Talk:Doxycycline/Archive 1

Archive 1

Gonorrhea indication and the below-mentioned warning

Why does the article not list this medication as indicated for the first line treatment of gonorrhea (since most strands are resistant to penicillin nowadays)?

Also, below there is a mention of a warning against lying down for 30 minutes after taking the medication. While it is not a part of the FDA slip insert, it does appear on those in Europe and Israel and pharmacist usually mention it upon providing the medication, along with taking it only on a full stomach and with nothing dairy due to binding with the milk proteins.

IUPAC name IS wrong

I agree, the IUPAC name IS wrong, mainly because the compound has only 2 carbonyl groups (and two enolic ones), and therefore could not possibly be called a -trione.

The IUPAC name and the structure do not match. The name gives it a dioxo structure and suggests an amide, whereas the structure is a trioxo compound and a hydroxyamine. I expect this is due to tautomerism, however, the name or structure should be edited to match.Kumorifox (talk) 12:07, 30 January 2014 (UTC)

unusual warning?

On the side of the bottle of this drug there's an unusual warning: Do not lie down for 30 minutes after taking this medication. Anyone know what that's about (and particularly how serious it is)? --Junkyard prince 11:08, 8 October 2005 (UTC)

Lying down after taking doxycycline can cause pain similar to heartburn. There is some evidence to suggest that if this occurs regularly over a long period of time, oesophagal damage similar to Barrett's Esophagus can occur. For the small amount of effort it takes, it is a wise precaution to obey.Rossheth 14:28, 27 November 2005 (UTC)

This warning is probably because of the possible risk of the pill getting stuck in your esophagus. This has been known to happen specifically with doxycycline just because the pill is so large. There have been reports of cases of teenagers who were taking doxycycline for acne having esophageal damage and tears because the pill was stuck for longer than 24 hours.--Beezer137 (talk) 18:24, 20 January 2008 (UTC)

Doxycycline in Vibrio Cholera

There is no mention that doxycycline and tetracycline are the drugs of choice for cholera in adults.

• Probably because most doctors who contribute to this English wikipedia are from English-speaking countries (USA, UK) where fortunately cholera is infrequently encountered. A quick search indicates they do indeed have a role (some articles highlight onset of resistance to the group). However whilst they help reduce the severity of an episode, the more important "drug" is actually the provision of oral rehydration fluids, intravenous fluids on occasion and of course public health measures to both prevent and contain outbreaks. I'll add a section to the main tetracycline antibiotics article.David Ruben ^Talk 14:38, 17 March 2006 (UTC)

Tooth Discoloration?

Hello,

How likely is it that tooth discoloration will occur. My dermatologist reccommended I take this for atleast two months! I do not have severe acne but have a small cyst...very minor under the skin. Any information would be greatly appreciated before I begin taking this!

above added by User:24.73.242.194 at 18:51, 3 May 2006

Firstly please note it is policy to sign talk page entries, the easiest method is to use 4 tildes (~~~~) which will add your name, date & time for you.

• Tetracyclines stain teeth and restrict tooth development by binding to the calcium as the tooth forms - hence the restriction on their use in children under 12. As far as I am aware, beyond this age, no perminant tooth staining occurs.
• All acne treatments (whether benzoyl peroxide or any of the oral or topical antibiotics) generally take 4-6 weeks to start to work well and 6-8 weeks to have their main effect, hence the typical length of treatment you have been prescribed.
• Cystic acne is a more severe form of acne than just simple surface pimples, although sounds as if you are lucky to have only to a limited extent. David Ruben ^Talk 19:12, 3 May 2006 (UTC)

I agree. No tooth discoloration occurs after the age when your teeth have fully grown and developed, after about age 12.--Beezer137 (talk) 18:28, 20 January 2008 (UTC)

treatment for blepharitis?

I was prescribed 100mg doxycycline tablets on a one-month course to treat what my eye specialist considers to be stubborn blepharitis. He said it wasn't known why doxycycline was effective, but that it seemed to be. Does anyone know why? Nbertram 12:16, 12 September 2006 (UTC)

blood thinners

do you think it is good to take at the same time as blood thinners? Above posted User:66.25.164.66 on 21:23, 6 May 2006

• Please note it is policy to sign talk-page entries - done for you by using 4 tildes ~~~~
• Whilst (as my British National Formulary indicates) studies fail to demonstrate an interaction with broad-spectrum antibiotics, common experience in anticoagulation clinics is that the INR may be altered. Given that most antibiotics therefore may have an interaction (amoxicillin, quinolones, macrolides, trimethoprom, sulphonamides etc) the question is not whether it is "good" to take, presumably there is a need to take an antibiotic else "bad" might occur. So presuming antibiotic is necessary, the issue is whether one needs the INR rechecking after a few days to adjust the anticoagulant dosage whilst taking the antibiotic:
  • Hence worthwhile checking back with the doctor to ensure that they did not forget about possible interactions and whether an additional anti-coagulation clinic check is required...
  • Patient should also remember to advise the anti-coag clinic that they are on antibiotic and how long its course is for (if teh anti-coagulant dose required changing then a further rcheck may be required few days after finishing the antibiotic). David Ruben ^Talk 22:22, 6 May 2006 (UTC)

