MIRACLIN ® Doxycycline

MIRACLIN ® is a drug based on doxycycline hyclate

THERAPEUTIC GROUP: General antimicrobials for systemic use - Tetracycline

IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects

Indications MIRACLIN ® Doxycycline

MIRACLIN ® is indicated in the treatment of infectious diseases of various organs and systems supported by bacteria sensitive to tetracyclines.

Mechanism of action MIRACLIN ® Doxycycline

Doxycycline, the active ingredient of MIRACLIN ®, is an antibiotic belonging to the tetracycline category obtained synthetically from natural precursors such as oxytetracycline, normally extracted from yeasts belonging to the Streptomyces family.

Taken orally, it is rapidly absorbed in the intestinal tract, where in a few hours it reaches its maximum plasma concentration, distributing itself, bound to plasma proteins, in various biological fluids and in various tissues.

Here permeating the bacterial wall and the plasma membrane, through dedicated protein structures, it reaches the cytoplasmic environment where it binds the 30S bacterial ribosomal subunits, thus preventing the tRNA from transporting the amino acid useful for elongation of the peptide chain.

The bacteriostatic action at low doses, bactericidal at high doses of doxycycline, is therefore carried out mainly through the inhibition of bacterial protein synthesis which profoundly compromises the vital biosynthetic properties of the pathogen.

Once their biological activity is over, effective against Gram positive and negative microorganisms but also against ticks belonging to the Ixodes family, doxycycline is eliminated mainly via the kidney, and only to a small extent following a hepatic metabolism.

Studies carried out and clinical efficacy

1 DOXYCYCLINE AND PARASITIC DISEASES

Parasit Vectors. 2012 Mar 20; 5: 53.

Yet another study that demonstrates the therapeutic efficacy of doxycycline even against parasitic diseases. In this case, in fact, the treatment with doxycycline has guaranteed a significant reduction in the cases of onchocerciasis sustained by filiform nematodes.

2 . DOXYCHYCLYLIN IN THE ERADICATION OF HELICOBACTER PYLORI

Singapore Med J. 2012 Apr; 53 (4): 273-6.

Interesting study that demonstrates how the Helicobacter Pylori eradication therapy can benefit from the use of doxycycline in a quadruple effective and safe therapy for the patient even after failure of the triple therapy.

3. ESOPHAGEE ULCERUM FROM DOXYCYCLIN

Singapore Med J. 2012 Apr; 53 (4): e69-70.

Case report demonstrating the occurrence of esophageal ulcers complicated by gastro-esophageal reflux that appeared following prolonged use of doxycycline. These studies reaffirm the importance of precautions in the use of apparently safe drugs such as antibiotics.

Method of use and dosage

MIRACLIN ®

Doxycycline 100 mg tablets.

The therapeutic scheme and duration of therapy may vary based on the patient's clinical conditions and the therapeutic goals to be achieved.

The daily dose of 100-200 mg is generally effective in controlling most infections due to Gram positive and negative microorganisms.

In any case the specific dosage formulation is up to the doctor, following a careful evaluation of the clinical picture.

A dosage adjustment could be envisaged for example in the treatment of primary syphilis.

In order to avoid recurrences, it is advisable to prolong the treatment more than 48 hours after the disappearance of the symptoms.

Warnings MIRACLIN ® Doxycycline

The patient receiving MIRACLIN ® should be periodically monitored for liver and kidney function by their doctor.

Continuous supervision is in fact an effective tool in reducing the potential side effects of therapy, while safeguarding its effectiveness.

Particular caution should also be reserved for elderly patients or those suffering from liver and kidney diseases, given the greater susceptibility to the development of the side effects of antibiotic therapy.

In order to reduce the risk of erosions and ulcers of the esophageal mucosa it would be advisable to take MIRACLIN ® with plenty of water while maintaining the upright position for several minutes after ingestion of the tablet.

Prolonged use of tetracycline may facilitate intestinal colonization by microorganisms such as Clostridium difficile, responsible for serious diseases including pseudo-membranous colitis.

Also remember to avoid direct exposure to sunlight following the intake of tetracycline, given the photosensitizing action of the same.

PREGNANCY AND BREASTFEEDING

The use of MIRACLIN ® is generally contraindicated during pregnancy and in the subsequent period of breastfeeding, given the absence of studies demonstrating the safety of doxycycline for the fetus.

Any treatment, justified by urgent medical needs, must necessarily be supervised by the specialist doctor.

Interactions

The patient receiving MIRACLIN ® should pay particular attention to the simultaneous intake of:

Oral anticoagulants, due to the increased bleeding risk associated with antibiotic therapy;
Antacid preparations based on bivalent ions such as magnesium, calcium and aluminum, capable of compromising the therapeutic efficacy of tetracyclines, significantly reducing intestinal absorption;
Penicillin and beta-lactams, due to the documented reciprocal interference with the mechanism of action.

Given the ability of antibiotic therapies to compromise the intestinal absorption of oral contraceptives, it would be advisable to use contraceptive methods of coverage during tetracycline therapy.

Contraindications MIRACLIN ® Doxycycline

The use of MIRACLIN ® is contraindicated in patients with hypersensitivity to tetracycline and its excipients.

Undesirable effects - Side effects

Despite the treatment with tetracycline, carried out according to the appropriate therapeutic schemes, it is generally effective and well tolerated by most patients, the use of MIRACLIN ® especially at high dosages or for prolonged periods could determine the appearance of:

Gastrointestinal reactions such as nausea, vomiting, diarrhea and abdominal pain;
Hypersensitivity skin manifestations such as erythema, papules and macules;
Neurological symptoms such as headache, dizziness and exhaustion;
Haematological changes such as anemia, neutropenia, thrombocytopenia and eosinophilia.

It should also be remembered, especially for elderly and pediatric patients, how prolonged use of doxycycline could determine the appearance of hyperazotemia and hypercreatininemia, linked to the catabolic action of the drug and enamel hypoplasia and dental dyschromia, due to the drug's ability to react with calcium salts.