Doxycycline can cause yeast infection

DOXYCYCLIN AL 100

Patient information for "Doxycycline"

1. What is "Doxycycline" and what is it used for?

1.1 What are the properties of the medicinal product?

"Doxycycline" contains the active ingredient doxycycline, a drug from the group of so-called tetracyclines.

Tetracyclines are broad-spectrum antibiotics.

Doxycycline is used for infectious diseases caused by germs sensitive to doxycycline.

Doxycycline requires a prescription and should only be used on medical advice.

1.2 What strengths and dosage forms are there?

Oral Doxycycline is commonly available as

- Dragées, tablets, capsules, film-coated tablets as well as drinking tablets (tabs) / effervescent tablets and granules (in sachets) with a strength of 100 mg or 200 mg.

Please note that the information in this patient information sheet relates to the strengths and dosage forms mentioned here!

1.3 Doxycycline is commonly used in

1.3.a) Infections of the respiratory tract and the ear, nose and throat area:

- acute flare-ups of chronic bronchitis

- inflammation of the sinuses (sinusitis)

- inflammation of the middle ear (otitis media)

- certain forms of pneumonia caused by mycoplasma, rickettsia or chlamydia.

1.3.b) Urogenital tract infections:

- Inflammation of the urethra (urethritis) caused by chlamydia and ureaplasma urealyticum

- acute inflammation of the prostate gland (prostatitis)

- uncomplicated gonorrhea (gonorrhea; especially with simultaneous chlamydial infection)

- infections of the female genital organs

- Syphilis with penicillin allergy

- Urinary tract infections (only if the pathogen is proven to be susceptible)

1.3.c) Infections of the gastrointestinal tract:

- Cholera

- Yersinia or Campylobacter infection

- Shigella infection if susceptibility is demonstrated

1.3.d) Outpatient therapy for biliary tract infections

1.3.e) Skin diseases, including infected severe forms of acne vulgaris and rosacea

1.3.f) conjunctivitis caused by chlamydia (chlamydial conjunctivitis) and trachoma

1.3.g) diseases caused by Borrelia such as erythema chronicum migrans and Lyme disease (mainly infections caused by tick bites)

1.3.h) Rare infections such as brucellosis, ornithosis, bartonellosis, listeriosis, rickettsiosis, melioidosis, plague, granuloma inguinale.

1.3.i) Other diseases:

1.3.j) Malabsorption syndromes (diseases associated with digestive disorders) such as tropical sprue and Whipple's disease

2. What should you watch out for before taking "Doxycycline"?

2.1. "Doxycycline" must not be taken / used

- if you are known to be hypersensitive to the active substance or other tetracyclines.

- Doxycycline must not be used in patients with severe liver dysfunction.

2.2.Special care is required when taking / using "Doxycycline"

In general, no special precautions are required for patients with impaired renal function.

Note:

Proven infections by staphylococci, streptococci and pneumococci should not be treated with doxycycline because the resistance situation (sensitivity of the pathogens to the drug) is unfavorable.

2.2.a) Children

Children under 8 years of age should only be treated with doxycycline according to the strictest indication.

2.2.b) Elderly people

There are no special considerations for older people.

2.2.c) Pregnancy and breastfeeding

During pregnancy, "Doxycycline" may only be used if the indications are particularly strict, as the storage of doxycycline in fetuses from the 4th month onwards as well as in infants and children up to the age of 8 leads to a mostly reversible bone growth disorder and before the end of the tooth eruption phase permanent tooth discoloration and tooth enamel defects can occur.

2.2.d) Breastfeeding

During breastfeeding as well as in babies and children up to the age of 8, "Doxycycline" may only be used after particularly strict indications, since in babies and children up to the age of 8 the storage of doxycycline leads to a mostly reversible bone growth disorder and before the end of the Tooth eruption phase can lead to permanent tooth discoloration and tooth enamel defects.

2.2.e) Ability to drive and use machines

There have been isolated reports of usually temporary nearsightedness (myopia) which can develop during treatment with "doxycycline". This can impair the safety when driving vehicles and using machines.

2.2.f) What else should you watch out for?

If "Doxycycline" is used in combination with certain blood sugar-lowering or anti-coagulant drugs (see interactions), the blood sugar and coagulation parameters should be checked and, if necessary, the dose of these drugs should be reduced accordingly.

The detection of sugar, protein, urobilinogen and of catecholamines in the urine can be disturbed by ingestion of tetracyclines.

Sun exposure can cause phototoxic reactions of the exposed skin areas (see side effects). Sunbathing outdoors or in solariums should therefore be avoided during treatment with "Doxycycline".

Before anesthesia, inform your doctor about treatment with "doxycycline" (see interactions).

If treatment lasts longer than 21 days, regular blood, liver and kidney tests should be done.

