Doxycycline (COPD Exacerbation / CAP)

This is the SPC's usual dosage for the treatment of acute infections in adults and children aged 12 years to less than 18 years; the SPC does not give a regimen specific to COPD exacerbation or community-acquired pneumonia, so duration should follow current local guidance. Therapy should be continued for at least 24 to 48 hours after symptoms and fever have subsided; in streptococcal infections therapy should be continued for 10 days to prevent rheumatic fever or glomerulonephritis. Exceeding the recommended dosage may increase side effects. If gastric irritation occurs the capsules may be given with food or milk (absorption is not notably influenced by food or milk). Other indication-specific regimens in the same SPC include: acne vulgaris 50 mg daily with food or fluid for 6 to 12 weeks; uncomplicated chlamydial/gonococcal genital infections and non-gonococcal urethritis 100 mg twice daily for 7 days; acute epididymo-orchitis 100 mg twice daily for 10 days; primary and secondary syphilis in non-pregnant penicillin-allergic patients 200 mg twice daily for two weeks; chloroquine-resistant falciparum malaria 200 mg daily for at least 7 days with a rapid-acting schizonticide; malaria prophylaxis 100 mg daily; prevention of scrub typhus 200 mg as a single dose; prevention of travellers' diarrhoea 200 mg on day 1 then 100 mg daily; prevention of leptospirosis 200 mg once weekly plus 200 mg at completion of the trip; Rocky Mountain spotted fever 100 mg every 12 hours. Elderly: usual dosages, no special precautions. Interactions listed below are from the US FDA label because SPC section 4.5 was not captured in this bundle; SPC sections 4.4 and 4.8 were truncated at the source-fetch limit. Source product: Doxycycline 100 mg capsules.

Applies only to children aged 8 years to less than 12 years weighing 45 kg or less, and only where use is carefully justified because other drugs are not available, are not likely to be effective, or are contraindicated. Doxycycline should not be used in children younger than 8 years because of the risk of permanent tooth discolouration (yellow-grey-brown) and enamel hypoplasia, except where potential benefits outweigh the risks in severe or life-threatening conditions with no adequate alternative. Children aged 12 years and over receive the adult dose. For Rocky Mountain spotted fever the SPC gives 2.2 mg/kg twice a day for children weighing less than 45 kg. Verify against a children's formulary before prescribing.