Expand article

I would like to see more info on uses...whoever knows more about this medicine, please expand the article.--AAAAA 16:44, 2 August 2006 (UTC)

By and large, all members of the tetracyclines have similar activity and thus clinical use. Certainly the longer acting members are more useful for those on long courses (acne, malaria prevention) if only because aid medication compliance. Main discussion of use needs be in tetracycline antibiotics, with just brief outline and any specific points or distinguishing features of use appearing for each member of the group. David Ruben ^Talk 18:15, 2 August 2006 (UTC)

Why is Doxycyline use for malaria

Malaria is caused by an acutal parasite not a bacteria. So how can it be effective? Is it the fact that it is semisynthetic and it possesses the properties of both antbiotic and antiparasitic?

SPC Bevers Combat Medic User:65.74.212.241 07:00, 6 November 2006

Good question - yes clearly by acting as antiparasite, but the question is really whether this is a similar mechanism to its antibacterial activity. Recent paper confirms the mecahism (blocks a plasmid in the malaria from later being able to divide) and whilst the paper I've cited in the article was about specifically about Doxycycline, the authors presume this is a class effect by which other tetracycline antibiotics also have anti-malaria effects. David Ruben ^Talk 14:38, 6 November 2006 (UTC)

Sexual Side effects?

Are there any documented cases of sexual side effects with this medication? At the pharmacy where I work, I looked the info packet and saw none. However, I seem to be experiencing the symptoms of ED only on days when I take this mass. PowderedToastMan 08:18, 7 February 2007 (UTC) 5 May 2014. I was prescribed Doxycycline HYC 100mg twice daily. Since starting this med I have had less sensitivity during sex. Erection was not inhibited although orgasm was difficult. — Preceding unsigned comment added by 97.85.52.52 (talk) 18:48, 5 May 2014 (UTC)

Other effects?

When taking doxycycline for malaria prevention (I remember its brand name at the time as "Doximol", though I can find no other reference other than a single entry in the Indian Trademarks index) I remember it giving me particularly vivid dreams. Are there any listed psychoactive side effects of this substance?

need some info..

i've been using doxycycline for almost a year and a half for my acne and it has started to lose its effect on treating my acne. My friend has told me about minocycline and that it has really work well for him and i was wondering if the change in medication would help? I went to see a pharmacist today and he told me that 90% of doxycycline and minocycline are the same. Also, i wanted some opinion on GERD and barrnetts diesase. During the prolong period i had taken doxycycline, there would be theses days where i thought i would have taken the medication wrong and it had gotten stuck in my throat and released. I would have the pain in my throat all day, that would really bother me, and this would happen i would say at least twice a month, do i need to be worried about anything???? Also, are there any side effects or things i need to be worried about for prolonged used of doxycycline??

---

If you specifically have an issue with the pill getting stuck, I would suggest you change to a different one. This issue is specifically because of how large the pill is, and there have been reports of esophageal rupture with this as well. The abstract is available on the web.[1]

Also, even though the pharmacist is right about how similar doxycycline and minocycline are, it happens all the time that for a particular individual, one medication will work while another does not. Acne can be a problem where you may have to keep switching medications and trying out different things for quite a while.--Beezer137 (talk) 18:41, 20 January 2008 (UTC)

I was taking doxycycline for a issue caused by my mirena IUC and it gave me that lump in the throat feeling. I continued to take it for 10 days as directed it just got worse. 2 days after stopping the medication i still had that feeling that the pill was stuck in my throat! i looked at my tongue and on the back was this string white stuff. The doc said it had given me "white hairy tongue" a rare side effect. Now he has me on Fluconazole for it. This morning i woke up with a sinus infection! why do i keep getting so many side effects from medication?== Names ==

Sorry if this sounds really stupid, but is there a difference between Doxycycline and Doxycycline Hyclate? 88.105.14.145 18:08, 15 August 2007 (UTC)

combination of doxycycline with lactic acid bacillus

why combination of doxycycline with lactic acid bacillus is used? —Preceding unsigned comment added by 59.181.100.28 (talk) 08:12, 19 September 2007 (UTC)

Veterinary usage?

