Demeclocycline

Aka: Demeclocycline

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II. Indications

  1. Similar Indications to Tetracycline and Doxycycline
  2. SIADH (off-label)
    1. Due to its unique Vasopressin inhibition (see mechanism below)
    2. Limited evidence for use in SIADH

III. Mechanism

  1. See Tetracyclines
  2. Semi-synthetic, broad-spectrum Naphthacene antibiotic produced by the bacterium Streptomyces aureofaciens
  3. Inhibits Bacterial Protein synthesis
    1. Binds to Bacterial 30S ribosomal subunit
    2. Blocks aminoacyl-tRNA binding to mRNA-ribosome complex
  4. Other effects
    1. Inhibits Vasopressin activity at the renal tubules, with secondary diuresis

IV. Dosing

  1. Take on an empty Stomach, with large glass of non-dairy fluid
  2. General
    1. Take 150 mg orally four times daily (or 300 mg orally twice daily)
  3. SIADH
    1. Take 600 to 1200 mg/day divided four times orally daily
    2. Effect is delayed 5 to 14 days after dose change
      1. Avoid modifying dose more than every 4 days

V. Adverse Effects

  1. See Tetracyclines
  2. Diabetes Insipidus
  3. Photosensitivity
  4. Pill Esophagitis

VI. Drug Interactions

  1. Food
    1. Milk and Calcium-rich food decrease absorption
    2. Take 1 hour before or 2 hours after a meal
    3. Take with a full glass of water (risk of Pill Esophagitis)

VII. Safety

  1. Pregnancy Category D
  2. Unknown safety in Lactation

VIII. Resources

  1. Demeclocycline (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=645af8f4-0843-4afb-9ddc-f587f38adb68

IX. References

  1. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 112-3
  2. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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