Applies to demeclocycline: oral tablets.

Side effects include:

GI effects (anorexia, nausea, vomiting, diarrhea); maculopapular and erythematous rash; dose-related BUN increase; hypersensitivity reactions.

For Healthcare Professionals

Applies to demeclocycline: oral tablet.

Dermatologic

Phototoxic reactions appear to be more common with demeclocycline than with other tetracyclines. These reactions may reoccur up to 3 weeks after demeclocycline is discontinued. Patients receiving demeclocycline should avoid sun exposure and use sunscreen for about 3 weeks after completing demeclocycline therapy.^[Ref]

Dermatologic reactions associated with tetracyclines have included photosensitivity, maculopapular rash, erythematous rash, erythema multiforme, exfoliative dermatitis, fixed drug eruption, Stevens-Johnson syndrome, and skin and mucous membrane pigmentation.^[Ref]

Renal

Demeclocycline has been used to produce nephrogenic diabetes insipidus in patients with hyponatremia associated with the syndrome of inappropriate anti-diuretic hormone (SIADH) secretion. Demeclocycline use for this indication may be limited by increases in BUN and serum creatinine, which appear to be dose-related but are reversible when the drug is discontinued. Decreases in glomerular filtration rate and creatinine clearance, as well as azotemia, have been reported in patients with congestive heart failure, cirrhosis, and cancer treated with demeclocycline. Azotemia has been associated with increases in demeclocycline serum concentrations. In one report of three patients with cirrhosis, the decrease in inulin clearance associated with demeclocycline ranged from 63% to 78%.^[Ref]

Renal effects have included the inhibition of antidiuretic hormone (ADH) in the renal tubules. This action produces nephrogenic diabetes insipidus, resulting in polyuria and an inability to concentrate urine. Nephrogenic diabetes insipidus occurs at dosages between 600 to 1200 mg per day, generally after approximately 5 days of therapy, and reverses within approximately one week after therapy is discontinued. Tetracyclines have also been associated with acute renal failure and increased BUN.^[Ref]

Gastrointestinal

Gastrointestinal side effects associated with tetracyclines have included nausea, anorexia, vomiting, diarrhea, glossitis, dysphagia, enterocolitis, pancreatitis, anogenital inflammation, and moniliasis. Esophageal ulceration has been reported in patients given demeclocycline without proper fluid when in a supine position. Tooth discoloration has been reported in pediatric patients and rarely in adults.^[Ref]

Nervous system

Nervous system side effects associated with tetracyclines have included dizziness, headache, tinnitus, visual disturbances, and pseudotumor cerebri.^[Ref]

Hypersensitivity

Hypersensitivity reactions associated with tetracyclines have included urticaria, angioneurotic edema, polyarthralgia, anaphylaxis, anaphylactoid purpura, pericarditis, exacerbation of systemic lupus erythematosus, lupus-like syndrome, and pulmonary infiltrations with eosinophilia.^[Ref]

Hematologic

Hematologic side effects associated with tetracyclines have included hemolytic anemia, thrombocytopenia, neutropenia, and eosinophilia.^[Ref]

Hepatic

Hepatic side effects associated with tetracyclines have included increased liver enzymes, hepatic toxicity, hepatitis, and liver failure.^[Ref]

Genitourinary

Genitourinary side effects associated with tetracyclines have included penile lesions and balanitis.^[Ref]

Other

The long-term use of tetracyclines has been associated with microscopic brown-black discoloration of the thyroid gland. Abnormal thyroid function has rarely been reported.^[Ref]