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Doxycycline (Tetracycline)

Use
Prevention of malaria in areas with resistance to chloroquine. Doxycycline is an alternative to Malarone (atovaquone/proguanil) or Lariam (mefloquine).

Dose
One tablet daily from the day before arrival in the malaria area, during the stay and 28 days after leaving the malaria endemic area. The tablets should be taken at the same time of the day with abundant fluid. Milk may reduce the efficacy of doxycyclin.
  • Doxycyclin tablets 100 mg:
  • Adults > 45 kg body weight: 1 tablet daily
  • Children > 12 years: 2 mg per kg body weight daily.
    Doxycyclin must not be used to children below 12 years (in critical situations 8 years) as tetracycline may give permanently discoloured teeth.

    Pregnancy
    Pregnant women must not use doxycycline because it is deposited in the bone and teeth of the foetus where it may give permanent discoloration or malformation of the bones. 

    Lactation
    Must not be used by lactating women.

    Side effects
    Nausea and stomach pain are the most frequent complaints. In rare case itching, rash and allergic reactions may be seen. Doxycycline increases the sensitivity to sunlight, and may trigger a so-called “photo-allergic dermatitis” on areas of the skin exposed to sunlight or artificial sunlight. This reaction may be seen up to a week after the last tablet of doxyclycline. The frequency of photo allergic reactions are probably around 1 per 300 users for the most serious to about 3% for mild reactions. Prescription of doxycycline should be followed by advise on protection against sun light.

    Who can not use doxycycline?
    Persons with previous reactions to tetracyclines. Persons with severe liver and kidney diseases. Children below 12 years, pregnant and lactating women.

    Interactions with other drugs
    Inform your doctor if you take other tablets also non-prescription drugs. The efficacy of doxycycline is reduced if taken together with drugs containing calcium, magnesia or iron. These are found in antacids (against ulcer) drugs against constipation, vitamins and food supplements. Allow at least 3 hours between use of any of the above drugs and the intake of doxycycline.

    Note
    No antimalarial drug provides 100% protection even if used strictly according to the recom-mendations. Malaria drugs reduce the risk of infection with around 80% to 95% depending of your destination and living conditions. Prevention of mosquito bites is therefore still important even if you take malaria drugs regularly.

    The UK HPA recommendations
    Guidelines malaria prevention in travellers from the United Kingdom 2008

    Edited 27. December 2008