Initial dose of 100 mg IV load, followed by 50 mg IV q12h
Mild-to-moderate hepatic impairment (Child-Pugh class A or B):
no dosage adjustment necessary
Severe hepatic impairment (Child-Pugh class C):
Initial dose of 100 mg IV load, followed by 25 mg IV q12h
Reserved for highly resistant infections or when significant allergies restrict other options and when there is documented susceptibility.
Associated with more treatment failures than alternatives and excess mortality - Black Box Warning.
Avoid or use with caution in patients with tetracycline reactions due to possibility of cross-reaction.
GI side effects very prominent with significant nausea and vomiting.
Tetracycline related adverse events: photosensitivity, acute pancreatitis.
Rash, abnormal liver enzymes.
May increase warfarin concentrations.
Oral contraceptives less effective.
Documented safety concerns in bacteremia especially.
Antimicrobial class: Tetracycline derivative
Pregnancy category: D
Average serum half life: Single dose: 27 hours; following multiple doses or at steady state: 42 hours
Biliary penetration: Therapeutic
Lung penetration: Therapeutic