Tetracycline

Brand Name: Apo-Tetra Nu-Tetra Novo-Tetra

Prescription Needed: Yes

What is this drug used for?


Tetracycline is an antibiotic that is primarily used to treat infections caused by bacteria including pneumonia bronchitis sexually transmitted diseases (STD) infections of the bladder kidney prostate stomach ears nose skin throat and to prevent malaria when traveling to other countries where malaria is prevalent.
 
It can be used in the long-term treatment of acne and rosacea. 

Tetracycline has been prescribed in combination with other drugs to treat H.Pylori infection often associated with stomach ulcers.

Is there any reason not to take this drug?

You should not take this drug if you are allergic to tetracycline doxycycline or minocycline. Children younger than 13 years old should not take tetracycline. Tell your doctor if you are pregnant planning to get pregnant or breastfeeding (safer alternatives may be available) or if you have or have ever had:
  • porphyria (blood disorder)
  • problems with your liver or kidneys
  • esophagitis (a serious form of heartburn involving inflammation and irritation of the lower throat area)
  • systemic lupus erythematosus (SLE)
Always disclose your full medical history with the medical team that is taking care of you in order for them to provide you with the safest and most effective care.

What about possible side effects? 

This medication is usually well tolerated but you should be aware of some potential side effects. The following side effects are more common and can be quite bothersome but unless they are severe you should continue taking tetracycline as prescribed. Contact your doctor or pharmacist to get advice on how to manage these side effects.
  • nausea
  • vomiting
  • diarrhea
  • loss of appetite
  • stomach upset
  • lightheadedness or dizziness
  • increased sensitivity of the skin to sunlight including sun lamps
Other less common side effects include:
  • burning sensation in the throat or chest (see Special Instructions)
  • hearing problems or ringing in the ears
  • mild rash or itching
  • change in colour of nails skin or teeth (higher risk with long term use)
Antibiotics may make you prone to oral thrush infections and vaginal yeast infections. Contact your doctor or pharmacist regarding treatments.

These side effects may be related to the dose the use of other medications or other factors (e.g. older age other medical conditions).  As well some of these side effects may go away with time. Talk to your doctor or pharmacist about whether you have any risk factors that may make you more sensitive to these side effects.  Contact your doctor if these symptoms continue or become worse

Call your doctor immediately if you experience any of the following more serious side effects:

  • difficulty breathing or swallowing
  • headache and blurry vision
  • hives all over the body or near the face and throat
  • itching all over the body
  • severe skin rash
  • swelling of the lips face or tongue
  • unusual bleeding or bruising
  • wheezing
  • blood in the stool
  • yellowing of eyes or skin
  • unexplained sore throat fever chills
This is not a complete list of side effects.  If you are concerned about these or other unusual symptoms while taking this medication ask your doctor and/or pharmacist for more information and advice.

What if I am taking other drugs?

Always provide your doctor with a list of all other drugs you are taking (including over-the-counter medications and herbal/natural products) as they may interact with and/or may change the safety or effectiveness of either drug. Tell your doctor specifically if you are taking any of these drugs as these are the most common interactions and he/she may need to make changes or monitor you more closely:

