Doxycycline capsules USP 75mg Taj Pharma

1. Name of the medicinal product

Doxycycline capsules USP 50mg Taj Pharma
Doxycycline capsules USP 75mg Taj Pharma
Doxycycline capsules USP 100mg Taj Pharma

2. Qualitative and quantitative composition

a) Doxycycline capsules USP 50mg Taj Pharma
Each hard gelatin capsule contains:
Doxycycline Hyclate USP
Equivalent to Doxycycline (Base) 50mg
Excipients: Q.S.

b) Doxycycline capsules USP 75mg Taj Pharma
Each hard gelatin capsule contains:
Doxycycline Hyclate USP
Equivalent to Doxycycline (Base) 75mg
Excipients: Q.S.

c) Doxycycline capsules USP 100mg Taj Pharma
Each hard gelatin capsule contains:
Doxycycline Hyclate USP
Equivalent to Doxycycline (Base) 100mg
Excipients: Q.S.

Excipient with known effect: Each capsule contains sucrose.

For the full list of excipients, see section 6.1.

3. Pharmaceutical form

Hard gelatin capsule

Hard gelatin capsule with opaque green cap and opaque green body with “100mg” printed in white ink.

4. Clinical particulars

• Therapeutic indications

Doxycycline Taj Pharma has been found clinically effective in the treatment of a variety of infections caused by susceptible strains of Gram-positive and Gram-negative bacteria and certain other micro- organisms.

Respiratory tract infections

Pneumonia and other lower respiratory tract infections due to susceptible strains of Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae and other organisms. Mycoplasma pneumoniae pneumonia. Treatment of chronic bronchitis, sinusitis.

Urinary tract infections

Infections caused by susceptible strains of Klebsiella species, Enterobacter species.

Escherichia coli, Streptococcus faecalis and other organisms.

Sexually transmitted diseases

Infections due to Chlamydia trachomatis including uncomplicated urethral, endocervical or rectal infections. Non-gonococcal urethritis caused by Ureaplasma urealyticum (T- mycoplasma).

Doxycycline Taj Pharma is also indicated in chancroid, granuloma inguinale and lymphogranuloma venereum. Doxycycline Taj Pharma is an alternative drug in the treatment of gonorrhoea and syphilis.

Dermatological infections

Acne vulgaris when antibiotic therapy is considered necessary.

Since Doxycycline Taj Pharma is a member of the tetracycline group of antibiotics, it may be expected to be useful in the treatment of infections, which respond to other tetracyclines, such as:

Ophthalmic infections

Due to susceptible strains of gonococci, staphylococci and Haemophilus influenzae. Doxycycline Taj Pharma Capsules are indicated in the treatment of trachoma, although the infectious agent is not always eliminated, as judged by immunofluorescence.

Rickettsial infections

Rocky Mountain spotted fever, typhus group, Q fever, Coxiella endocarditis and tick fevers.

Other infections

Psittacosis, cholera, meliodosis, leptospirosis, other infections due to susceptible strains of Yersinia species, Brucella species (in combination with Streptomycin), Clostridium species, Francisella tularensis and chloroquine-resistant falciparum malaria.

Doxycycline Taj Pharma Capsules are indicated for prophylaxis in the following conditions: Scrub typhus, travellers’ diarrhoea (enterotoxigenic Escherichia coli), leptospirosis.

Consideration should be given to official guidance on the appropriate use of antibacterial agents.

• Posology and method of administration

The capsules should be swallowed with plenty of fluid in either the resting or standing position and well before going to bed for the night to reduce the likelihood of oesophageal irritation and ulceration.

If gastric irritation occurs, it is recommended that Doxycycline Taj Pharma Capsules be given with food or milk. Studies indicate that the absorption of Doxycycline Taj Pharma is not notably influenced by simultaneous ingestion of food or milk.

