ALAMYCYCIN-LA 22.7%M/V INJECTION

Indications

• Bacterial infections
• Respiratory tract infections
• Urinary tract infections
• Acne vulgaris
• Chlamydia infections
• Rickettsial infections
• Brucellosis

Dosage

Children: Refer to the BNF for Children for age-appropriate dosing information.

Adults: Refer to standard dosing guidelines for specific infections, as dosages can vary based on the type and severity of the infection.

Mechanism of action

Oxytetracycline works by binding to the 30S ribosomal subunit of bacterial ribosomes, inhibiting the attachment of aminoacyl-tRNA to the ribosomal acceptor (A) site. This action prevents the addition of new amino acids to the nascent peptide chain, effectively inhibiting bacterial protein synthesis, which is essential for bacterial growth and reproduction.

Pharmacodynamics

The pharmacodynamics of oxytetracycline involve its ability to inhibit bacterial protein synthesis, leading to bacteriostasis. The drug has a broad spectrum of activity against both aerobic and anaerobic bacteria, as well as certain protozoa. Its effectiveness can be influenced by factors such as the presence of efflux pumps in bacteria, which can lead to resistance. The drug has a long half-life, allowing for less frequent dosing in many cases.

Pharmacokinetics

Oxytetracycline is well absorbed from the gastrointestinal tract but its absorption can be reduced by the presence of divalent and trivalent metal ions (such as calcium, magnesium, and iron). It is widely distributed in body tissues and fluids, including the liver, kidneys, and lungs. The drug is metabolized in the liver and excreted primarily in the urine, with a small fraction excreted in feces. The half-life of oxytetracycline is approximately 6 to 12 hours, depending on the renal function of the patient.

Contra-indications

• Hypersensitivity to oxytetracycline or any tetracycline antibiotics
• Pregnancy, especially during the second and third trimesters
• Children under the age of 8 years due to potential for teeth discoloration

Adverse effects

• Gastrointestinal disturbances, including nausea, vomiting, and diarrhea
• Photosensitivity leading to increased risk of sunburn
• Teeth discoloration and enamel hypoplasia in children
• Hepatotoxicity, particularly in cases of overdose or in patients with liver impairment
• Allergic reactions including rash, urticaria, and anaphylaxis

Interactions

• Antacids and supplements containing calcium, magnesium, or iron may reduce absorption
• Concurrent use with penicillin antibiotics may be antagonistic
• Oral contraceptives may be less effective when taken with oxytetracycline

Precautions

• Use with caution in patients with renal impairment
• Monitor liver function in patients with pre-existing liver disease
• Avoid exposure to sunlight or UV light due to the risk of photosensitivity

Pregnancy

Oxytetracycline is contraindicated during pregnancy due to risks of fetal harm, particularly to the developing teeth and bones.

Breast-feeding

Oxytetracycline is excreted in breast milk and may affect the infant's teeth development; caution is advised.

Storage

Store in a cool, dry place away from light. Keep out of reach of children.

Formulations

• Tablets
• Capsules
• Oral suspension
• Topical ointment