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Doryx MPC
doxycycline
Adult Dosing .
Dosage forms: DR TAB: 60 mg
Special Note
- [strength clarification]
- Info: 60 mg Doryx MPC = 50 mg Doryx
infections, mild-moderate bacterial
- [120 mg PO qd]
- Start: 120 mg PO bid x1 day; Info: duration varies by indication; do not cut/crush/chew tab
infections, severe bacterial
- [120 mg PO bid]
- Info: duration varies by indication; do not cut/crush/chew tab
severe acne vulgaris, adjunct tx
- [120 mg PO q12h]
- Info: do not cut/crush/chew tab
pneumonia, community-acquired
- [120 mg PO q12h for at least 5 days]
- Info: refer to IDSA guidelines; do not cut/crush/chew tab
sinusitis, acute bacterial
- [240 mg/day PO divided q12-24h x5-7 days]
- Info: do not cut/crush/chew tab
infections, chlamydial
- [treatment]
- Dose: 120 mg PO q12h x7 days; Info: 1st-line agent; do not cut/crush/chew tab
- [presumptive tx (off-label)]
- Dose: 120 mg PO q12h x7 days; Info: for sexual assault victims; give w/ ceftriaxone and metronidazole in female pts; give w/ ceftriaxone in male pts; do not cut/crush/chew tab
- [post-exposure prophylaxis (off-label)]
- Dose: 240 mg PO x1; Start: w/in 72h of oral, vaginal, or anal sex; Max: 240 mg/24h; Info: for men who have sex with men and transgender women w/ hx of at least 1 bacterial sexually transmitted infection during the past 12mo; may repeat dose; do not cut/crush/chew tab
syphilis
- [primary, secondary, or latent <1y]
- Dose: 120 mg PO q12h x14 days; Info: for pts w/ hypersens. to PCN; not 1st-line agent; do not cut/crush/chew tab
- [latent >1y or unknown duration]
- Dose: 120 mg PO q12h x28 days; Info: for pts w/ hypersens. to PCN; not 1st-line agent; do not cut/crush/chew tab
- [post-exposure prophylaxis (off-label)]
- Dose: 240 mg PO x1; Start: w/in 72h of oral, vaginal, or anal sex; Max: 240 mg/24h; Info: for men who have sex with men and transgender women w/ hx of at least 1 bacterial sexually transmitted infection during the past 12mo; may repeat dose; do not cut/crush/chew tab
lymphogranuloma venereum
- [120 mg PO q12h x21 days]
- Info: may give for 7 days if asymptomatic dz; 1st-line agent; do not cut/crush/chew tab
urethritis, non-gonococcal
- [120 mg PO q12h x7 days]
- Info: 1st-line agent; do not cut/crush/chew tab
epididymitis
- [120 mg PO q12h x10 days]
- Info: give w/ ceftriaxone; do not cut/crush/chew tab
proctitis
- [120 mg PO q12h x7 days]
- Info: give w/ ceftriaxone; extend duration to 21 days if positive rectal chlamydia test w/ bloody discharge, perianal or mucosal ulcers, or tenesmus; do not cut/crush/chew tab
anthrax
- [systemic]
- Dose: 120 mg PO q12h; Start: use after IV tx; Info: not recommended for CNS anthrax; may use in pregnant women; not 1st-line agent; part of multi-drug regimen; continue abx for post-exposure prophylaxis if inhalational exposure; do not cut/crush/chew tab
- [cutaneous]
- Dose: 120 mg PO q12h x7-10 days; Info: for non-systemic infection; 1st-line agent; use extended duration for post-exposure prophylaxis if bioterrorism suspected; may use in pregnant women; do not cut/crush/chew tab
- [post-exposure prophylaxis]
- Dose: 120 mg PO q12h x60 days; Info: 1st-line agent; give in combo w/ anthrax vaccine; may use in pregnant women; may give x42 days, or x14 days after last vaccine dose, in immunocompetent pts 18-65 yo if anthrax vaccine regimen completed; do not cut/crush/chew tab