Posology

Adults and children aged 12 years to less than 18 years

The usual dosage of Doxycycline Taj Pharma for the treatment of acute infections in adults and children aged 12 years to less than 18 years is 200mg on the first day (as a single dose or in divided doses with a twelve hour interval) followed by a maintenance dose of 100mg/day. In the management of more severe infections (particularly chronic infections of the urinary tract), 200mg daily should be given throughout the treatment period.

Exceeding the recommended dosage may result in an increased incidence of side effects. Therapy should be continued for at least 24 to 48 hours after the symptoms and fever have subsided.

When used in streptococcal infections, therapy should be continued for 10 days to prevent the development of rheumatic fever or glomerulonephritis.

Dosage recommendations in specific infections:

Acne vulgaris

50mg daily with food or fluid for 6 to 12 weeks.

Sexually transmitted diseases

100mg twice daily for 7 days is recommended in the following infections: uncomplicated gonococcal infections (except anorectal infections in men); uncomplicated urethral, endocervical or rectal infection caused by Chlamydia trachomatis; non-gonococcal urethritis caused by Ureaplasma urealyticum.

Acute epididymo-orchitis caused by Chlamydia trachomatis or Neisseria gonorrhoea 100mg twice daily for 10 days.

Primary and secondary syphilis:300mg a day in divided doses for at least 10 days.

Louse and tick-borne relapsing fevers

A single dose of 100mg or 200mg according to severity.

Treatment of chloroquine-resistant falciparum malaria

200mg daily for at least 7 days. Due to the potential severity of the infection, a rapid- acting schizonticide such as quinine should always be given in conjunction with Doxycycline Taj Pharma; quinine dosage recommendations vary in different areas.

Prophylaxis of malaria

100mg daily in adults and children over the age of 12 years. Prophylaxis can begin 1-2 days before travel to malarial areas. It should be continued daily during travel in the malarial areas and for 4 weeks after the traveller leaves the malarial area. For current advice on geographical resistance patterns and appropriate chemoprophylaxis, current guidelines or the Malaria Reference Laboratory should be consulted, details of which can be found in the British National Formulary (BNF).

For the prevention of scrub typhus

200mg as a single dose.

For the prevention of travellers’ diarrhoea in adults

200mg on the first day of travel (administered as a single dose or as 100mg every 12 hours) followed by 100mg daily throughout the stay in the area. Data on the use of the drug prophylactically are not available beyond 21 days.

For the prevention of leptospirosis

200mg once each week throughout the stay in the area and 200mg at the completion of the trip. Data on the use of the drug prophylactically are not available beyond 21 days.

Children aged 8 years to less than 12 years. (Section 4.4)

The use of Doxycycline Taj Pharma for the treatment of acute infections in children aged 8 years to less than 12 years should be carefully justified in situations where other drugs are not available, are not likely to be effective or are contraindicated.

In such circumstance, the doses for the treatment of acute infections are:

For children 45 kg or less- Initial dose: 4.4 mg/kg (in single or 2 divided doses) with maintenance dose: 2.2 mg/kg (in single or 2 divided doses). In the management of more severe infections, up to 4.4 mg/kg should be given throughout treatment.

For children, over 45 kg – Dose administered for adults should be used.

Children aged from birth to less than 8 years.

Doxycycline Taj Pharma should not be used in children aged younger than 8 years due to the risk of teeth discolouration. (Section 4.4 and 4.8)

Paediatric population: Not recommended.

Elderly patients

Doxycycline Taj Pharma may be prescribed in the usual dose with no special precautions. No dosage adjustment is necessary in the presence of renal impairment.

Renal impairment: Studies to date have indicated that administration of Doxycycline Taj Pharma at the usual recommended doses does not lead to excessive accumulation of the antibiotic in patients with renal impairment.

The anti-anabolic action of the tetracyclines may cause an increase in blood urea. Studies to date indicate that this does not occur with the use of Doxycycline Taj Pharma in patients with impaired renal function.

Haemodialysis does not alter the serum half-life of Doxycycline Taj Pharma.