Could someone speak to the usage of Doxycycline in veterinary medicine, specifically animal dosing and side effects? —Preceding unsigned comment added by 66.102.186.13 (talk) 04:17, 25 June 2008 (UTC) Used extensively in avian treatment and in my experience is very good in treating respiratory ailments. References can be found in any works on bird health. Mikeyc —Preceding unsigned comment added by 124.182.80.202 (talk) 03:06, 13 August 2008 (UTC)

I second this request. My dog was prescribed this for lyme disease and I was looking for information but nothing about vet usage here.   bsmithme  20:27, 22 October 2009 (UTC)

I work at a Veterinary Clinic and our doctors use Doxycycline pretty regularly for dogs and cats with various issues, one being part of heartworm treatment, "Doxycycline reduces Wolbachia numbers in all stages of heartworms. Doxycycline administration during the first or second month following infection with heartworms was lethal to third- and fourth-stage heartworm larvae in experimental infections. In addition, in dogs with adult infections, doxycycline gradually suppressed microfilaremia. " http://www.heartwormsociety.org/veterinary-resources/canine-guidelines.html --VetTech21 (talk) 02:46, 14 March 2012 (UTC)

Liver damage???

Can someone clarify on the liver damage? What do you mean by slim liver damage? Please elaborate 72.79.36.199 (talk) 20:10, 30 July 2008 (UTC)SF403

The citation does not appear relevant to the claim about liver damage. —Preceding unsigned comment added by Binarybottle (talk • contribs) 03:14, 21 May 2009 (UTC)

i have a slight liver problem. my doctor said the warning talks about the liver is because just about all medications you take can cause liver damage and if you have severe liver problems that taking it could make it worse. but on the list on side effect liver damage is so far down on the list that i shouldnt worry about it. —Preceding unsigned comment added by 74.67.80.209 (talk) 01:20, 31 July 2009 (UTC)

As mentioned above, the citation does not mention anything about "liver damage during prolonged use of the drug", it only mentions short term autoimmune reactions. I'll remove that sentence as unsourced. Kernow (talk) 09:01, 21 September 2010 (UTC)

Alzheimers and epigenetics??

Can someone say more about this and the experiments done on mice? Also, where is this chemical derived from nutritionally or bacterially? 96.246.2.245 (talk) 03:46, 6 September 2008 (UTC)

I, too, would like to know more on this topic. 213.243.137.56 (talk) 08:11, 18 June 2009 (UTC)

yeast infection in partner

I have used the antibiotic for a few days 100 mg 2x day. My partner seems to have a bad reaction to my semen,I used a condom after that and notice that I get a rash and sensitivity to my semen also.72.73.22.13 (talk) 12:59, 4 October 2008 (UTC)

Other side effects?

Is there anything in the medical literature about headaches as a result of taking doxycycline? 74.78.116.93 (talk) 01:11, 9 January 2009 (UTC)

Apparently, yes, there is - tetracycline antibiotics. Bananabananabanana (talk) 16:35, 1 October 2009 (UTC)

ELEVATED BILIRUBIN & SERUM CREATNINE

Can Doxycycline cause elevated bilirubin (to the point of jaundice) & serum creatnine after only 2 days of 100mg QD dosing? —Preceding unsigned comment added by 65.69.19.33 (talk) 17:52, 16 April 2009 (UTC)

story at the bottom of the article

"Doxycycline is also effective in the treatment of the skin disease Hydradentitis Suppurativa. This condition is similar to severe acne but different in the respect that it attacks the intimate areas of the body such as: The armpits, breasts, inner thighs, the groin and sometimes the anal area. It causes boils that are extremely painfull to the touch and, the condition is linked to the apocrine sweat glands. (See Wikipedia for more details). There is no cure for this condition, and it is very rare so often gets misdiagnosed. Some dermatologists suggest medicines such as Minocycline, or tetracycline even stronger treatments such as Ro acutaine (Isotretinoin) but Doxycycline is very effective and should be tried before the final option of surgery. It works especially well when used in conjunction with Clindamycin Phosphate topical lotion, and Clorhexidine Antimicrobial Skin wash. I have no references to back my statement up, but I have had this condition for ten years and it has been misdiagnosed, and no treatment that I have tried has worked except Doxycycline and I have tried many treatments." -- posted by Suzanne Howard and previously at the bottom of the reflist. We can't take it, obviously, because it's original research, but a paragraph about HS if we can find a citation for use of doxycycline would be a nice addition. Bananabananabanana (talk) 16:33, 1 October 2009 (UTC)

Hidradenitis suppurativa is the relevant article (note different spelling) --220.101 (talk) ^\Contribs 19:32, 16 July 2010 (UTC)

RE: premanent sensitive and thin skin

"However, the risk of photosensitivity skin reactions is of particular importance for those intending long-term use for malaria prophylaxis because it can cause permanent sensitive and thin skin."

Is this saying that doxycycline can cause permanent sensitive and thin skin?