malaria prophylaxis
- [120 mg PO qd]
- Start: 1-2 days before exposure; Info: do not cut/crush/chew tab; D/C 4wk after exposure; see CDC Pre-Travel Malaria Prophylaxis recommendations in Guidelines > Specialties > Infectious Diseases
tularemia
- [120 mg PO q12h x14-21 days]
- Info: do not cut/crush/chew tab
Rocky Mountain spotted fever
- [120 mg PO q12h x5-14 days]
- Info: do not cut/crush/chew tab
cholera
- [360 mg PO x1]
- Info: do not cut/crush/chew tab
brucellosis
- [120 mg PO q12h x6wk]
- Info: part of multi-drug regimen; do not cut/crush/chew tab
granuloma inguinale
- [120 mg PO q12h for at least 3wk]
- Info: may extend tx if not healed after 3wk; not 1st-line agent; do not cut/crush/chew tab
gonococcal infections, post-exposure prophylaxis (off-label)
- [240 mg PO x1 dose]
- Start: w/in 72h of oral, vaginal, or anal sex; Max: 240 mg/24h; Info: for men who have sex with men and transgender women w/ hx of at least 1 bacterial sexually transmitted infection during the past 12mo; may repeat dose; do not cut/crush/chew tab
PID (off-label)
- [mild-moderate infection]
- Dose: 120 mg PO q12h x14 days; Info: give w/ ceftriaxone and metronidazole, cefotaxime and metronidazole, or cefoxitin plus probenecid and metronidazole; 1st-line agent; do not cut/crush/chew tab
- [severe infection]
- Dose: 120 mg PO q12h x14 days; Info: give w/ ceftriaxone plus metronidazole, cefotetan, cefoxitin, ampicillin/sulbactam, or cefotaxime plus metronidazole; 1st-line agent; do not cut/crush/chew tab
Lyme dz (off-label)
- [120 mg PO q12h x14-21 days]
- Alt: 240 mg q24h x14-21 days; Info: may give for 10-14 days if early, localized dz; extend duration to 28 days if Lyme arthritis; 1st-line agent; do not cut/crush/chew tab; search 'Lyme' for epocrates Lyme Disease Dx & Tx decision tool
Lyme dz prophylaxis, post-exposure (off-label)
- [240 mg PO x1 dose]
- Start: w/in 72h of tick removal after high-risk bite; Info: do not cut/crush/chew tab; search 'Lyme' for epocrates Lyme Disease Dx & Tx decision tool
cervicitis, presumptive (off-label)
- [120 mg PO q12h x7 days]
- Info: 1st-line agent; do not cut/crush/chew tab
Mycoplasma genitalium infection (off-label)
- [macrolide-susceptible]
- Dose: 120 mg PO q12h x7 days; Info: follow w/ azithromycin 1 g PO x1, then 500 mg PO qd x3 days; do not cut/crush/chew tab
- [macrolide-resistant or resistance unknown]
- Dose: 120 mg PO q12h x7 days; Info: follow w/ moxifloxacin 400 mg PO qd x7 days; do not cut/crush/chew tab
endocarditis prophylaxis, dental (off-label)
- [120 mg PO x1]
- Start: 30-60min before procedure; Info: see Infectious Disease: Endocarditis Prophylaxis, Adult table
malaria tx, uncomplicated (off-label)
- [120 mg PO q12h x7 days]
- Info: give w/ quinine sulfate; follow up tx w/ primaquine to avoid relapse in acute P. vivax or P. ovale infection; refer to CDC guidelines; do not cut/crush/chew tab
non-cholera vibrio infection, gastroenteritis (off-label)
- [120 mg PO q12h x3 days]
- Info: for diarrhea persisting >5 days; do not cut/crush/chew tab
anaplasmosis (off-label)
- [120 mg PO q12h x10-14 days]
- Info: do not cut/crush/chew tab
ehrlichiosis (off-label)
- [120 mg PO q12h x5-14 days]
- Info: do not cut/crush/chew tab
onchocerciasis (off-label)
- [240 mg PO qd x6wk]
- Start: 1wk after ivermectin tx; Info: may decr. to 120 mg PO qd if not tolerated; not 1st-line agent; do not cut/crush/chew tab