• Contraindications

• Hypersensitivity to the active substance, any of the tetracyclines or to any of the excipients listed in section 6.1
• Pregnancy: Doxycycline Taj Pharma is contraindicated in pregnancy (see section 4.6). It appears that the risks associated with the use of tetracyclines during pregnancy are predominantly due to effects on teeth and skeletal development (see Section 4.4 regarding use during tooth development).
• Nursing mothers: Tetracyclines are excreted into milk and are therefore contraindicated in nursing mothers (see Section 4.4 regarding use during tooth development).
• Sucrose intolerance: Patients with rare hereditary problems of fructose intolerance, glucose galactose malabsorption or sucrose-isomaltase insufficiency should not take Doxycycline Taj Pharma.
  • Special warnings and precautions for use

Paediatric population

The use of drugs of the tetracycline class during tooth development (last half of pregnancy; infancy and childhood to the age of 8 years) may cause permanent discolouration of the teeth (yellow-grey-brown). This adverse reaction is more common during long-term use of the drugs but has been observed following repeated short-term courses. Enamel hypoplasia has also been reported. Use Doxycycline Taj Pharma in paediatric patients aged younger than 8 years only when the potential benefits are expected to outweigh the risks in severe or life- threatening conditions (e.g. Rocky Mountain spotted fever), particularly only when there are no adequate alternative therapies.

Although the risk of permanent teeth staining is rare in children aged 8 years to less than 12 years, the use of Doxycycline Taj Pharma should be carefully justified in situations where other drugs are not available, are not likely to be effective or are contraindicated.

Photosensitivity

Photosensitivity manifested by an exaggerated sunburn reaction has been observed in some individuals taking tetracyclines, including Doxycycline Taj Pharma. Patients likely to be exposed to direct sunlight or ultraviolet light should be advised that this reaction can occur with tetracycline drugs and treatment should be discontinued at the first evidence of skin erythema.

Use in patients with impaired hepatic function

Doxycycline Taj Pharma should be administered with caution to patients with hepatic impairment or those receiving potentially hepatotoxic drugs. Abnormal hepatic function has been reported rarely and has been caused by both the oral and parenteral administration of tetracyclines, including Doxycycline Taj Pharma.

Use in patients with renal impairment

Excretion of Doxycycline Taj Pharma by the kidney is about 40%/72 hours in individuals with normal renal function. This percentage excretion may fall to a range as low as 1-5%/72 hours in individuals with severe renal insufficiency (creatinine clearance below 10ml/min). Studies have shown no significant difference in the serum half-life of Doxycycline Taj Pharma in individuals with normal and severely impaired renal function.

Haemodialysis does not alter the serum half-life of Doxycycline Taj Pharma. The anti-anabolic action of the tetracyclines may cause an increase in blood urea. Studies to date indicate that this anti-anabolic effect does not occur with the use of Doxycycline Taj Pharma in patients with impaired renal function.

Microbiological overgrowth

The use of antibiotics may occasionally result in overgrowth of non-susceptible organisms including Candida. If a resistant organism appears, the antibiotic should be discontinued and appropriate therapy instituted.

Pseudomembranous colitis has been reported with nearly all antibacterial agents, including Doxycycline Taj Pharma, and has ranged in severity from mild to life-threatening. It is important to consider this diagnosis in patients who present with diarrhoea subsequent to the administration of antibacterial agents.

Clostridium difficile associated diarrhoea (CDAD) has been reported with use of nearly all antibiotics, including Doxycycline Taj Pharma, and has ranged in severity from mild diarrhoea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C difficile. C difficile produces toxins A and B, which contribute to development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD should be considered in all patients who present with diarrhoea after antibiotic treatment. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.

Oesophagitis

Instances of oesophagitis and oesophageal ulcerations have been reported in patients receiving capsule and tablet forms of drugs in the tetracycline class, including Doxycycline Taj Pharma. Most of these patients took medications immediately before going to bed or with inadequate amounts of fluid.

