Tetracycline antibiotic

Lymecycline

Brand names: Tetralysal 300

Adult dose

Dose: 408mg OD (equivalent to tetracycline 300mg) for at least 8 weeks

Route: Oral

Frequency: OD

Clinical pearls

NICE NG198 Acne: oral tetracycline (lymecycline or doxycycline) first-line antibiotic for moderate–severe acne (≤3 months continuous)
Always combined with topical retinoid or BPO to reduce resistance
BAD guidance on antibiotic stewardship in acne

Contraindications

Pregnancy
Breastfeeding
Children <12 years
Severe renal impairment
SLE (relative)
Hypersensitivity to tetracyclines

Side effects

GI upset
Photosensitivity
Oesophageal ulceration (take with water, upright)
Benign intracranial hypertension
Tooth discolouration in children <12
Hepatotoxicity (rare)

Interactions

Iron, calcium, magnesium, antacids (chelation — separate by 2 hours)
Warfarin (potentiation)
Retinoids (avoid concurrent — intracranial hypertension)
Penicillins (antagonism)

Monitoring

Treatment response at 3 months
Photosensitivity precautions

Reference: BNF; NICE NG198; BAD acne guidance; https://bnf.nice.org.uk/drugs/lymecycline/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways