독시사이클린
Doxycycline
Doxycycline calcium, Doxycycline hyclate, Doxycycline monohydrate
다른 이름: Vibramycin · Doxirobe · Periostat · Doryx · Oracea · Monodox · Adoxa · Atridox · Doxybactin · Ronaxan · Doxycycline hydrochloride · Doxycycline monohydrate · Doxycyclinum · GS-3065 · Doxycycline hyclate
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
감사 완료 v13 용량 근거
구조화 용량 계산 근거Borreliosis (ie, Borrelia burgdorferi [Lyme disease]) (extra-label)
- q12-24h
NA
반드시 함께 고려할 임상 맥락 (2)
- ■ Do not give multivitamins, calcium supplements, antacids, or laxatives 2 hours before or after giving doxycycline as these products can reduce effectiveness of the medicine.
- Doxycycline hyclate tablets and capsules should be stored in tight, light-resistant containers below 30°C (86°F), preferably at controlled room temperature (15°C to 30°C [59°F-86°F]). After being reconstituted with water, the monohydrate oral suspension is stable for 14 days when stored at room temperature.
Susceptible bacterial infections (extra-label)
- q12-24h
NA
반드시 함께 고려할 임상 맥락 (2)
- ■ Do not give multivitamins, calcium supplements, antacids, or laxatives 2 hours before or after giving doxycycline as these products can reduce effectiveness of the medicine.
- Doxycycline hyclate tablets and capsules should be stored in tight, light-resistant containers below 30°C (86°F), preferably at controlled room temperature (15°C to 30°C [59°F-86°F]). After being reconstituted with water, the monohydrate oral suspension is stable for 14 days when stored at room temperature.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
독시사이클린은 옥시테트라사이클린에서 파생된 광범위 반합성 테트라사이클린계 항생제입니다. 기존 테트라사이클린계 약물에 비해 유리한 약동학적 특성으로 인해 수의학에서 널리 사용됩니다.
주요 임상적 장점:
- 높은 지용성: 중추신경계(CSF), 전립선, 눈을 포함한 조직 침투력이 매우 뛰어납니다.
- 신장 안전성: 다른 테트라사이클린계와 달리 주로 비활성 킬레이트 형태로 대변을 통해 배설됩니다. 신기능 장애 환자에게 축적되지 않으므로 질소혈증 환자에게 우선적으로 선택되는 테트라사이클린계 약물입니다.
- 심장사상충 보조 치료: 현대 반려견 심장사상충 치료 프로토콜의 핵심 요소입니다. 심장사상충의 생존과 번식에 필수적인 내부 공생 세균인 Wolbachia를 제거하여 성충을 약화시키고 성충 구제 후의 폐 병리를 감소시킵니다.
보렐리아(라임병), 렙토스피라, 리케차, 클라미디아, 마이코플라스마, 바르토넬라, 보르데텔라를 포함한 비정형 병원체에 매우 효과적입니다.
작용 기전
Doxycycline is a bacteriostatic antibiotic.
- Primary Mechanism: It reversibly binds to the 30S ribosomal subunit of susceptible organisms → prevents the binding of aminoacyl transfer-RNA to the mRNA-ribosome complex → inhibits bacterial protein synthesis.
- Secondary Mechanisms: It may also reversibly bind to 50S ribosomes and alter cytoplasmic membrane permeability.
- Anti-inflammatory/Immunomodulatory Effects: Beyond its antimicrobial properties, doxycycline inhibits matrix metalloproteinases (MMPs) and scavenges reactive oxygen species, which contributes to its efficacy in treating chronic inflammatory conditions (e.g., idiopathic rhinitis, arthritis).
안전성·주의사항
금기사항
- Hypersensitivity to tetracyclines
- Intravenous administration in horses (associated with fatal cardiac arrhythmias)
- First half of pregnancy (can retard fetal skeletal development and discolor deciduous teeth, though less likely than other tetracyclines)
- Pregnant animals
- Animals with evidence of oesophagitis or dysphagia
부작용
- Vomiting
- Diarrhea
- Anorexia
- Elevated liver enzymes (ALT, ALP)
- Esophageal strictures (especially in cats if dry-pilled)
- Superinfections (non-susceptible bacteria or fungi)
- Photosensitivity (reported in humans)
- Cardiac arrhythmias, collapse, and death (if given IV to horses)
- Nausea
- Diarrhoea
- Oesophagitis
- Oesophageal ulceration/stricture (especially in cats)
- Tooth discoloration (if given during tooth development, though risk is lower than other tetracyclines)
주의
WARNING: Do not administer IV to horses due to risk of fatal cardiac arrhythmias. Do not give IM or SC to any species.
- Esophageal Strictures: Highly associated with "dry pilling" in cats. Always follow oral solid doses with at least 6 mL of water or liquid.
- Hepatotoxicity: Use with caution in animals with significant liver dysfunction, as increases in hepatic enzymes have been documented.
- Pregnancy/Pediatric: Use with caution in pregnant and young animals due to potential for bone and teeth abnormalities, though doxycycline is safer than older tetracyclines.
- MDR1 Mutants: Safe to use; no dose alterations recommended for dogs with MDR1 mutations.
약물 상호작용
Chelates with divalent/trivalent cations, significantly decreasing doxycycline absorption. Give at least 1-2 hours apart.
May reduce gastrointestinal absorption of doxycycline.
Decreases tetracycline absorption. Give iron 3 hours before or 2 hours after doxycycline.