Bulging fontanelles

Bulging fontanelles in infants and benign intracranial hypertension in juveniles and adults have been reported in individuals receiving full therapeutic dosages. These conditions disappeared rapidly when the drug was discontinued.

Porphyria

There have been rare reports of porphyria in patients receiving t e t r a c y c l i n e s .

Venereal disease

When treating venereal disease, where co-existent syphilis is suspected, proper diagnostic procedures, including dark-field examinations, should be utilised. In such cases monthly serological tests should be performed for at least four months.

Beta-haemolytic streptococci infections

Infections due to Group A beta-haemolytic streptococci should be treated for at least 10 days.

Myasthenia gravis

Due to a potential for weak neuromuscular blockade, care should be taken in administering tetracyclines to patients with myasthenia gravis.

Systemic lupus erythematosus

Tetracyclines can cause exacerbation of systemic lupus erythematosus (SLE).

Jarisch-Herxheimer reaction

Some patients with spirochete infections may experience a Jarisch-Herxheimer reaction shortly after Doxycycline Taj Pharma treatment is started. Patients should be reassured that this is a usually self-limiting consequence of antibiotic treatment of spirochete infections.

Methoxyflurane

Caution is advised in administering tetracyclines with methoxyflurane (see section 4.5).

• Interaction with other medicinal products and other forms of interaction

There have been reports of prolonged prothrombin time in patients taking warfarin and Doxycycline Taj Pharma.

Tetracyclines depress plasma prothrombin activity and reduced dosage of concomitant anti-coagulants may be necessary

Since bacteriostatic drugs may interfere with the bactericidal action of penicillin, it is advisable to avoid giving Doxycycline Taj Pharma in conjunction with penicillin.

The absorption of Doxycycline Taj Pharma may be impaired by concurrently administered antacids containing aluminium, calcium, magnesium or other drugs containing these cations; oral zinc, iron salts or bismuth preparations. Dosages should be maximally separated.

Phenobarbital, carbamazepine, primidone and phenytoin may increase the metabolism of Doxycycline Taj Pharma (reduced half-life).An increase in the daily dosage of Doxycycline Taj Pharma should be considered.

Alcohol may decrease the half-life of Doxycycline Taj Pharma.

The concurrent use of tetracyclines and methoxyflurane has been reported to result in fatal renal toxicity (see section 4.4).

Doxycycline Taj Pharma may increase the plasma concentration of ciclosporin. Co-administration should only be undertaken with appropriate monitoring.

Drugs that induce hepatic enzymes such as rifampicin may accelerate the decomposition of Doxycycline Taj Pharma, thereby decreasing its half-life. Sub-therapeutic Doxycycline Taj Pharma concentrations may result. Monitoring concurrent use is advised and an increase in Doxycycline Taj Pharma dose may be required.

There is a possible increased risk of benign intra-cranial hypertension when Doxycycline Taj Pharma given with retinoids. Concomitant use should be avoided.

Antibacterials inactivate oral typhoid vaccines. Avoid administration of vaccine during treatment with Doxycycline Taj Pharma.

Ergotamine and methysergide; There is an increased risk of ergotism when Doxycycline Taj Pharma is co-administered with ergotamine and methysergide.

Methotrexate; Doxycycline Taj Pharma increases the risk of methotrexate toxicity; prescribe with caution to patients on methotrexate.

Kaolin and sucralfate may reduce the absorption of Doxycycline Taj Pharma.

Quinapril contains magnesium carbonate and may interfere with the absorption of Doxycycline Taj Pharma

A few cases of pregnancy or breakthrough bleeding have been attributed to the concurrent use of tetracycline antibiotics with oral contraceptives.

Laboratory test interactions

False elevations of urinary catecholamine levels may occur due to interference with the fluorescence test.

• Fertility, pregnancy and lactation

See “Contra-indications”, section 4.3.

