumed to inhibit bacterial protein synthesis, although the specific mechanism for demeclocycline is not detailed in the excerpts. It also attenuates the antidiuretic effects of vasopressin, likely by decreasing the accumulation and action of cyclic AMP, though the full mechanism for this interference is not completely determined.

Indications

Susceptible infections (e.g. chlamydia, rickettsia and mycoplasma)Severe infections (including refractory urinary-tract infections)Acute sinusitisAcute cough (if systemically very unwell or at higher risk of complications)Community-acquired pneumoniaHospital-acquired pneumoniaSyndrome of inappropriate ADH secretion (SIADH)Hyponatremia secondary to excessive ADH secretion in congestive heart failure (CHF) patients on diureticsTumor-Associated Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

Dosing

Adult: Susceptible infections (e.g. chlamydia, rickettsia and mycoplasma): Initially 200 mg daily in 1–2 divided doses for 1 day, then maintenance 100 mg daily. Severe infections (including refractory urinary-tract infections): 200 mg daily.…
Pediatric: Child 12–17 years (Susceptible infections, e.g. chlamydia, rickettsia and mycoplasma): Initially 200 mg daily in 1–2 divided doses for 1 day, then maintenance 100 mg daily. Child 12–17 years (Severe infections, including refractory urinary-tract infections): 200 mg daily.…
Renal adjustment: Dose has to be reduced in renal failure.
Hepatic adjustment: Manufacturers generally advise caution.

Pharmacokinetics

Bioavailability

Incompletely absorbed from gastrointestinal tract; absorption is better if taken in empty stomach.

Protein binding

Variable degree of protein binding.

Excretion

Primarily excreted in urine by glomerular filtration.

Contraindications

Pregnant women
Breast-feeding women

Side effects

Common

DizzinessTooth discolourationEpigastric painNauseaVomitingDiarrhoeaOral disordersHeadacheVisual disturbancesphototoxic photosensitivity (sunburn-like erythema, edema, blistering)

Serious

Fontanelle bulging (in infants)
Haemolytic anaemia
Hepatic disorders
Idiopathic intracranial hypertension
Increased risk of infection
Neutropenia
Pancreatitis
Pseudomembranous enterocolitis
Stevens-Johnson syndrome
Thrombocytopenia

Pregnancy & lactation

Pregnancy

Lactation

Should not be given to women who are breast-feeding (although absorption and therefore discoloration of teeth in the infant is probably usually prevented by chelation with calcium in milk).