GENERIC NAME: tetracycline
BRAND NAME: Sumycin
DRUG CLASS AND MECHANISM: Tetracycline is an antibiotic with a broad spectrum, that is, it is active against many different bacteria. It is effective against Hemophilus influenzae, Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydia psittaci, Chlamydia trachomatis, Neisseria gonorrhoeae, and many others. Tetracycline prevents growth of bacteria by preventing the bacteria to manufacture proteins that they need to survive. The first drug of the tetracycline family, chlortetracycline, was introduced in 1948.
GENERIC AVAILABLE: Yes
PREPARATIONS: Capsules: 250 and 500mg; Oral Suspension: 125 mg/5 ml (teaspoon).
STORAGE: Tetracycline should be stored below 30 C (86 F).
PRESCRIBED FOR: Tetracycline is used for treating several types of infections caused by susceptible bacteria. Some examples include infections of the respiratory tract, urinary tract, and skin. It also is prescribed for nongonococcal urethritis, Rocky Mountain spotted fever, typhus, chancroid, cholera, brucellosis, anthrax, syphilis, and acne. It is used in combination with other medications to treat Helicobacter pylori, the bacteria associated with ulcers and inflammation of the stomach and duodenum.
DOSING: Food reduces the absorption of tetracycline. Therefore, tetracycline should be taken at least two hours before or after meals. For most infections, tetracycline is taken two to four times daily for 7 to 14 days. The usual adult dose is 1-2 g/day in 2 or 4 divided doses.
DRUG INTERACTIONS: Tetracycline should not be taken at the same time as aluminum, magnesium, or calcium-based antacids [for example, aluminum with magnesium hydroxide-oral (Mylanta, Maalox), calcium carbonate (Tums, Rolaids)]; iron supplements; bismuth subsalicylate (Pepto-Bismol), and dairy products. These agents bind tetracycline in the intestine and reduce its absorption into the body.
Tetracycline may enhance the activity of the blood thinner, warfarin (Coumadin), and result in excessive "thinning" of the blood, necessitating a reduction in the dose of warfarin. Phenytoin (Dilantin), carbamazepine (Tegretol), and barbiturates (such as phenobarbital) may enhance the elimination of tetracycline. Tetracycline may reduce the effectiveness of oral contraceptives.
PREGNANCY: Tetracycline antibiotics can impair development of bone in the fetus. Therefore, tetracycline is not recommended during pregnancy unless there is no other appropriate antibiotic.
NURSING MOTHERS: Tetracycline is secreted into breast milk. Since tetracycline can impair the development of bone in infants, nursing mothers should not use tetracycline.
SIDE EFFECTS: Tetracycline is generally well-tolerated. The most common side effects are diarrhea or loose stools, nausea, abdominal pain, rash, and vomiting. Headache and dizziness may also occur. Tetracycline may cause discoloration of teeth if used in patients below 8 years of age. Exaggerated sunburn can occur with tetracycline (photosensitivity). Therefore, sunlight or sunlamp exposure should be minimized during treatment.
How does it work?
Floxapen capsules contain the active ingredient flucloxacillin. (NB. Flucloxacillin is also available without a brand name, ie as the generic medicine.) Flucloxacillin belongs to a group of antibiotics called penicillins. It is used to treat infections caused by bacteria.
Flucloxacillin works by interfering with the ability of bacteria to form cell walls. The cell walls of bacteria are vital for their survival. They keep unwanted substances from entering their cells and stop the contents of their cells from leaking out. Flucloxacillin impairs the bonds that hold the bacterial cell wall together. This allows holes to appear in the cell walls and kills the bacteria.
Flucloxacillin differs from other penicillin-type antibiotics. When bacteria become resistant to penicillin antibiotics it is because they produce an enzyme called penicillinase. This enzyme breaks down the penicillin and makes it ineffective at killing the bacteria. Flucloxacillin is not affected by this enzyme. This means it is used primarily to treat infections caused by bacteria that are resistant to other penicillin-type antibiotics.