• Effects on ability to drive and use machines

Visual disturbances such as blurring of vision may occur during treatment with Doxycycline Taj Pharma and in such cases; patients must refrain from driving or operating machinery.

• Undesirable effects

The following adverse reactions have been observed in patients receiving tetracyclines, including Doxycycline Taj Pharma.

Hypersensitivity reactions, including anaphylactic shock, anaphylaxis, anaphylactoid reaction, anaphylactoid purpura, hypotension, pericarditis, angioneurotic oedema, exacerbation of systemic lupus erythematosus, dyspnoea, serum sickness, peripheral oedema, tachycardia and urticaria.

Infections and infestations

As with all antibiotics, overgrowth of non-susceptible organisms may cause candidiasis, glossitis, staphylococcal enterocolitis, pseudomembranous colitis (with Clostridium difficile overgrowth) and inflammatory lesions (with candidal overgrowth) in the anogenital region.

Blood and lymphatic system disorders

Haemolytic anaemia, thrombocytopenia, neutropenia, porphyria, and eosinophilia have been reported with tetracyclines.

Immune system disorders

Jarisch-Herxheimer reaction (Frequency Not known) (see Section 4.4)

Endocrine disorders

When given over prolonged periods, tetracyclines have been reported to produce brown-black microscopic discolouration of thyroid tissue. No abnormalities of thyroid function are known to occur.

Nervous system disorders

Headache. Bulging fontanelles in infants and benign intracranial hypertension in juveniles and adults have been reported in individuals receiving full therapeutic dosages of tetracyclines. These are reversible on stopping the drug. Symptoms included blurring of vision, scotomata, diplopia and permanent visual loss has been reported.

Ear and labyrinth disorders

Tinnitus

Gastrointestinal disorders

Gastrointestinal symptoms are usually mild and seldom necessitate discontinuation of treatment. They include abdominal pain, stomatitis, anorexia, nausea, vomiting, diarrhoea, dyspepsia and rarely dysphagia. Oesophagitis and oesophageal ulceration have been reported in patients receiving Doxycycline Taj Pharma. A significant proportion of these cases occurred with the hydrochloride salt in the capsule form (see section 4.4). Tooth discolouration (Reversible and superficial discolouration of permanent teeth has been reported with the use of Doxycycline Taj Pharma but frequency cannot be estimated from available data) Black hairy tongue (frequency not known).

Hepatobiliary disorders

There have been rare reports of hepatotoxicity with transient increases in liver function tests, hepatitis, jaundice, hepatic failure and pancreatitis.

Skin and subcutaneous tissue disorders

Rashes including maculopapular and erythematous rashes, exfoliative dermatitis, erythema multiforme, Stevens-Johnson syndrome and toxic epidermal necrolysis have been reported. Photosensitivity (see section 4.4) and photo-onycholysis. Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) (frequency not known).

Musculoskeletal and connective tissue disorders

Arthralgia and myalgia

Renal and urinary system disorders

Increased blood urea (see section 4.4).

Reproductive system and breast disorders

Vaginitis

Psychiatric disorders Anxiety

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product.

• Overdose

Acute overdosage with antibiotics is rare. In the event of overdosage gastric lavage plus appropriate supportive treatment is indicated.

Dialysis does not alter serum half-life and thus would not be of benefit in treating cases of overdosage.

5. Pharmacological properties
   • Pharmacodynamic properties

Pharmacotherapeutic group: tetracyclines

Doxycycline Taj Pharma is primarily a bacteriostatic antibiotic.

Mechanism of action

The main mechanism of action of Doxycycline Taj Pharma is on protein synthesis. Doxycycline Taj Pharma passes directly through the lipid bilayer of the bacterial cell wall and an energy dependent active transport system pumps the drug through the inner cytoplasmic membrane. Once inside the cell Doxycycline Taj Pharma inhibits protein synthesis by binding to 30S ribosomes and prevents the addition of amino acids to the growing peptide chain. Doxycycline Taj Pharma will impair protein synthesis in mammalian cells at very high concentrations but these cells lack the active transport system found in bacteria.

