Drug reference

Tetracycline

Tetracycline · Antibiotic

TetracyclineAntibioticATC J01AA07

CDSCO approvedSchedule H1ATC J01AA07

EXCRETION

—

not curated

INTERACTIONS

12 major

incl. contraindicated

PREGNANCY

Contraindicated during pregnancy

FDA category + note

Top interactionssee all 12 →

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DesogestrelSevereTextbook-citedKDT 7e · p949
EthinylestradiolSevereTextbook-citedKDT 7e · p949
LevonorgestrelSevereTextbook-citedKDT 7e · p949

Mechanism

Tetracycline enters bacterial cells via energy-dependent active transport and binds reversibly to the 30S ribosomal subunit at the A (aminoacyl) site, blocking attachment of aminoacyl-tRNA to the mRNA-ribosome complex and halting peptide chain elongation. This produces broad-spectrum bacteriostatic activity against gram-positive and gram-negative bacteria, rickettsiae, mycoplasmas, and chlamydiae. The requirement for active bacterial uptake systems means mammalian cells are largely spared, and resistance most commonly arises from plasmid-encoded efflux pumps or ribosomal protection proteins.

Indications

Bacterial infectionsSmall intestinal bacterial overgrowth (SIBO)combined with quinine/quinidine for p. falciparum and p. vivax from chloroquine-resistant areasBalantidiasisreducing severe eyelid inflammationH. pylori eradication therapy (quadruple therapy for eradication failure cases)chlamydia trachomatis cystitisgranuloma inguinale/donovanosisTreatment of CQ-resistant falciparum as well as vivax malaria (only in combination with quinine)Adjunctive antibiotic for patients with moderate or severe dehydration due to cholera (in areas with confirmed susceptibility)Extraintestinal non-O1/O139 V. cholerae infections (in vitro sensitive)Vibrio vulnificus infections (in vitro sensitive)

Dosing

Adult: . Changes, provides a list of signiﬁcant changes, dose changes, classiﬁcation changes, new names, and new preparations that have been incorporated into the BNF, as well as a list of preparations that have been discontinued and removed from the BNF.…
Pediatric: 25 mg/kg/day orally, divided, 4 daily 7 days. IV: dosage same as for oral.

Pharmacokinetics

Bioavailability

77%

Protein binding

65 ± 3%

Excretion

58 ± 8%

Contraindications

Pregnancy
Breastfeeding
Children under 12 years
Young children (not routinely recommended)
pregnant women
children younger than 8 years
renal impairment (except doxycycline)
Children

Side effects

Common

Intrinsic staining of teethNauseaVomitingHeadacheGI disturbancesAbdominal paindiarrheadizzinessphotosensitivityesophagitisodynophagiayellow discoloration of the light-exposed conjunctiva

Serious

Permanent, unsightly intrinsic staining of teeth in children (color varying from yellow to grey)
hepatotoxicity (rarely)
pancreatitis (rarely)
benign intracranial hypertension (rarely)
Fetal bone-growth abnormalities (avoid in pregnancy and children <8 years old)