Or is it saying that photosensitivity skin reactions can cause permanent sensitive and thin skin? —Preceding unsigned comment added by Josh7289 (talk • contribs) 07:55, 10 October 2009 (UTC)

Food interactions

Food, including dairy products, does not interfere with the absorption of doxycycline, unlike most other tertacycline antibiotics.[21]

Really? Probably better to say that food/dairy products do not interfere with absorption of doxycycline to the same extent as other tetracyclines. It is still widely advised not to take doxy with dairy.

http://aac.asm.org/cgi/content/abstract/11/3/462 Facts and Comparisons

Goodman and Gillman 12e: Doxycycline and minocycline are less affected than tetracyclines and administration with milk or calcium-containing foods is unlikely to impair absorption substantially, but co-administration of antacids or mineral supplements should be avoided.

Interaction of drugs with foods and nutrients MJ Mycek - Nutrition assessment: a comprehensive guide for …, 1995 - books.google.com ... The medications may be taken with food to lessen the gastric irritation, but not with dairy products. The absorption of doxycycline (Vibramycin") and minocycline (Minocin*) is not affected to the same extent as that of other tetracyclines. ... — Preceding unsigned comment added by 71.155.228.125 (talk) 06:44, 27 September 2011 (UTC)

Milk also causes acid reflux in some people. Source: http://www.acidrefluxsymptomsnow.com/can-milk-cause-heartburn.html — Preceding unsigned comment added by TomLibelt (talk • contribs) 05:15, 10 December 2011 (UTC)

Anxiety

I removed a statement about doxycycline causing severe anxiety attacks and an external link to a forum page where this was discussed which I assume to be the source for the statement. I looked but couldn't find a reliable source for doxycycline and anxiety. If a good source is found, the statement should go under the side effect heading rather than under Experimental Applications. -Slapmaster3000 (talk) 21:26, 28 March 2012 (UTC)

On the Rxisk.org site (at http://rxisk.org) which provides free access to databases including side effects information from FDA, a compelling case is made for doxycycline causing both anxiety and suicide (http://wp.rxisk.org/rxisk-says-doxycycline-causes-suicide/). But I'm a newbie here and not sure how to correctly add this information on the main article page... Exdc (talk) 15:58, 12 March 2013 (UTC)

Antihelmintic

It's great that there's mention of the use of doxycycline in treatment of nematode infections like lymphatic filariasis, but the paragraph about this currently gives generic info on LF rather than focus on the use of the drug to treat such parasitic infections. I'm considering streamlining this section, and adding some more links to the research into Wolbachia-nematode interactions that are disrupted by doxycycline. If people have more to add on this section I'd be very grateful for the extra input. Emble64 (talk) 14:02, 4 July 2012 (UTC)

Edit request

The brand name drug Apprilon should be added to the list of other Doxycycline brand names in the first paragraph of the article. The next sentence should read "In Canada, Oracea is marketed under the brand name Apprilon. Health Canada approved Apprilon for use in the treatment of rosacea in November 2012". the word rosacea should be linked to its wikipedia article. The information cited for this recommended edit can be found at: http://www.galderma.ca/Includes/PDF/Apprilon_PM_EN.pdf and the approval of Apprilon by Health Canada can be found at: http://canadianpharmacistsletter.therapeuticresearch.com/pl/NewDrugs.aspx?cs=&s=PLC&pt=21&yr=2012 -- The above edit request was actually submitted by Nickwilliams9, as determined by edit history. -- [ UseTheCommandLine ~/talk ]# ▄ 12:19, 13 August 2013 (UTC)

@Nickwilliams9: Thanks for your request. It looks reasonable, and the sources seem to back it up, so feel free to go ahead and make the edit yourself. — Mr. Stradivarius ^{♪ talk ♪} 11:25, 23 October 2013 (UTC)

Edits of December 30, 2014

Hello BP, I have to disagree. The price increase is already resolved. a temporary phenomenon of the type that has been seen before arsing from price gouging during a temporary supply shortage. Its off patent, and if the price remains high for anything approaching a year, other manufacturers will enter production to take advantage of the higher profit margin, until the high margins are eliminated by competition. That's how non-monopolistic markets work.

Its notable enough to add a sentence or two. But a 6-12 month increase in the price is getting 3 times the number of lines of commentary than the discovery and development of the drug (without which no one would have access at any price). This temporary price history does not constitute 70% of the notable history of the drug.

The claim that the price of a single Rx went to $3000 is dubious to say the least. The same article quotes 50 tablets for $250, so the $3K Rx would have to include 600 tablets. The normal regimen of therapy is 14 pills, taken 2 on the first day and then once a day. A 600 pill Rx would be nearly 2 years of therapy. No one Rxs for that.

Lastly this does not deserve this much space because it is all USA-centric. The drug is still available in other countries for a modest price. The problem is that those manufacturers do not yet have FDA approval to sell in the US. Formerly 98 (talk) 17:58, 31 December 2014 (UTC)

Your own link is currently showing (non-coupon) prices (at the pharmacies it says adhere to adequate quality standards) in the range of $64–$188 for 28 pills – i.e., $2–$7 per pill at low-cost pharmacies (with the highest price being at the major discount store Kmart). How can you call that resolved for a 50-year-old generic off-patent product that previously cost 6 cents per pill? That's a 4,000–10,000% increase in price.