Doxycycline Taj Pharma is clinically effective in the treatment of a variety of infections caused by a wide range of gram-negative and gram-positive bacteria, as well as certain other micro- organisms.

• Pharmacokinetic properties

Absorption

Doxycycline Taj Pharma is almost completely absorbed and is not subject to presystemic metabolism, the mean bioavailability being approximately 93%.

Absorption is rapid (effective concentrations are attained as from the first hour), and the peak serum concentration occurs after 2 to 4 hours.

Almost all of the product is absorbed in the upper part of the digestive tract. Absorption is not modified by administration with meals, and milk has little effect.

Distribution

Tissue distribution is good and Doxycycline Taj Pharma has a strong affinity for renal and lung tissue. The volume of distribution for Doxycycline Taj Pharma ranges from 0.9-1.8 lkg-1.

In adults, an oral dose of 200 mg results in;

• A peak serum concentration of more than 3 μg/ml
• A residual concentration of more than 1 μg/ml after 24 hours
• A serum half-life of 16 to 22 hours.
• Protein binding varying between 82 and 93% (labile binding) intra- and extracellular diffusion is good.

With usual dosages, effective concentrations are found in the ovaries, uterine tubes, uterus, placenta, testicles, prostate, bladder, kidneys, lung tissue, skin, muscles, lymph glands, sinus secretions, maxillary sinus, nasal polyps, tonsils, liver, hepatic and gallbladder bile, gallbladder, stomach, appendix, intestine, omentum, saliva and gingival fluid. Doxycycline Taj Pharma is transferred into breast milk.

Only small amounts are diffused into the cerebrospinal fluid.

Biotransformation

No significant metabolism occurs.

Elimination

Doxycycline Taj Pharma is cleared intact by renal and biliary mechanisms

The antibiotic is concentrated in the bile. About 40% of the administered dose is eliminated in 3 days in active form in the urine and about 32% in the faeces.

Urinary concentrations are roughly 10 times higher than plasma concentrations at the same time. In the presence of impaired renal function, urinary elimination decreases, faecal elimination increases and the half-life remains unchanged. The half-life is not affected by haemodialysis.

• Preclinical safety data

Not Applicable

6. Pharmaceutical particulars
   • List of excipients

Sugar Sphere

Crospovidone

Polymethacrylate

Talc

Capsules shell

Indigo carmine,Yellow iron oxide, Black iron oxide, Titanium dioxide, GelatinPrinting ink

Shellac

Ethyl Alcohol

Isopropyl Alcohol

n – Butyl Alcohol

Propylene Glycol

Ammonium Hydroxide

Purified Water

Potassium Hydroxide

Titanium dioxide

• Incompatibilities

None Stated

• Shelf life

5 years

• Special precautions for storage

Store below 25°C.

• Nature and contents of container

Each capsules contains active substance Doxycycline Taj Pharma.

Doxycycline Taj Pharma capsules are packed in blister packs made of one sheet of 200 micron rigid, opaque white polyvinyl chloride and a second sheet of 20 micron aluminium.

Pack size:
Each pack contains:8, 10, 14 and 50 capsule.

Each box contains: 50, 100, 250, 350, 400, 500 and 1000 capsules.

Not all pack size may be marketed.

• Special precautions for disposal and other handling

No special requirements.

Manufactured in India by:
TAJ PHARMACEUTICALS LTD.
Mumbai, India
Unit No. 214.Old Bake House,
Maharashtra chambers of Commerce Lane,
Fort, Mumbai – 400001
at:Gujarat, INDIA.
Customer Service and Product Inquiries:
1-800-TRY-FIRST (1-800-222-434 & 1-800-222-825)
Monday through Saturday 9:00 a.m. to 7:00 p.m. EST
E-mail: tajgroup@tajpharma.com

Doxycycline capsules USP 75mg Taj Pharma

PACKAGE LEAFLET: INFORMATION FOR THE USER

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible effects not listed in this leaflet. see section 4.

