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demeclocycline

D06AA01

Forms & Strengths

Oral capsules: 150 mg
Oral tablets: 150 mg, 300 mg

Adult Dosing

Syndrome of inappropriate antidiuretic hormone (SIADH): 600 to 1200 mg/day orally divided every 6 to 12 hours
Bacterial infections: 150 mg orally every 6 hours or 300 mg every 12 hours

Pediatric Dosing

Children > 8 years: 6.6 to 13.3 mg/kg/day orally divided every 6 to 12 hours
Not recommended in children < 8 years due to permanent tooth discoloration and enamel hypoplasia

Indications

Adjunctive management of chronic syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Treatment of susceptible bacterial infections (rarely used for this purpose currently)

Mechanism of Action

Tetracycline derivative that inhibits bacterial protein synthesis by binding to 30S ribosomal subunits
Induces nephrogenic diabetes insipidus by directly interfering with the action of antidiuretic hormone (vasopressin) on the renal distal tubules, lowering cAMP

Contraindications

Hypersensitivity to demeclocycline or other tetracyclines
Pregnancy (risk of bone growth retardation and tooth discoloration in the fetus)
Children under 8 years of age
Severe hepatic impairment

Adverse Reactions

Photosensitivity and severe sunburn reactions
Nephrogenic diabetes insipidus (polyuria, polydipsia)
Azotemia and increased BUN (dose-related, reversible)
Gastrointestinal disturbances (nausea, vomiting, diarrhea)
Tooth discoloration and enamel hypoplasia in pediatric patients
Pseudotumor cerebri (benign intracranial hypertension)

Drug Interactions

Antacids containing aluminum, calcium, or magnesium, and iron preparations decrease absorption
Enhances the hypoprothrombinemic effect of anticoagulants
May decrease the efficacy of oral contraceptives
Methoxyflurane increases risk of fatal nephrotoxicity
Lithium may potentiate diabetes insipidus effects and increase risk of lithium toxicity

Curated Content: Needs Vetting Before Put to Clinical Use