Please keep the appointment to check the success of the treatment 3 to 4 days after the end of treatment with a gonococcal infection (gonorrhea) particularly carefully in order to avoid a relapse.

Note for capsules containing doxycycline hyclate:

If capsules containing doxycycline hyclate are improperly taken (lying down), ulcers can occur because the capsules stick to the mucous membrane of the esophagus and can release strongly acidic solutions.

2.3 Interactions with other medicinal products

Please inform your doctor or pharmacist if you are taking / using or have recently taken / used any other medicines, including medicines obtained without a prescription.

The absorption of doxycycline from the gastrointestinal tract can be caused by certain divalent or trivalent cations such as aluminum and magnesium (contained, for example, in agents for binding gastric acid) or calcium (also contained in milk and milk products), through iron supplements and through medicinal charcoal and cholestyramine (used to lower high blood lipid levels).

Therefore, drugs or food with these components should be taken at intervals of 2 to 3 hours.

The antibiotic rifampicin, substances from the class of barbiturates (e.g. also contained in sedatives and sleeping pills) and other agents against seizure disorders (carbamazepine, diphenylhydantoin and primidone) as well as regular, habitual and / or abusive consumption of alcohol (alcohol abuse) can reduce the breakdown of doxycycline (by enzyme induction in the liver) accelerate with the consequence of a loss of effectiveness of "doxycycline", since the blood level of the drug cannot be reached sufficiently high.

How does "Doxycycline" affect the effect of other drugs?

Doxycycline may increase the effects of certain blood sugar lowering agents (oral sulphonylurea antidiabetic agents) and of certain anticoagulants (anticoagulants of the dicumarol type) (see section 2.2). In the case of combined administration, the blood sugar and coagulation parameters should be checked and, if necessary, the dose of these drugs should be reduced accordingly.

"Doxycycline" can increase the damaging (toxic) effect of Ciclosporin A (agent for suppressing the body's own immune system).

Other interactions:

Anesthesia with methoxyflurane or other substances that may be harmful to the kidneys can lead to kidney failure during treatment with "doxycycline" (see section 2.2).

Shortly before, during or after isotretinoin treatment of acne, treatment with "doxycycline" should not be carried out, as both drugs can in rare cases cause reversible pressure increases in the cranial cavity (pseudotumor cerebri), which resolve on their own after treatment is stopped .

The simultaneous intake of "doxycycline" and certain other antibiotics (beta-lactam antibiotics such as penicillins, cephalosporins) should be avoided, as a weakening (antagonistic) effect was observed in laboratory diagnostic tests with regard to the antibacterial effect.

The simultaneous use of "doxycycline" and theophylline (asthma drug) can lead to increased side effects in the gastrointestinal tract.

Please note that this information can also apply to recently used drugs.

Note:

In rare cases, during treatment with "doxycycline", the safety of the contraceptive effect of oral hormonal contraceptives ("pill") may be questioned. It is therefore advisable to use additional non-hormonal contraceptive measures.

2.4 If "Doxycycline" is taken with food and drink

Please take milk, milk products and fruit juices that do not contain calcium together with "Doxycycline". Keep an interval of 2 to 3 hours (see section 2.3).

Please note that with regular, habitual and / or abusive consumption of alcohol, the breakdown of doxycycline is accelerated (see also chapter 2.3: Interactions with other drugs).

3. How should "Doxycycline" be used?

Always take "Doxycycline" exactly as your doctor has told you. Please ask your doctor or pharmacist if you are not sure.

3.1 Type and duration of application

Doxycycline should either be taken regularly in the morning with breakfast or at the same time as another meal with plenty of fluids (no milk or dairy products), e.g. a glass of water. Taking it with a meal can reduce the incidence of gastrointestinal disorders.

To avoid errors in use, always take the tablets with plenty of liquid in an upright position (sitting or standing). Drink plenty of liquid again about 10 to 15 minutes after ingestion!

Capsules containing doxycycline hyclate should be taken with plenty of fluids (no milk), in an upright position and not immediately before going to bed to prevent ulcers on the lining of the esophagus. Taking it with a meal can reduce the incidence of gastrointestinal disorders.

Please note the following for drinking tablets, effervescent tablets and sachets with granules:

Dissolve the drinking tablets, effervescent tablets or the contents of a sachet in a glass of water (while stirring) and drink the solution completely.

How long should you use doxycycline?

The duration of treatment depends on the type, severity and course of the disease. In general, doxycycline is taken between 5 and 21 days for acute infections. Your doctor will determine the respective duration of treatment (see also special dosage recommendations).

If infections with beta-hemolytic streptococci are treated with proven susceptibility, this must be done for at least 10 days in order to prevent long-term damage (such as rheumatic fever or glomerulonephritis).

