Doxycycline hyclate Intravenous for Adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Important information

• Unlicensed preparation - rarely used by the intravenous route
• Intravenous use is associated with local irritation and may cause thrombophlebitis, therefore, IV therapy should be switched to PO as soon as possible.
• Avoid in pregnancy and breastfeeding

Available preparations

Doxycyclin-ratiopharm 100mg per 5ml ampoule

Reconstitution

Already in solution

Draw up using a 5 micron filter needle

Infusion fluids

Sodium chloride 0.9% or Glucose 5%

Methods of intravenous administration

Intermittent intravenous infusion - preferred method due to risk of thrombophlebitis ^{(ref 1)}

Dose of 100mg	Dose of 200mg
Give 100mg in at least 100ml over 1 to 4 hours	Give 200mg in at least 250ml over 2 to 4 hours

Slow intravenous injection - 100mg only and where INFUSION is not possible

• Administer dose over at least 2 minutes (not to exceed 50mg per minute)
• A slower rate of injection of at least 3 minutes is required for elderly, frail, critically ill and patients with cardiac arrhythmias
• The rate of administration is important. If the injection is administered too quickly it may cause vertigo, sensation of heat, facial flushing and collapse
• May cause thrombophlebitis

Dose in adults

Usual dose

• Give 200mg on day 1, then...
• Give 100 once or twice daily, or 200mg once daily - depending on the infection being treated, and the severity of the infection (ref 2)

Hepatic impairment

• Use with caution in hepatic impairment

Renal impairment

• Oral administration is preferred in patients with severely impaired renal function (due to risk of accumulation of povidone solvent).
• Otherwise, no dosage adjustment is necessary

Monitoring

• Monitor renal and hepatic function during treatment (especially during prolonged courses of treatment.)

Further information

• Intravenous infusion is the preferred method of administration, due to the risk of thrombophlebitis
• Contraindicated in myasthenia gravis - risk of neuromuscular block (due to the magnesium content)

Storage

• Protect mixed infusion solution from direct sunlight
• Store between 2 and 8⁰C

References

German SPC Doxycycline Ratiopharm July 2021

1. Injectable medicines administration guide Medusa, downloaded 18th Oct 2022

Therapeutic classification

Antibiotic - tetracycline