The types of infection flucloxacillin is used to treat include: infections affecting the skin and soft tissue (eg boils, cellulitis, impetigo, and infected eczema, ulcers, burns and wounds); bone infections; urinary tract infections; respiratory tract infections (eg pneumonia, sinusitis, lung abcess, pharyngitis, quinsy); meningitis; and blood poisoning (septicaemia). Flucloxacillin is also sometimes used to prevent infections during major surgery, for example bone or heart surgery.
To make sure the bacteria causing an infection are susceptible to flucloxacillin your doctor may take a tissue sample, for example a swab from the throat or skin, or a urine or blood sample.
What is it used for?
- Bacterial infections of the skin and soft tissue, such as infected ulcers, wounds or burns, abscesses, boils, cellulitis, impetigo.
- Bacterial infections of the lungs and airways (respiratory tract), such as pneumonia, lung abscess.
- Bacterial ear, nose and throat infections, such as sinusitis, tonsillitis, pharyngitis, quinsy, otitis media and otitis externa.
- Bacterial infections of bone (osteomyelitis).
- Bacterial infections of the urinary tract.
- Bacterial meningitis.
- Bacterial infections of the blood (septicaemia or blood poisoning).
- Bacterial infections of the lining of the heart or heart valves (endocarditis).
- Bacterial infections of the intestine (enteritis).
- Preventing bacterial infections during major surgery, eg heart or bone surgery.
How do I take it?
- The dose of this medicine and how long it needs to be taken for depends on the type and severity of infection you have, your age, weight and kidney function. Follow the instructions given by your doctor. These will be printed on the dispensing label that your pharmacist has put on the packet of medicine.
- Flucloxacillin is usually taken four times a day (every six hours), but follow the instructions given by your doctor. You should try to space the doses evenly throughout the day.
- Flucloxacillin should be taken on an empty stomach, which means either half an hour to an hour before food or two hours after food.
- The capsules should be swallowed with liquid.
- Unless your doctor tells you otherwise, it is important that you finish the prescribed course of this antibiotic medicine, even if you feel better or it seems the infection has cleared up. Stopping the course early increases the chance that the infection will come back and that the bacteria will grow resistant to the antibiotic.
- Broad-spectrum antibiotics can sometimes cause inflammation of the bowel (colitis). For this reason, if you get diarrhoea that becomes severe or persistent or contains blood or mucus, either during or after taking this medicine, you should consult your doctor immediately.
- It is recommended that your kidney and liver function are monitored if you receive prolonged treatment (longer than two weeks) with this medicine.
- On very rare occasions this medicine may cause liver problems, either during treatment, or up to a few months after treatment is finished. For this reason, you should consult your doctor promptly if you experience symptoms that could suggest a liver problem either during or after taking this medicine. These symptoms might include unexplained itching, nausea and vomiting, abdominal pains, loss of appetite or flu-like symptoms, yellowing of the skin or whites of the eyes (jaundice), or unusually dark urine.
Use with caution in
- Decreased liver function.
- Severely decreased kidney function.
- People over 50 years of age.
- People with serious underlying illness.
- History of allergies.
Not to be used in
- People allergic to penicillin or cephalosporin-type antibiotics.
- People with a history of liver problems or jaundice caused by previous treatment with this medicine.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- There are no known harmful effects when this medicine is used during pregnancy. However, as with all medicines, it should be used with caution during pregnancy and only if the expected benefits outweigh any potential risk. Seek further medical advice from your doctor.
- This medicine passes into breast milk in small amounts that are unlikely to be harmful to the nursing infant. However, as with all medicines it should be used with caution in breastfeeding mothers, and only if the expected benefit outweighs any possible risk. Seek further medical advice from your doctor.
- Take this medication an hour before food or on an empty stomach.
- Take at regular intervals. Complete the prescribed course unless otherwise directed.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.
Prolonged treatment with antibiotics can sometimes cause overgrowth of other organisms that are not susceptible to the antibiotic, for example fungi or yeasts such as Candida. This may sometimes cause infections such as thrush. Tell your doctor if you think you have developed a new infection during or after taking this antibiotic.
