Last update: Aug. 6, 2018

Doxycycline Calcium

Low Risk for breastfeeding


Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.

Indicated in the treatment of infections caused by Mycoplasma pneumoniae, Chlamydia, Rickettsia and spirochetes.
Oral administration once a day.

Excreted into breast milk in quantities that would be clinically significant (Matsuda 1984, Lutziger 1969, Morganti 1968), however, intestinal absorption by infant's gut is hampered because of formation of chelating products by union with the milk's calcium (Chin 2001).

Tetracycline is at lesser amount excreted into breast milk and at higher proportion bound to calcium, hence, it is fewer absorbed than Doxycycline (Hale 2017 p312, Chin 2001).

Long-term treatments are not recommended (over 3-4 weeks) since it may cause damage of the growth cartilage, teeth discoloration and imbalance of intestinal flora.

Several medical societies, experts and expert consensus, consider the use of this medication safe or probably safe during breastfeeding (Hale 2017 p312, Briggs 2017, Rowe 2013, Chen 2010, Mitrano 2009, Nahum 2006, Mahadevan 2006, WHO 2002, Chin 2001).

Be aware of false negative results of bacterial cultures obtained from febrile infants whose mothers are on antibiotics, as well as the possibility of gastroenteritis due to altered intestinal flora (Briggs 2017, Ito 1993).

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
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Other names

Doxycycline Calcium is also known as Doxycycline. Here it is a list of alternative known names::


Doxycycline Calcium in other languages or writings:

Group

Doxycycline Calcium belongs to this group or family:

Tradenames

Main tradenames from several countries containing Doxycycline Calcium in its composition:

List of 22 tradenames

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 90 - 100 %
Molecular weight 462 daltons
Protein Binding 90 %
VD 0,75 l/Kg
Tmax 2 - 3 hours
T1/2 18 - 22 hours
M/P ratio 0,3 - 0,4 -
Theoretical Dose 0,12 - 0,29 mg/Kg/d
Relative Dose 7,2 - 17,4 %
Relat.Ped.Dose 6 - 14,5 %

References

  1. Hale TW, Rowe HE. Medications & Mothers' Milk. A Manual of Lactation Pharmacology. Springer Publishing Company. 2017
  2. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  3. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  4. Chen LH, Zeind C, Mackell S, LaPointe T, Mutsch M, Wilson ME. Breastfeeding travelers: precautions and recommendations. J Travel Med. 2010 Jan-Feb;17(1):32-47. Abstract Full text (link to original source) Full text (in our servers)
  5. Mitrano JA, Spooner LM, Belliveau P. Excretion of antimicrobials used to treat methicillin-resistant Staphylococcus aureus infections during lactation: safety in breastfeeding infants. Pharmacotherapy. 2009 Sep;29(9):1103-9. Abstract
  6. Nahum GG, Uhl K, Kennedy DL. Antibiotic use in pregnancy and lactation: what is and is not known about teratogenic and toxic risks. Obstet Gynecol. 2006 Abstract
  7. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006 Jul;131(1):283-311. Review. Abstract Full text (link to original source) Full text (in our servers)
  8. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  9. Chin KG, McPherson CE 3rd, Hoffman M, Kuchta A, Mactal-Haaf C. Use of anti-infective agents during lactation: Part 2--Aminoglycosides, macrolides, quinolones, sulfonamides, trimethoprim, tetracyclines, chloramphenicol, clindamycin, and metronidazole. J Hum Lact. 2001 Feb;17(1):54-65. Abstract
  10. Fulton B, Moore LL. Antiinfectives in breastmilk. Part II: Sulfonamides, tetracyclines, macrolides, aminoglycosides and antimalarials. J Hum Lact. 1992 Dec;8(4):221-3. Review. No abstract available. Abstract
  11. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy Perinatol. 1984;5(2):57-60. Abstract
  12. Lutziger H. [Concentration determinations and clinical effectiveness of doxycycline (Vibramycin) in the uterus, adnexa and maternal milk]. Ther Umsch. 1969 Abstract
  13. Morganti G, Ceccarelli G, Ciaffi G. [Comparative concentrations of a tetracycline antibiotic in serum and maternal milk]. Antibiotica. 1968 Abstract

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