As recently as two weeks ago there were still news stories saying it wasn't resolved, and 6–12 months is clearly a gross underestimate (as I have seen citations in reliable sources spanning at least from March 2013 to December 2014, it's clear that it's been at least about 2 years), and the magnitude of the increase has been very dramatic. Here's one article from 18 December that cites doxycycline as its prime example, referring to an 8,000 percent increase in price and saying costs "could rise further in 2015". That story's not the only one – here's another this month (referring to a price increase from $20 to $1800 for a 500 pill supply between October 2013 and April 2014), and more such sources are not difficult to find. Another from this month says the price has increased more than 50-fold (from $0.063 to $3.36 per 100-mg pill). Today, the Poughkeepsie Journal included the doxycycline price rise in its list of top stories of 2014, and said the cost "soared 6000 percent for some formulations, the biggest hike among any generic drug nationwide".

Regarding what is the normal dosage and duration, you're clearly neglecting some uses. Horses may need six 500-tablet bottles for a 30-day treatment, with each bottle costing $400 instead of the prior $36, that works out to $2,400, making the treatment simply "not an option", according to one quoted equine veterinarian. Moreover, for some conditions, such as acne and rosacea, people take doxycycline every day ad infinitum.

You removed all reference to the amount of the price increase, and all reference to congressional investigation of the problem (both of which were added by other people and have been in the article for more than a month, so they are not just "Edits of December 30, 2014"). This was not an undue amount of discussion of the issue, as this was only one moderate-length paragraph buried at the very end of the article. Perhaps it's only relevant to the U.S., but the U.S. is a major part of the drug market. If the length of it exceeds the description of the discovery and development of the drug, then I suggest that it's because the discovery and development discussion really needs to be expanded.

—BarrelProof (talk) 18:41, 31 December 2014 (UTC)

OK thanks.

• Please see WP:BALASPS re recent events.
• I really don't think most of these local papers and blogs are reliable sources. I find they have a tendency both to sensationalize and not get their facts straight. The nationally syndicated papers are reporting that the peak price was about $3.50 a pill, which is high for a generic, but hardly a national emergency given that a typical Rx is less than 20 pills, and the doctor appointment to get the Rx probably costs $90.
• The CDC reports the shortage beginning in Feb 2013 and ending in October of the same year. http://www.cdc.gov/std/treatment/doxycyclineShortage.htm
• I can buy it right now for less than a dollar a pill from Walgreens, Target, Safeway, CVS, or Walmart. Costco independently lists it for about $1.25 a pill. That's about $25 for a 20 day course of therapy. Yes, $1.25 a pill is a 2500% markup if you start from 5 cents a pill, but remember that gumball machines now come with a slot for a 25 cent coin.

Fundamentally it sounds like we are not going to agree on this, so I suggest we just go directly to a RFC and not waste a lot of time arguing. I think you are putting vastly too much weight on an episode that is short lived, U.S. centric, not really all that consequential in the long run, and which has more to do with the dynamics of the U.S. regulatory system for pharmaceuticals than it does with doxycycline. Formerly 98 (talk) 22:05, 31 December 2014 (UTC)

Added a request for comment to the Medicine project talk page. Formerly 98 (talk) 22:28, 31 December 2014 (UTC)

BarrelProof the article has a sentence on the price spike. i just added some detail on the background... there has been interesting ferment in the generics industry which ends up messing with supply and demand and so the prices of generic drugs (which are very subject to the basic economics of supply and demand) can fluctuate pretty wildly. I think the content is fine now. it would be super interesting to have an article on the economics of the generic drug industry. Jytdog (talk) 22:43, 31 December 2014 (UTC)

The price depends on the exact variant, of course. The article is also the target for the Oracea redirect, which is a 40 mg doxycycline pill that seems to cost around $20 per pill and is taken daily, indefinitely – roughly $7000+ per year – well beyond what the average person could possibly pay (unless they have good insurance coverage). —BarrelProof (talk) 23:13, 31 December 2014 (UTC)

Your opinion about drug prices doesn't belong here. Talk pages are not a forum and WP is not a place to right great wrongs. Drugs cost what they cost in the US due to choices made by the people of that country. They cost differently elsewhere in the world due to choices made by those people. Please check your outrage at the login page. Jytdog (talk) 23:27, 31 December 2014 (UTC)

What part of my comments (or edits) expressed opinion or outrage? As far as I know, I have only discussed facts and reliable sources, except perhaps that remark about affordability by the average person, although I thought that was self-evidently true (and wouldn't advocate putting it into the article). —BarrelProof (talk) 23:31, 31 December 2014 (UTC)