What is in this leaflet:

1. What Doxycycline Taj Pharma is and what it is used for
2. What you need to know before you take Doxycycline Taj Pharma
3. How to take Doxycycline Taj Pharma
4. Possible side effects
5. How to store Doxycycline Taj Pharma
6. Contents of the pack and other information

1. WHAT DOXYCYCLINE IS AND WHAT IT IS USED FOR

Doxycycline Taj Pharma belongs to a group of medicines called tetracycline antibiotics. It is also known as a broadspectrum antibiotic and may be used to treat a wide range of infections caused by bacteria, these include:

• Respiratory tract infections.
• Urinary tract infections
• Sexually transmitted diseases
• Skin infections such as Acne
• Infections of the eye
• Rickettsial infections such as Q fever or tick fever
• Other infections such malaria, cholera, brucellosis, leptospirosis,
• psittacosis and fevers caused by lice or ticks. or prevent:
• travellers diarrhoea, scrub typhus and leptospirosis.

2. WHAT YOU NEED TO KNOW BEFORE YOU TAKE DOXYCYCLINE

Do not take Doxycycline Taj Pharma if you:

• are allergic to Doxycycline Taj Pharma, other similar antibiotic ( such as minocycline or tetracycline) or any of the other ingredients of this medicine (listed in section 6).
• are pregnant, breastfeeding, think or may be pregnant or planning to become pregnant, ask your doctor or pharmacist for advice before taking any medicine as Doxycycline Taj Pharma could harm the baby.

Warnings and precautions

Talk to your doctor, pharmacist or nurse before taking Doxycyline if you:

• have liver disease or are taking medicines which affect your liver
• have porphyria (a genetic disorder of the blood)
• suffer from myasthenia gravis, a condition characterised by muscle weakness, difficulty chewing and swallowing and slurred speech
• are sensitive to sunlight
• have systemic lupus erythematosus (SLE) a condition characterised by a rash (especially on the face), hair loss, fever, malaise and joint pain.

Children and adolescents

Doxycycline Taj Pharma capsules should not be use during periods of tooth development (pregnancy, infancy or in children below 8 years old) as it can cause permanent discolouration (yellow-grey-brown) or affect the proper growth of the teeth.

There may be circumstances (e.g., severe or life-threatening conditions), where your physician may decide that the benefits outweigh this risk in children below 8 years and Doxycycline Taj Pharma should be prescribed.

Other medicines and Doxycycline Taj Pharma

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

• Warfarin or other anticoagulants (to stop blood clotting).
• Penicillin or rifampicin (to treat infections).
• medicines such as Antacids containing aluminium, calcium or magnesium, or other medicines containing iron, bismuth, zinc salts. Do not take at the same time as Doxycycline Taj Pharma, as absorption of Doxycycline Taj Pharma may be reduced.
• Carbamazepine, phenytoin or primidone (to treat epilepsy)
• Methoxyflurane (an anaesthetic), if you need an operation, tell your doctor or dentist you are taking Doxycycline Taj Pharma capsules
• Cyclosporin (used following organ transplants).

Important information about some of the ingredients of Doxycycline Taj Pharma

Doxycycline Taj Pharma 50 mg Capsules contain the colouring agent sunset yellow which may cause allergic reactions.

3. HOW TO TAKE DOXYCYCLINE

Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.

You should not drink alcohol whilst taking Doxycycline Taj Pharma capsules, speak to your doctor if you have any questions.

Swallow the capsules whole with a full glass of water, if the capsules irritate your stomach take them with food or milk. You should take the capsules either sitting down or standing up and well before you go to bed for the night to stop irritation and ulceration of your gullet. It is important not to lie down for at least thirty minutes after taking Doxycycline Taj Pharma capsules.

The recommended doses are shown in the list below. These are the different doses that your doctor may prescribe depending on the infection being treated.

