๐ Indications & Clinical Dosage
*Upper Respiratory Infection & Lower Respiratory Infection:*
Adults: 100 mg every 12 hr on day 1 then 100 mg once daily or 50 mg every 12 hr. In severe cases: 100 mg every 12 hr.
Children 8 yrs (less than 100 lbs body weight): 1 mg/lb every 12 hr on day 1, then 1 mg/lb once daily or 0.5 mg/lb every 12 hr. In severe case: 2 mg/lb; Above 100 lbs body weight: same as adult dose.
*Inhalation Anthrax (Post-Exposure):*
Adults: 100 mg every 12 hr for 60 days.
Children 8 yrs less than100 lbs body weight:1 mg/lb every 12 hr for 60 days; Above 100 lbs body weight: same as adult dose.
*Urinary Tract Infection:*
Adults: 100 mg every 12 hr on day 1, then 100 mg once daily or 50 mg every 12 hr. In severe infection; 200 mg once daily
Children 8 yrs less than100 lbs body weight: 1 mg/lb every 12 hr on day 1, then 1 mg/lb once daily or 0.5 mg/lb every 12 hr; Above 100 lbs body weight: same as adult dose.
*Skin and soft tissue infection:*
Adults: 100 mg every 12 hr or 50 mg every 6 hr on day 1, then 100 mg once daily or 50 mg every 12 hr. In severe case: 100 mg every 12 hr.
Children 8 yrs less than100 lbs body weight: 1 mg/lb every 12 hr on day 1, then 1 mg/lb once daily or 0.5 mg/lb every 12 hr. Severe: 2 mg/lb; Above 100 lbs body weight: same as adult dose.
*Susceptible infections (e.g. chlamydia, rickettsia and mycoplasma):*
Adult and Children above 12 yrs: Initially 200 mg daily for 1 dose, then maintenance 100 mg once daily.
*Early syphilis:*
Adult & Children above 12 yrs: 100 mg twice daily for 14 days.
*Late latent syphilis:*
Adult & Children above 12 yrs: 100 mg twice daily for 28 days.
*Neurosyphilis:*
Adult: 200 mg twice daily for 28 days
Uncomplicated genital chlamydia, Non-gonococcal urethritis.
Adult & Children above 12 yrs: 100 mg twice daily for 7 days.
*Pelvic inflammatory disease:*
Adult & Children above 12 yrs: 100 mg twice daily for 14 days.
*Adjunct to quinine in treatment of Plasmodiumfalciparum malaria:*
Adult & Children above 12yrs: 200 mg daily for 7 days.
๐ Mode of Administration
By slow IV infusion, usually over 1-4 hours; rapid administration should be avoided. To make concentration of 10 mg/ml add water for injection 10 ml in 100 mg vial. This solution must be further diluted to a concentration of 0.1 to 1 mg/ml with a compatible infusion solution prior to use. Infusion must be completed within 12 hours.
โ Contraindications
Children under 12 years (deposition in growing bone and teeth, by binding to calcium, causes staining and occasionally dental hypoplasia)
โ ๏ธ Precautions & Warnings
Hepatic impairment, myasthenia gravis (muscle weakness may be increased), systemic lupus erythematosus (may be exacerbated), avoid exposure to sunlight or UV light, risk of super-infection.
๐ Drug Interactions
Antacids, mineral supplements, anticoagulants, barbiturates, rifampicin, carbamazepine, phenytoin, penicillin and beta-lactam antibiotics, alcohol, oral contraceptives, methoxyflurane, cyclosporin, quinapril, isotretinoin, sulphonylureas.
โ ๏ธ Adverse Reactions / Side Effects
Anaphylaxis, angioedema, blood disorders, exfoliative dermatitis, hepatotoxicity, hypersensitivity reactions, pancreatitis, pericarditis, photosensitivity, rash, Stevens-Johnson
Syndrome, urticaria, colitis, benign intracranial hypertension, bulging fontanelles, diarrhoea, dysphagia, headache, nausea, oesophageal irritation, visual disturbances, vomiting, anorexia, anxiety, flushing, fungal super-infection (when used for periodontitis), tinnitus, oesophageal ulcers, photosensitivity, hepatic dysfunction
๐คฐ Pregnancy & Lactation Safety
Pregnancy Risk:
Contraindicated in pregnancy.
Lactation / Breastfeeding:
Contraindicated, avoid
๐งช Compatibility & Storage Stability
Compatibility: Stable in Dextrose 5%, NaCI 0.9%, ringers injection, lactated ringers, D5LR.
Stability & Storage: When diluted to 0.1 to 1 mg/ml in D5W or NaCI 0.9 %, solution is stable for 48 hours in room temperature or 72 hours when refrigerated. Protect from light.