Note - I added to the history section, to deal with Formerly 98's valid concerns about WEIGHT - the history of the discovery of dox was sorely lacking. Jytdog (talk) 23:53, 31 December 2014 (UTC)

Excellent. The article is certainly improved, and I thank you and F 98 for that. —BarrelProof (talk) 00:10, 1 January 2015 (UTC)

Cost in the USA

This ref [1] lists costs. Some do indeed sell it for more than 10USD per pill

• "Adoxa 100MG Tablets (AK DERMATOLOGICS): 30/$407.97 or 90/$1,169.97"

While others sell it for much much less

• "Doxycycline Hyclate 100MG Capsules (WEST-WARD): 30/$12.99 or 60/$19.97"

Doc James (talk · contribs · email) 19:08, 23 September 2015 (UTC)

@Doc James:If you go to the bottom of the page you cited, there is a statement that the "pricing information was last updated in 2/2014" which would be right in the middle of the shortage described here as having arisen in mid 2013 and having been resolved by mid 2015. http://www.fiercepharmamanufacturing.com/story/hikma-profits-soften-shortages-doxycycline-are-resolved/2015-03-12

As a second point, maybe its just me, but it seems like there are so many interesting things to say about this drug, I'm not sure why a short term US-centric shortage and price spike belongs here. This material is unlikely to be of interest to most readers who come here looking for info on doxycycline, but would fit nicely in an article on drug pricing. Its reaaly about US regulatory failure more than about the drug per se. — Preceding unsigned comment added by 2600:1010:B00C:B39C:AC8F:DCF5:D371:F16B (talk) 15:19, 24 September 2015 (UTC)

Very interesting. I added a date to the claim. Doc James (talk · contribs · email) 18:01, 24 September 2015 (UTC)

Fair enough, but do really think a temporary price surge in a single market belongs in the lede? I think you are making a well-intentioned, but ultimately inappropriate political statement. The price surge you are referring to lasted 4% of the drug's history and affected about 5% of potential users. Thats quite a mix of recentism and US-centricism. — Preceding unsigned comment added by 2600:1010:B06D:5E2F:BA5E:1404:71DE:5437 (talk) 18:14, 24 September 2015 (UTC)

First sentence should be short and simple

We should write the leads in relatively simple En. This means using short sentences. Thus

• "Doxycycline is an antibiotic that is used in the treatment of a number of types of infections caused by bacteria and protozoa. " with "Doxycycline is a broad-spectrum of the tetracycline class." coming later

is better than

• "Doxycycline is a broad-spectrum tetracycline antibiotic that is used in the treatment of a number of types of infections caused by bacteria and protozoa."

Doc James (talk · contribs · email) 19:19, 25 September 2015 (UTC)

Sure I'll accept this (although out of curiosity I was wondering if you have any consensus or manual of styles to support the idea that the lead should be in simple English), but I fixed a grammatical error, "broad-spectrum antibiotic" should be used instead of "broad-spectrum" in that later sentence. Brenton (contribs · email · talk · uploads) 19:36, 25 September 2015 (UTC)

Thanks for the fix. We state in the WP:MEDMOS "The leads of articles, if not the entire article, should be written as simply as possible without introducing errors." Doc James (talk · contribs · email) 19:42, 25 September 2015 (UTC)

Mitochondria

User:Mrdthree please discuss what you are after with this and this and now this. You are putting biochemistry in an adverse effects section and not naming any actual adverse effects. Jytdog (talk) 06:56, 24 June 2016 (UTC)

Perhaps it belongs in a section called pathophysiology? Tetracyclines suppress mitochondrial function, altering normal physiology. At what level is your inquiry. I am happy to have an expert conversation if you are an expert. I have an MS in molecular biology and a PhD in computational biology.Mrdthree (talk) 11:21, 25 June 2016 (UTC)

if you cannot name an organism level negative effect you cannot put this in that section. that is what the section is for. it is about medicine. not biochemistry. Jytdog (talk) 11:36, 25 June 2016 (UTC)

Let me explain the background of an expert reader. The mitochondria is the powerhouse of the cell. It produces 90% of the ATP in a cell. All cellular processes from from transciption, translation, and ionic balance require ATP. without the oxygen from needed by mitochondria, cell fall apart quickly. Mitochondria have a highly oxidative environment as a result they have a high protein turnover rate. Protein units have a life of at most 1-2 weeks. There are certain cells in the body that reproduce rapidly. Especially those of the gut and skin these can be completely replaced in 2-3 days. Reproduction requires the replication of organelles and cells. SO yes its a potential mechanisms that links all the adverse effects (nausea, sunburn, etc.). --Mrdthree (talk) 11:58, 25 June 2016 (UTC)

This is not a Drug Manual or a medical encyclopedia. It spans disciplines. Perhaps it deserves its own section in Mitochondrial Interactions, Cytopathology, pathophysiology,--Mrdthree (talk) 12:03, 25 June 2016 (UTC)