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: DR TAB: 60 mg
Special Note
- [strength clarification]
- Info: 60 mg Doryx MPC = 50 mg Doryx
infections, mild-moderate bacterial
- [>8 yo]
- Dose: 2.6 mg/kg/dose PO qd; Start: 2.6 mg/kg/dose PO bid x1 day; Max: 120 mg/dose; Info: duration varies by indication; do not cut/crush/chew tab
infections, severe bacterial
- [>8 yo]
- Dose: 2.6 mg/kg/dose PO bid; Max: 120 mg/dose; Info: duration varies by indication; do not cut/crush/chew tab
severe acne vulgaris, adjunct tx
- [>8 yo]
- Dose: 2.6 mg/kg/dose PO qd; Start: 2.6 mg/kg/dose PO bid x1 day; Max: 120 mg/dose; Info: do not cut/crush/chew tab
community-acquired pneumonia, atypical
- [>8 yo]
- Dose: 2.6-5.2 mg/kg/day PO divided q12h x7-10 days; Info: do not cut/crush/chew tab
infections, chlamydial
- [treatment, 8 yo and older]
- Dose: 120 mg PO q12h x7 days; Info: 1st-line agent; do not cut/crush/chew tab
- [presumptive tx, 8 yo and older (off-label)]
- Dose: 120 mg PO q12h x7 days; Info: for sexual assault victims; give w/ ceftriaxone and metronidazole in female pts; give w/ ceftriaxone in male pts; do not cut/crush/chew tab
syphilis
- [primary, secondary, or latent <1y, adolescents]
- Dose: 120 mg PO q12h x14 days; Info: for pts w/ hypersens. to PCN; not 1st-line agent; do not cut/crush/chew tab
- [latent >1y or unknown duration, adolescents]
- Dose: 120 mg PO q12h x28 days; Info: for pts w/ hypersens. to PCN; not 1st-line agent; do not cut/crush/chew tab
lymphogranuloma venereum
- [preadolescents >45 kg and adolescents]
- Dose: 120 mg PO q12h x21 days; Info: may give for 7 days if asymptomatic dz; 1st-line agent; do not cut/crush/chew tab
urethritis, non-gonococcal
- [preadolescents >45 kg and adolescents]
- Dose: 120 mg PO q12h x7 days; Info: 1st-line agent; do not cut/crush/chew tab
epididymitis
- [preadolescents >45 kg and adolescents]
- Dose: 120 mg PO q12h x10 days; Info: give w/ ceftriaxone; do not cut/crush/chew tab
proctitis
- [preadolescents >45 kg and adolescents]
- Dose: 120 mg PO q12h x7 days; Info: give w/ ceftriaxone; extend duration to 21 days if positive rectal chlamydia test w/ bloody discharge, perianal or mucosal ulcers, or tenesmus; do not cut/crush/chew tab
anthrax
- [systemic]
- Dose: 2.6 mg/kg/dose PO q12h; Start: use after IV tx; Max: 120 mg/dose; Info: not recommended for CNS anthrax; not 1st-line agent; part of multi-drug regimen; give x60 days total if inhalational exposure; do not cut/crush/chew tab
- [cutaneous]
- Dose: 2.6 mg/kg/dose PO q12h x7-10 days; Max: 120 mg/dose; Info: for non-systemic infection; give abx x60 days total if bioterrorism suspected; do not cut/crush/chew tab
- [post-exposure prophylaxis]
- Dose: 2.6 mg/kg/dose PO q12h x60 days; Max: 120 mg/dose; Info: 1st-line agent; do not cut/crush/chew tab
malaria prophylaxis
- [>8 yo]
- Dose: 2.6 mg/kg/dose PO qd; Start: 1-2 days before exposure; Max: 120 mg/day; Info: D/C 4wk after exposure; do not cut/crush/chew tab; see CDC Pre-Travel Malaria Prophylaxis recommendations in Guidelines > Specialties > Infectious Diseases
Rocky Mountain spotted fever
- [2.6 mg/kg/dose PO q12h x5-14 days]
- Max: 120 mg/dose; Info: do not cut/crush/chew tab
cholera
- [>8 yo]
- Dose: 5.2-8 mg/kg/dose PO x1; Max: 360 mg/dose; Info: do not cut/crush/chew tab
brucellosis
- [>8 yo]
- Dose: 120 mg PO q12h x6wk; Info: part of multi-drug regimen; do not cut/crush/chew tab
granuloma inguinale
- [adolescents]