  • antacids containing aluminum calcium or magnesium (e.g. Gaviscon Rolaids Tums) sodium bicarbonate calcium supplements (e.g. Caltrate certain multivitamins) iron supplements (e.g. ferrous gluconate ferrous sulfate Slow-Fe Palafer certain multivitamins) kaolin/pectin laxatives bismuth subsalicylate (e.g. Pepto Bismol) zinc sulfate didanosine (Videx buffered formulation non-enteric coated) - these drugs may decrease the amount of tetracycline that can get into the body; try to avoid use of these drugs together. If that is not possible MUST take tetracycline at least two hours before or 6 hours after any of these medications.
  • cholestyramine colestipol (e.g. Colestid) quinapril (e.g. Accupril Accuretic) - these drugs may decrease the amount of tetracycline that can get into the body. Separate doses by at least 2 hours.
  • Aminoglutethimide carbamazepine efavirenz oxcarbazepine phenytoin phenobarbital primidone rifabutin rifampin St John's Wort - may decrease the effects of tetracycline
  • Amiodarone pimecrolimus amlodipine atorvastatin citalopram cyclosporine diazepam diltiazem lovastatin nifedipine theophylline verapamil - may experience increased effects from these drugs
  • typhoid vaccine e.g. Vivotif - wait at least 24 hours after stopping tetracycline to vaccinate with the oral typhoid vaccine
  • birth control pills - there have been case reports suggesting antibiotics may decrease how well your birth control pills work to prevent pregnancy. While this interaction is unlikely for peace of mind consider using an additional method of birth control (i.e. condom) for the rest of that cycle.
  • Penicillin antibiotics - tetracycline could interfere with how well penicillins work
  • Isotretinoin (e.g. Accutane Clarus) - may increase risk of serious side effects such as blurry vision and headache
  • methotrexate - starting tetracycline or increasing the dose may increase risks of side effects from methotrexate
  • anticoagulants such as warfarin (e.g. Coumadin) - increased risk of bleeding problems
  • digoxin - increased risk of side effects from digoxin
  • dong quai St John's Wort  - increased risk of skin reactions from direct sunlight
  • insulin - less insulin may be needed monitor your blood sugars closely
This is not a complete list of drug interactions.  Ask your doctor or pharmacist to review your list of medications.

Special Instructions:

To lower risk of esophagitis (throat burning and irritation) you should take tetracycline with a full glass of water and avoid lying down for at least 30-60 minutes afterward. Most times esophagitis occurred when this medication was taken at bedtime with insufficient water.

Sun-Protection:  Since your skin may burn more easily while taking this medication it is advised to limit exposure to the sun and avoid use of tanning lamps. If sun exposure is unavoidable apply sunblock and wear protective clothing to decrease the chances of this happening. Sunblock should have at least an SPF 15 rating (Sun Protection Factor). Protective clothing includes light breathable cotton fabrics including long-sleeved tops to protect the arms and a wide-brimmed hat to protect the face neck and ears.

Even though it has not been proven tetracycline can interfere with how well the birth control pill works due to the potential effects on the unborn child consult with your doctor about ways to prevent pregnancy while taking tetracycline.

Dietary precautions: Do not take tetracycline within two hours of calcium rich drinks or food (e.g. milk cheese yogurt) as it may decrease the amount that gets into the body.

This medication is best taken on an empty stomach for best absorption- an hour before or 2 hours after meals or snack.  Take tetracycline with a snack (e.g. crackers toast) only if you experience upset stomach. 

Children: Not typically recommended unless over 13 years of age. If used there is a risk of side effects that affect tooth colour and development. Talk to your doctor.

Seniors: May be more sensitive to side effects but dose is usually the same.

Pregnancy:  Not generally recommended due to potential effects on growth and risk of discolouration of bones and teeth in the unborn child. Consult with your doctor about safer alternatives.

Women who are nursing: A small amount of this drug passes into breast milk. Long term use may result in staining of the child's teeth. Consult with your doctor about safer alternatives.

People who drive or operate machinery: Should not do so until they know how this drug affects them personally

Alcohol: Should always be consumed in moderation since both alcohol and tetracycline are processed by the liver.

Overdose: A large dose of tetracycline could cause stomach upset dizziness nausea vomiting. If you suspect an overdose or if you experience any unusual reactions call your doctor or 911.

Stopping the drug: Do not do so without talking to your doctor even if you are feeling better.  It is important to take all the medication you have been prescribed to ensure all the bacteria causing the infection has been removed from your body.  Stopping the medication too early may make the infection come back and this antibiotic may no longer work.

If you miss a dose: Take it as soon as you remember. However if you are taking tetracycline 4 times daily and your next dose is within three hours take the missed dose skip the next scheduled dose then continue as usual. If you are taking tetracycline twice daily and your next dose is within 6 hours take the missed dose skip the next scheduled dose then continue as usual. Do not take a double dose.

Storage conditions: Closed container; cool dry location away from excess moisture (not in the bathroom) and light; always out of reach of children.