Did you notice that I added a section on the research reagent use: Doxycycline#Use_as_a_research_reagent based on the sources you brought? Your claim that that there are organism level effects seems to be WP:OR: I noticed that all you added was vague hand-wavy content like this about "leading to many side-effects" or like this about "alter... physiology." Jytdog (talk) 12:22, 25 June 2016 (UTC)

It was found that doses of 1/10 of those used clinically in humans retard plant growth (pathophysiology) and impair liver function in rats (pathophysiology) relative to amoxocillin and other antibacterial classes (That target the bacterial cell wall, etc.) .Mrdthree (talk) 12:28, 25 June 2016 (UTC)

None of that is a human side effect. That is research stuff. plant/animal work doesn't go in medical sections. Please see WP:MEDMOS. the only kinds of biochemistry that are relevant to medical sections are those that are known to actually drive a tissue or organism level change in a human. Jytdog (talk) 12:32, 25 June 2016 (UTC)

I guess its nice that its copied in the tetracycline page. though I disagree with your desire to turn physiology into a research method concern. Thats only true if you think of the page as a medical encyclopedia. That said the studies arent sexy yet. They reported two organism level impairments: reduced plant growth at clinically low doses (1/10- 1/100 maximal dose), impaired liver function in rats as measured by energy storage (2 week course of antibiotics). They used amoxocillin ( a beta lactam antibiotic) as a control I suppose absolutely tying the physiological functions directly to mitochondrial function would require some experimental group with rescued mitochondrial function. The nausea thing but not photosensitivity is shared with beta-lactam antibiotics whose mechanism targets bacterial cell walls(could be gut flora related).Mrdthree (talk) 12:28, 25 June 2016 (UTC)

The titles of the two papers you cited, which accurately reflect their content, are:

• PMID 25772356: Tetracyclines Disturb Mitochondrial Function across Eukaryotic Models: A Call for Caution in Biomedical Research
• PMID 26475870: Tetracycline antibiotics impair mitochondrial function and its experimental use confounds research

Both these papers come from one lab. Only one of them is actually a review and is useful for content about health. Neither paper identifies any actual side effects in people. Jytdog (talk) 21:28, 25 June 2016 (UTC)

Biologists dont care if its about humans or not. Mrdthree (talk) 15:46, 3 July 2016 (UTC)

All right fine Ill put it in the article on Mitochondria. you get your wish to turn an encyclopedia into a medical dictionary.Mrdthree (talk) 23:41, 5 July 2016 (UTC)

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Request for comment on antibiotic articles

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

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Antibiotics mechanism of action are either bactericidal or bacteriostatic. They can also have antiprotozoal actions. However this is not clear or not specified for many of the individual antibiotic pages. I note this article on Doxycycline is an example where the mechanism of action of doxycycline is not clearly specified. I would argue that by a concerted effort to edit in this information across all individual pages on antibiotics would greatly improve the quality of all those articles on Wikipedia. Does anyone wish to comment or if appropriate circulate this matter for further discussion? Dr.khatmando (talk) 01:19, 24 January 2017 (UTC)

• This isn't really an RfC question, but rather a more general question about content. I'd say sure, it would be fine to add such information with appropriate sourcing. And feel free to WP:BEBOLD and do it. A better place to ask for help from more editors would be WT:PHARM and/or WT:MED. --Tryptofish (talk) 02:49, 24 January 2017 (UTC)

• Agree with Tryptofish; the principle IMO stands for a lot of articles apart from pharmacological material. My main reservation is caution in structuring related sets of articles so as to avoid duplicating common principles and data in multiple subordinate articles. Examples include those dealing with particular items such as individual antibiotics. For example "...bactericidal or bacteriostatic. They can also have antiprotozoal actions..." would belong in a root antibiotics article, whereas in the doxycycline article it would only be appropriate to link to the parent article for such information, and mention points particularly relevant to the class of compounds immediately in question, say, whether doxycycline is bactericidal or bacteriostatic, plus what the significance might be in principle or in clinical practice. JonRichfield (talk) 06:38, 24 January 2017 (UTC)

• • I am happy with this content being adding. Many antibiotics are both bacteriostatic and bacteriocidal depending on the dose and the organism in question.Doc James (talk · contribs · email) 23:23, 24 January 2017 (UTC)