Bacteriostatic drugs (doxycycline) may theoretically interfere with the bactericidal activity of these antibiotics.
May decrease doxycycline half-life and reduce serum levels.
Tetracyclines may depress plasma prothrombin activity; anticoagulant dosage may need adjustment.
Reduced absorption of doxycycline
Reduced absorption of doxycycline
Reduced absorption of doxycycline
Reduced absorption of doxycycline
May increase doxycycline metabolism, decreasing plasma levels
Reduced absorption of doxycycline (though less marked than with water-soluble tetracyclines)
모니터링
- Clinical efficacy
- Adverse effects (GI upset)
- Liver enzymes (ALT, ALP) with prolonged use
- Clinical response to therapy
- Signs of dysphagia, regurgitation, or oesophagitis (especially in cats)
- Gastrointestinal upset
약동학
반감기
흡수
Well absorbed after oral administration (90-100% bioavailability in humans/monogastrics). Unlike other tetracyclines, absorption is only minimally reduced (by ~20%) by food or dairy products. However, in horses, feeding can reduce bioavailability to <5% due to high fiber content.
분포
Highly lipid-soluble. Widely distributed to heart, kidney, lungs, muscle, pleural fluid, bronchial secretions, bile, saliva, synovial fluid, and aqueous/vitreous humor. Penetrates CSF, prostate, and eye better than other tetracyclines. Volume of distribution (Vd) in dogs is ~1.5 L/kg. Protein binding: 75-86% (dogs), 82% (horses), 93% (cattle/pigs/cats).
대사
Partially inactivated in the intestine by chelate formation.
배설
Primarily excreted into the feces via non-biliary routes in an inactive form (chelate). Renal excretion accounts for only ~25% in dogs, and biliary excretion <5%. Does not accumulate in patients with renal dysfunction.
과다투여
Doxycycline is generally quite safe in mild overdose situations (except for IV administration in horses).
- Oral Overdose: Most likely associated with gastrointestinal disturbances (vomiting, anorexia, diarrhea).
- Treatment: Oral administration of divalent or trivalent cation antacids (e.g., calcium, magnesium, aluminum) can bind the drug in the gut and reduce GI distress. Monitor and replace fluids/electrolytes if severe emesis or diarrhea occurs.
- IV Overdose: Rapid intravenous injection has induced transient collapse and cardiac arrhythmias in several species, presumably due to chelation with intravascular calcium ions.
제품
제형
- Delayed-Release Tablets and Capsules
- Powder for Oral Suspension
- Oral Syrup
- Injection (Lyophilized powder)
- Periodontal Gel (8.5%)
- 20 mg tablet
- 50 mg tablet
- 100 mg tablet
- 200 mg tablet
- 400 mg tablet
- Oral paste (named patient basis)
동물용의약품
- Doxirobe® (Pfizer): Doxycycline gel 8.5% activity once mixed (for periodontal disease in dogs)
- Doxybactin 20 mg, 50 mg, 200 mg, 400 mg tablets
- Ronaxan 20 mg, 100 mg tablets
- Oral paste (named patient basis)
인용의약품
- Periostat®, Alodox Convenience Kit®, Vibramycin®, Vibra-Tabs®, Oraxyl®, generic: Tablets & Capsules (20 mg, 50 mg, 100 mg)
- Doryx®, Oracea®: Delayed-Release Tablets & Capsules (40 mg, 75 mg, 100 mg, 150 mg)
- Monodox®, Adoxa®, generic: Tablets and Capsules (as monohydrate) (50 mg, 75 mg, 100 mg, 150 mg)
- Vibramycin®, Doxycycline (Teva): Powder for Oral Suspension (5 mg/mL after reconstitution)
- Vibramycin®: Oral Syrup (as calcium salt) (10 mg/mL)
- Atridox®: Injection (42.5 mg in vials)
- Doxy®-100 & -200, generic: Lyophilized Powder for Injection (100 mg, 200 mg)
규제 현황
POM-V
POM-V
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보관·안정성
Tablets and capsules should be stored in tight, light-resistant containers at <30°C (preferably 15-30°C). Reconstituted monohydrate oral suspension is stable for 14 days at room temperature. Compounded oral suspensions degrade rapidly between 7-14 days even if refrigerated. Tablets mixed with water/food lose >10% potency after 24 hours. Reconstituted hyclate injection (0.1-1 mg/mL) is stable for 72 hours refrigerated.
보호자 정보
- 고양이에 대한 중요 경고: 절대 물 없이 알약만 먹이지 마십시오("드라이 필링" 금지). 독시사이클린 캡슐이나 알약이 식도에 달라붙어 심각하고 영구적인 손상(식도 협착)을 일으킬 수 있습니다. 알약을 먹인 후에는 반드시 최소 6mL(1티스푼보다 약간 많은 양)의 물이나 액체를 먹이십시오. 투약 후 입술에 버터를 발라주면 침 분비를 유도하여 알약이 잘 넘어가도록 도울 수 있습니다.
- 음식 및 유제품: 독시사이클린은 음식과 함께 또는 빈속에 투여할 수 있습니다. 음식과 함께 먹이면 위장 장애를 예방하는 데 도움이 될 수 있습니다. 기존 테트라사이클린계 약물과 달리 우유나 유제품이 독시사이클린의 흡수를 크게 방해하지 않습니다.
- 햇빛: 드물게 이 약물로 인해 피부가 햇빛에 더 민감해질 수 있습니다.
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