In the following, the duration of use is

- acute gonorrheic urethritis (gonorrhea) in men: 7 days

- acute gonococcal epididymitis: 10 days

- acute gonococcal infection in women: at least 7 days

- Syphilis (primary and secondary form in penicillin allergy): 15 days

- Lyme disease (stage I): 2 to 3 weeks

3.2 Unless otherwise prescribed by the doctor, the usual dose is

Adolescents (and children over 8 years of age) over 50 kg body weight and adults under 70 kg body weight take 200 mg doxycycline (2 tablets, film-coated tablets, dragees or capsules equivalent to 200 mg doxycycline) on the first day and 100 mg doxycycline (1 Tablet, film-coated tablet, dragee or capsule equivalent to 100 mg doxycycline). Proceed in the same way for granules, drinking tablets or effervescent tablets.

Adults with a body weight of more than 70 kg take 200 mg doxycycline daily, unless otherwise prescribed.

For the treatment of children under 50 kg body weight and from 8 years of age: 4 mg / kg body weight on the first and 2 mg / kg body weight on the following days.

Special dosage recommendations:

3.2.a) Acute gonorrheic urethritis (inflammation of the urethra caused by gonorrhea) in men

200 mg doxycycline daily for 7 days.

3.2.b) Acute gonococcal epididymitis (inflammation of the epididymis caused by gonococci)

200 mg doxycycline daily for 10 days.

3.2.c) Acute gonococcal infection in women

200 mg doxycycline daily for at least 7 days.

The success of treatment with a gonococcal infection should be checked by a cultural control 3 to 4 days after the end of treatment.

3.2.d) Syphilis (primary and secondary form in penicillin allergy)

100 mg 3 times daily, equivalent to 300 mg doxycycline, for 15 days.

3.2.e) Skin diseases, including infected severe forms of acne vulgaris and rosacea:

100 mg doxycycline daily, usually 7 to 21 days. Subsequently, the daily intake of 50 mg doxycycline is possible as maintenance therapy for a further 2 to 3 weeks (dosage forms with 50 mg are available for this purpose). Depending on the treatment result, long-term treatment with low-dose doxycycline (50 mg daily) for a period of up to 12 weeks can be used to treat acne.

3.2.f) Lyme disease (stage I)

200 mg doxycycline daily for 2 to 3 weeks (but at least 14 days).

3.2.g) Impaired kidney function

There is generally no need to reduce the dose of doxycycline in patients with impaired renal function.

Please talk to your doctor if you have the impression that the effect of "Doxycycline" is too strong or too weak.

3.3.What to do if you have taken / used more "Doxycycline" than you should?

Reports of cases of poisoning with doxycycline have not yet become known. However, since there is a risk of liver and kidney damage and inflammation of the pancreas in the event of overdosing, you should contact a doctor in case of suspicion.

When treating the overdose, the doctor will orientate himself towards the clinical picture.

3.4.What to do if you forget to take / use "Doxycycline"?

If you forget to take a dose, please continue taking "Doxycycline" in the prescribed amount the next day.

4. What side effects are possible?

Like all medicines, "Doxycycline" can have side effects.

When evaluating side effects, the following frequencies are used as a basis:

- very common: more than 1 in 10 people

- common: less than 1 in 10, but more than 1 in 100 patients

- uncommon: less than 1 in 100, but more than 1 in 1,000 patients

- rarely: less than 1 in 1,000 but more than 1 in 10,000 people treated

- very rare: less than 1 in 10,000 patients, including isolated cases

4.1 Side effects

4.1.a) gastrointestinal tract

During treatment with "Doxycycline" gastrointestinal disorders such as nausea, stomach pressure, heartburn, nausea, vomiting, flatulence, fatty stools and diarrhea can often occur.

Taking the drug after or with meals may reduce these undesirable effects to some extent; the resorption rate is only marginally affected.

Furthermore, the following can occasionally occur: mouth and throat inflammation, hoarseness, difficulty swallowing and occasionally black hairy tongue.

If severe, persistent diarrhea occurs during or in the first few weeks after treatment, pseudomembranous colitis should be considered (in most cases caused by Clostridium difficile). This bowel disease caused by antibiotic treatment can be life-threatening and requires immediate and appropriate treatment (see Countermeasures for Side Effects).

4.1.b) Nervous system

An increase in pressure in the cranial cavity (pseudotumor cerebri), which regresses after the end of treatment, is rarely observed. It manifests itself as headache, nausea, vomiting and possibly a visual disturbance due to papilledema (swelling of the optic nerve papilla as a result of increased fluid accumulation).

4.1.c) Skin and appendages

Allergic skin reactions to doxycycline occur occasionally (see also section on hypersensitivity symptoms).When exposed to sunlight, photosensitization can lead to phototoxic reactions of the exposed skin areas (with symptoms like those of a strong sunburn, e.g. reddening, swelling, blistering, discoloration), rarely with involvement of the nails (nail detachment and discoloration). Sunbathing outdoors or in solariums should therefore be avoided during treatment with "Doxycycline".