Common (affect between 1 in 10 and 1 in 100 people)
- Nausea and vomiting.
Uncommon (affect between 1 in 100 and 1 in 1000 people)
- Hives (urticaria).
Very rare (affect less than 1 in 10,000 people)
- Allergic reaction to active ingredient.
- Severe allergic skin reactions.
- Inflammation of the large intestine (pseudomembranous colitis) - see warning section above.
- Yellowing of the skin and eyes (jaundice).
- Inflammation of the liver (hepatitis) - see warning section above.
- Aching muscles or joints.
- Disturbance in the number of white blood cells or platelets in the blood.
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
You should tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, ask your doctor or pharmacist before taking any new medicines while taking this one, so they can check that the combination is safe.
In the past, women using hormonal contraception such as the pill or patch would be advised to use an extra method of contraception (eg condoms) while taking an antibiotic like this one and for seven days after finishing the course. However, this advice has now changed. You no longer need to use an extra method of contraception with the pill, patch or vaginal ring while you take a course of antibiotics. This change in advice comes because to date there is no evidence to prove that antibiotics (other than rifampicin or rifabutin) affect these contraceptives. This is the latest guidance from the Faculty of Sexual & Reproductive Healthcare.
However, if you are taking the contraceptive pill and experience vomiting or diarrhoea as a result of taking this antibiotic, you should follow the instructions for vomiting and diarrhoea described in the leaflet provided with your pills.
Flucloxacillin may rarely alter the anti-blood-clotting effects of anticoagulant medicines such as warfarin. Your doctor may want to do extra tests of your blood clotting time (INR) while you are taking both medicines.
Flucloxacillin may on rare occasions decrease the removal of the medicine methotrexate from the body, which could increase the risk of its side effects. If you are taking methotrexate, your doctor may want to perform some extra checks while you are taking a course of this antibiotic. You should let your doctor know if you think you have experienced any new or increased side effects after starting this antibiotic.
Oral typhoid vaccine (Vivotif) should not be taken until at least three days after you have finished a course of this antibiotic, because the antibiotic could make this vaccine less effective.
Probenecid may increase the blood level of flucloxacillin, and people taking probenecid may be prescribed a lower dose of flucloxacillin.
GENERIC NAME: clindamycin and benzoyl peroxide gel
BRAND NAME: Benzaclin
DRUG CLASS AND MECHANISM: Benzaclin is a combination of an antibiotic, clindamycin, and benzoyl peroxide, another drug that has antibacterial effects. Benzaclin is used topically (applied to the skin) for the treatment of acne.
PREPARATIONS: Gel: clindamycin 1% and benzoyl peroxide 5%.
STORAGE: The gel can be stored at room temperature, up to 25°C (77 °F), for up to two months after it is dispensed by the pharmacy. Unused gel should be discarded after two months.
PRESCRIBED FOR: Benzaclin is used to treat acne.
DOSING: Benzaclin usually is applied to the lesions of acne twice daily.
DRUG INTERACTIONS: There are no known drug interactions with Benzaclin.
PREGNANCY: Although clindamycin can be used safely during pregnancy, Benzaclin has not been tested in pregnant women, and its safety for the fetus is not known.
NURSING MOTHERS: Benzaclin has not been tested among nursing women. Because orally ingested clindamycin is secreted into breast milk and may cause side effects in infants, it is preferable for nursing mothers not to use Benzaclin.
SIDE EFFECTS: In general, Benzaclin is well-tolerated. The most frequently reported side effect is dry skin, which occurs in about 1 of 8 people who use it. Other side effects include skin reactions at the site of application (1 in 30), itching (1 in 50), peeling (1 in 50), redness (1 in 100), and sunburn 1 in 100). Diarrhea, sometimes bloody, has been reported with topical clindamycin. This reaction, although quite rare, can be dangerous. Discontinuation is recommended if marked diarrhea develops.