Oral Antibiotics - Tetracycline

Tetracycline was developed in 1953 and is a broad spectrum antibiotic, there is a family of tetracycline’s that include doxycycline and minocycline, the latter having longer half-lives and enhanced antibacterial activity and improved safety profiles.

Tetracycline is often the first used acne antibiotic, being the least expensive with few side effects and is generally well tolerated.

How Do Patients Use This Medication?

It is taken on an empty stomach half an hour before or 2 hours after a meal and it should not be taken with antacids or milk as it interacts with metallic ions. It should be taken with a large glass of water to avoid it becoming stuck in the esophagus, which might produce ulceration.

Cholystiramune should be avoided, the risk of interacting with the birth control pill is remote. Children and pregnant or breast feeding mothers' should avoid this drug.

Initially a dose of 1 gram a day can be used either in divided doses of 250 mg or even in a single dose, which is more convenient but increases the side effects especially of nausea or abdominal discomfort. In acne, the dose can be decreased after improvement is established.

How Well Does It Work?

It is not unreasonable to expect about a 25% improvement in acne per month. The first sign is less new acne lesions appearing. There is a feeling that this antibiotic does not work as well presently as it did in the past possibly due to antibiotic resistance issues.

How Does It Work?

Tetracycline interferes with bacterial protein synthesis. It is bacterioststic and has broad spectrum action. It blocks the binding to aminoacyl transfer RNA to messenger RNA. It has some immunosuppressive actions and is anti-inflammatory affecting the lymphocyte function, as well as neutrophil chemotaxis. It inhibits lipase and collagenase.

Will There Be Side Effects?

Sun sensitivity is common, pigmentation of the skin is uncommon but may occur in the mouth and teeth. Gastrointestinal irritation is also common. Staining of teeth, enamel hypoplasia, and inhibition of skeletal growth is documented. It should be avoided in children up to the age of 11. Yeast infections in the mouth, rectal and genital areas are increased.

Pseudotumor cerebri is very uncommon and may be seen after 2 weeks to 10 months of taking this drug. The symptoms are headache, vomiting, nausea and double vision. Discontinuing the drug early will reverse the problem.

What Other Conditions Are Treated By This Medication?

Clindoxyl® Gel

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INTRODUCTION
Clinical experience confirms what has been shown in clinical trials, that Clindoxyl Gel is effective and well tolerated Once daily application of topical that combines two active anti-acne agents may well increase patient compliance... | Read more ...

CLININCAL EXPERIENCE
More than six international studies involving over 6,000 patients have shown reductions in the PASI (Psoriasis Area and Severity Index) of approximately 40% after one week of treatment and 70% after four weeks... | Read more ...

INDICATIONS
Moderate comedonal and papulo-pustular acne Approved in Canada as a once daily topical for moderate Acne in December 2000... | Read more ...

PATIENT PROFILE
Any patient who has inflammatory acne can be treated with Clindoxyl Gel Acne patients with comedones only are best treated by topical retinoids Patients with cystic acne usually require systemic therapy... | Read more ...

DOSING
Once daily application of Clindoxyl Gel is recommended The product needs to be applied to the whole region of skin that is affected with acne. In other words... | Read more ...

EFFICACY
The following figures show pooled data from randomized, controlled double-blind trials involving 673 patients with acne... | Read more ...

COMPLIANCE
Three factors to consider for good compliance of Clindoxyl Gel are: Well tolerated by most patients, results are often seen within 2 weeks... | Read more ...

SIDE EFFECTS, SAFETY AND RISKS
Overall tolerance was rated as excellent in 94% of patients. Potential side effects expected in some patients... | Read more ...

COST OF TREATMENT
This is a cost effective product. Reducing inflammation can reduce the risks of scarring... | Read more ...

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Diane-35^®

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INTRODUCTION
There are limitations for regulators, pharmaceutical companies and pharmaceutical sales representatives to present clinical evidence following development of product monograph and drug approval... | Read more ...

CLININCAL EXPERIENCE
Diane-35® (2mg cyproterone acetate and 0.035mg ethinyl estradiol) is approved for use in Canada to treat women with severe acne who are unresponsive to other available treatments and who have associated symptoms of androgenization, such as seborrhea and mild hirsutism. In addition to treating acne, Diane-35® also provides reliable contraception... | Read more ...

INDICATIONS
Used to treat women with severe* acne and its associated symptoms of androgenization, including seborrhea and mild hirsutism.. | Read more ...

PATIENT PROFILE
Women who have acne associated or not with signs of hyperandrogenism. Any woman who has acne that is not controlled with topical medication... | Read more ...

DOSING
Diane-35® is sold in blister pack units containing 21 tablets. Each tablet contains 2mg of cyproterone acetate and 0.035mg of ethinyl estradiol. Each cycle consists of 21 days on the medication and a 7-day interval without it... | Read more ...

EFFICACY
Improvements in seborrhea are generally seen after 2 to 3 months. Improvements to acne are generally seen after 3 to 4 months. Numerous studies have proven the efficacy of hormonal therapy in treating acne over 6 or more months of use... | Read more ...

COMPLIANCE
Patients should take Diane-35® at the same time each day with liquid... | Read more ...

SIDE EFFECTS, SAFETY AND RISKS
Side effects are typical of most oral contraceptives and can include breast tenderness, headache, nausea, breakthrough bleeding, ankle swelling and weight gain. These side effects are typically mild and tend to resolve by the second or third cycle of therapy... | Read more ...

COST OF TREATMENT
Diane-35 is sold to pharmacy wholesalers at a cost of $19.00 per cycle... | Read more ...

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