• I also agree with adding the content. I noted the picture of an "Emergency MedKit" and looked that up -- it was a CDC program started in 2005 where households were given a supply of doxycycline or ciprofloxacin to be opened only in case of a "public health emergency." What the CDC had in mind was an anthrax attack. It was tested in a part of St. Louis. Interesting enough to consider expanding the caption. See here (PDF) for more. Roches (talk) 18:45, 26 January 2017 (UTC)
• I also agree that it is good to add relevant content to an article. Discussion of mechanism of action is very relevant to antibiotics. The problem here is who will do this? WP:LIGHTBULB --Tom (LT) (talk) 00:41, 28 January 2017 (UTC)
• Tetracyclines (including Doxycycline) can be bacteriostatic or bactericidal. It depends on the concentrations used. Said that, why are you posting an RfC for this? Did any user oppose your edits? Silvio1973 (talk) 10:57, 30 January 2017 (UTC)
• Perhaps it would be quicker and cleaner to add a new parameter to {{Drugbox}} like |mechanism_of_action=. Other parameters like |route_of_administration= and |metabolism= already exist, so it's only appropriate. —Hexafluoride ^{Ping me if you need help, or post on my talk} 12:31, 3 February 2017 (UTC)
• If there's an important detail such as this missing from the 'Mechanism of action' section on lots of antibiotics it might be worth mentioning to the Pharmacology Wikiproject in order to get lots of them added quickly. As it is a mechanism of action the edits should be fairly uncontroversial. PriceDL (talk) 05:17, 14 February 2017 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Protein synthesis

This ref says "inhibition of apicoplast proteosynthesis" So yes it inhibits protein production by the apicoplast and was therefore still correct before https://books.google.com.ar/books?id=AG47DwAAQBAJ&pg=PA113

Doc James (talk · contribs · email) 17:57, 9 December 2018 (UTC)

Malaria

Doxy is still recommended in a number of situations. Per WHO:[2] See page 83 or 246 for example. Doc James (talk · contribs · email) 01:35, 4 December 2018 (UTC)

Doxycycline is recommended by WHO for chemoprophylaxis.Sbelknap (talk) 02:19, 4 December 2018 (UTC)

Actually looks like doxycycline not recommended for chemoprevention in the current WHO guidelines. However, chemoprevention of malaria in non-immune travelers is not the focus of the WHO guidelines. The CDC has recommendations, though. Sbelknap (talk) 02:39, 4 December 2018 (UTC)

The current version of this subsection misrepresents the *recommendations* given by the WHO guidelines. Artemisinin-based combination therapies (ACTs) are recommended by WHO as the first-and second-line treatment for uncomplicated P. falciparum malaria. WHO recommends choosing one of these five regimens: Artesunate-amodiaquine; artesunate-mefloquine; artesunate+sulfadoxine-pyrimethamine; artemether-lumefantrine; dihydroartemisinin-piperaquine. In areas where there is resistance to these ACTs, WHO states that artesunate-pyronaridine may be considered. None of these five regimens contain doxycycline. Neither page 83 or page 246 discuss WHO recommendations. Page 83 covers situations where an ACT is not available (WHO recommends ACTs be made available). Page 246 mentions indications not recommendations.Sbelknap (talk) 02:19, 4 December 2018 (UTC)

Artemisinin-based combination therapies are not avaliable in a LOT of places. Doc James (talk · contribs · email) 17:57, 9 December 2018 (UTC)

The availability of artemisinin-derived compounds is an important but separate issue. The current draft of the doxycycline article obscures the important point that the WHO guidelines no longer recommend doxycycline + quinine for treatment of P. falciparum malaria. The rationale is that many people discontinue treatment with quinine + doxycycline because of adverse effects of this regimen. One might reasonably disagree with the WHO guidelines, but it is intellectually dishonest to obscure what WHO is recommending because one disagrees. This current draft quotes from the supporting materials in the latest WHO document, avoiding the term "recommendations" in the text. This is *not* NPOV! Sbelknap (talk) 02:39, 13 December 2018 (UTC)

Introduction needs updating

The price of this medication has apparently plummeted in the U.S.. Currently, 60 100mg. caps are only $7 at my pharmacy (2019). — Preceding unsigned comment added by 2602:306:CF99:2080:EDA5:2E3F:E1BA:80C1 (talk) 21:43, 23 February 2019 (UTC)

A reference also needs added to either the original $14 cost statement or to any new cost data. Data about cost to end user in other countries wouldn’t go amiss either. But thanks everyone for putting together such a good article. I came here originally for information and was really impressed with the quality of the page. Having worked on editing on Wikipedia a fair bit myself over the years I know how much it takes to get an article in such good shape. Thanks guys! Dakinijones (talk) 16:46, 10 September 2019 (UTC)

Uses in animals.

Our tiny dog has a faulty mitral valve in his heart. As a result, his heart is greatly enlarged. He is on a cardio medication and Lasix for oedema.

Despite all this, he still has a "cardio cough". Our vet has put him on doxycycline, because, she says, in dogs it is a very good anti-inflammatory for cough minimisation. — Preceding unsigned comment added by 2001:8003:e422:3c01:299f:5676:3200:25b2 (talk) 03:39, 12 August 2021 (UTC)

Can you drink coffee with this ned

Is coffee allowed 2600:1004:A023:B5E5:D421:EA72:A8C3:ED50 (talk) 18:03, 18 February 2023 (UTC)