- Dose: 120 mg PO q12h for at least 3wk; Info: may extend tx if not healed after 3wk; not 1st-line agent; do not cut/crush/chew tab
PID (off-label)
- [mild-moderate infection, preadolescents >45 kg and adolescents]
- Dose: 120 mg PO q12h x14 days; Info: give w/ ceftriaxone and metronidazole, cefotaxime and metronidazole, or cefoxitin plus probenecid and metronidazole; 1st-line agent; do not cut/crush/chew tab
- [severe infection, preadolescents >45 kg and adolescents]
- Dose: 120 mg PO q12h x14 days; Info: give w/ ceftriaxone plus metronidazole, cefotetan, cefoxitin, ampicillin/sulbactam, or cefotaxime plus metronidazole; 1st-line agent; do not cut/crush/chew tab
Lyme dz (off-label)
- [2.6 mg/kg/dose PO q12h x14-21 days]
- Max: 120 mg/dose; Info: may give for 10-14 days if early, localized dz; extend duration to 28 days if Lyme arthritis; 1st-line agent; do not cut/crush/chew tab; search 'Lyme' for epocrates Lyme Disease Dx & Tx decision tool
Lyme dz prophylaxis, post-exposure (off-label)
- [5.2 mg/kg/dose PO x1 dose]
- Start: w/in 72h of tick removal after high-risk bite; Max: 240 mg/dose; Info: do not cut/crush/chew tab; search 'Lyme' for epocrates Lyme Disease Dx & Tx decision tool
cervicitis, presumptive (off-label)
- [preadolescents >45 kg and adolescents]
- Dose: 120 mg PO q12h x7 days; Info: 1st-line agent; do not cut/crush/chew tab
Mycoplasma genitalium infection (off-label)
- [macrolide-susceptible, adolescents]
- Dose: 120 mg PO q12h x7 days; Info: follow w/ azithromycin 1 g PO x1, then 500 mg PO qd x3 days; do not cut/crush/chew tab
- [macrolide-resistant or resistance unknown, adolescents]
- Dose: 120 mg PO q12h x7 days; Info: follow w/ moxifloxacin 400 mg PO qd x7 days; do not cut/crush/chew tab
endocarditis prophylaxis, dental (off-label)
- [<45 kg]
- Dose: 2.6 mg/kg/dose PO x1; Start: 30-60min before procedure; Info: see Infectious Disease: Endocarditis Prophylaxis, Pediatric table
- [>45 kg]
- Dose: 120 mg PO x1; Start: 30-60min before procedure; Info: see Infectious Disease: Endocarditis Prophylaxis, Pediatric table
malaria tx, uncomplicated (off-label)
- [2.6 mg/kg/dose PO q12h x7 days]
- Max: 120 mg/dose; Info: give w/ quinine sulfate; follow up tx w/ primaquine to avoid relapse in acute P. vivax or P. ovale infection; refer to CDC guidelines; do not cut/crush/chew tab
non-cholera vibrio infection, gastroenteritis (off-label)
- [>8 yo, <45 kg]
- Dose: 2.6 mg/kg/dose PO q12h x3 days; Max: 240 mg/day; Info: for diarrhea persisting >5 days; do not cut/crush/chew tab
- [>8 yo, >45 kg]
- Dose: 120 mg PO q12h x3 days; Info: for diarrhea persisting >5 days; do not cut/crush/chew tab
non-cholera vibrio infection, invasive dz (off-label)
- [>8 yo, <45 kg]
- Dose: 2.6 mg/kg/dose PO q12h; Max: 240 mg/day; Info: part of multi-drug regimen; do not cut/crush/chew tab
- [>8 yo, >45 kg]
- Dose: 120 mg PO q12h; Info: part of multi-drug regimen; do not cut/crush/chew tab
anaplasmosis (off-label)
- [2.6 mg/kg/dose PO q12h x10-14 days]
- Max: 120 mg/dose; Info: do not cut/crush/chew tab
ehrlichiosis (off-label)
- [2.6 mg/kg/dose PO q12h x5-14 days]
- Max: 120 mg/dose; Info: do not cut/crush/chew tab
onchocerciasis (off-label)
- [240 mg PO qd x6wk]
- Start: 1wk after ivermectin tx; Info: may decr. to 120 mg PO qd if not tolerated; not 1st-line agent; do not cut/crush/chew tab
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [not defined]