4.1.d) Blood and blood cells

The following changes in the blood, which will return to normal after stopping treatment, may rarely occur: decrease in the number of blood platelets and red blood cells (thrombocytopenia, anemia), decrease or increase in the number of white blood cells (leukocytopenia, lymphocytopenia, leukocytosis) as well as changes in some types of blood cells (atypical lymphocytes and toxic granulations of the granulocytes), disease of the lymph nodes (lymphadenopathy).

4.1.e) Liver and pancreas

Overdosing can result in liver damage or inflammation of the pancreas (pancreatitis).

There is an increased risk of liver damage during pregnancy when taking tetracycline.

4.1.f) kidneys

Tetracyclines can cause kidney damage (nephrotoxicity) or worsen a pre-existing renal impairment (recognizable by an increase in creatinine and urea in the serum).

In connection with the administration of doxycycline, kidney damage, e.g. B. interstitial nephritis, acute kidney failure and lack of urine elimination (anuria) have been reported.

4.1.g) Symptoms of hypersensitivity

Hypersensitivity symptoms (e.g. allergic reactions) occasionally occur during "Doxycycline" treatment. These include skin reactions with and without itching, such as localized or extensive (generalized) rashes (exanthema), reddening of the skin (erythema), Hives with blistering and wheals (urticaria), disc rose (erythema exudativum multiforme), temporary local swelling of the skin, mucous membranes or joints (angioedema), asthma, rashes on the genitals and other parts of the body and a serum sickness-like reaction with fever , Headache and joint pain.

Serious skin symptoms with life-threatening general reactions (such as exfoliative dermatitis, Lyell's syndrome) have rarely been reported in connection with doxycycline treatment.

If you are hypersensitive to "doxycycline", you must not be treated with tetracyclines (complete cross-allergy).

Severe, sudden hypersensitivity symptoms are rarely possible. They can express themselves as: swelling of the face (facial edema), tongue swelling, internal swelling of the larynx with narrowing of the airways, rapid heartbeat, shortness of breath (shortness of breath), drop in blood pressure up to threatening circulatory collapse and cardiac arrest. If these symptoms occur, which can be life-threatening, immediate medical attention is required (see also section 4.2 Countermeasures).

4.1.h) Other side effects

Treatment with "doxycycline" can lead to a fungal colonization (Candida) of the skin or mucous membranes (especially of the genital tract and the oral and intestinal mucous membranes) with symptoms such as mouth and throat inflammation (glossitis, stomatitis), acute Inflammation of the external genital organs and the vagina in women (vulvovaginitis) and itching in the anal region.

Permanent tooth discoloration and enamel damage, as well as temporary delay in bone growth, have occasionally been observed in the treatment of children under 8 years of age.

Occasionally, bleeding disorders and blood in the urine (hematuria) have also been observed.

Abnormal sensations (paraesthesia), acceleration of the heartbeat (tachycardia), muscle pain (myalgia), joint pain (arthralgia), restlessness and anxiety have rarely been reported in connection with the administration of doxycycline.

Seizures after administration of doxycycline are very rare.

(One case of epileptic seizure has been reported following oral administration of doxycycline. Several cases of this side effect have been reported following intravenous administration.)

A disturbance or loss of smell and taste sensation were rarely described, which were only partially reversible in some cases.

4.2 Countermeasures for side effects

The following side effects (for a more detailed explanation of these side effects see above) can be acutely life-threatening under certain circumstances. Therefore, if such an event occurs suddenly or if it develops unexpectedly, a doctor should be informed immediately:

Pseudomembranous colitis: Here the doctor must consider ending treatment with "doxycycline" depending on the indication and, if necessary, immediately initiate appropriate treatment (e.g. taking special antibiotics / chemotherapeutic agents whose effectiveness has been clinically proven). that inhibit bowel movement (peristalsis) must not be taken.

Severe acute hypersensitivity reactions (e.g. anaphylaxis): In this case, treatment with "doxycycline" must be stopped immediately and the usual appropriate emergency measures (e.g. antihistamines, corticosteroids, sympathomimetics and, if necessary, ventilation) initiated.

Tell your doctor or pharmacist if you notice any side effects not listed here or in the package insert.

5. How should the medicine be stored?

Store the medicine at normal room temperature and keep the medicine in the original packaging, protected from light and moisture, unless the manufacturer specifies otherwise.

Medicines should generally be kept out of the reach of children.

Do not use the medicine after the expiry date stated on the pack.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer need. This measure helps to protect the environment.

6. Source and processing status

Information from the SCHOLZ database based on the data approved by the Federal Office for Drugs and Medical Devices

Copyright by ePrax GmbH; Munich May 2014 (7)