General infections:

Children aged 8 years to less than 12 years:

Doxycycline Taj Pharma for the treatment of acute infections in children aged 8 years to less than 12 years should be used in situations where other drugs are not available or are not likely to be effective. In such circumstances, the usual doses are:

For children 45 kg or less:

First day: 4.4 mg for each kg of bodyweight (in single or 2 divided doses) then 2.2 mg for each kg of bodyweight (in single or 2 divided doses) from the second day. The length of treatment is dependent on the infection being treated.

In more severe infections, up to 4.4 mg for each kg of bodyweight should be given throughout treatment.

For children, over 45 kg, dose administered for adults should be used; 200mg on the first day, then 100 mg daily. The length of treatment is dependent on the infection being treated.

Adults, Elderly and Children aged 12 years to less than 18 years:

200mg on the first day as a single or two 100mg doses, followed by 100mg a day. For severe infections your doctor may increase the dose to 200mg a day.

The recommended dose is for at least 10 days unless otherwise directed by your doctor:

Specific infections:

• Acne vulgaris -50mg a day with food or fluid for 6-12 weeks.
• Sexually transmitted disease – 100mg twice a day for 7-10 days
• Syphilis – 300mg a day in divided doses for 10 days.
• Fevers caused by lice or ticks – a single dose of 100-200mg depending upon severity of infection.
• Malaria – 200mg a day for at least 7 days, should be given with other drugs such as quinine.
• Prevent infection with scrub typhus – 200mg as a single dose.
• Prevent traveller’s diarrhoea – 200mg on the first day of travel followed by 100mg a day throughout the duration of the stay. Do not use for more than 3 weeks unless advised by your doctor.
• Prevent leptospirosis infections – 200mg once a week throughout the stay in the infected area and 200mg at the end of the trip. Do not use for more than 3 weeks unless advised by your doctor.

If you take more Doxycycline Taj Pharma than you should

If you (or someone else) swallow a lot of capsules at the same time, or you think a child may have

swallowed any contact your nearest hospital casualty department or tell your doctor immediately.

If you forget to take Doxycycline Taj Pharma

Do not take a double dose to make up for a forgotten dose. If you forget to take a dose take it as soon as you remember it and then take the next dose at the right time.

If you stop taking Doxycycline Taj Pharma

Do not stop taking Doxycycline Taj Pharma because you feel better, it is very important to take all the capsules your doctor has prescribed for you, if you do not your condition may recur or get worse.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. POSSIBLE SIDE EFFECTS

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Stop taking the capsules immediately and seek urgent medical advice if:

• you notice that your skin is very sensitive to light ( you may get a skin rash, itching, redness or severe sunburn when out in sunlight or after using a sun bed).

Contact your doctor at once if the following reaction happens:

• wheeziness, difficulty in breathing, fever, sudden swelling of the face, lips, throat, tongue, hands or feet, fast heart rate, low blood pressure, rash or itching (especially affecting the whole body), pericarditis (inflammation of the membrane surrounding the heart).
• Swollen tongue, watery diarrhoea, fever and cramps (pseudomembranous colitis), soreness and itching around the back passage and/or of the rectal and/or genital area, inflammation around the vagina, or thrush of the vagina or mouth.
• worsening of systemic lupus erythematosus (SLE)
• altered numbers of certain types of blood cells, you may notice that you bruise easily, have nose bleeds, or suffer from infections and sore throats, porphyria (sensitivity of the skin to sunlight, inflammation of nerves and stomach pains)
• tinnitus (ringing or buzzing in the ears)
• inflammation of the liver (hepatitis), jaundice (yellowing of the skin or white of the eyes), liver failure and inflammation of the pancreas (pancreatitis)
• severe skin reactions such as erythema multiforme (circular, irregular red patches), StevensJohnson syndrome (rash with flushing, fever, blisters or ulcers), toxic epidermal necrolysis (reddening, peeling and swelling that resembles burns).
• The Jarisch-Herxheimer reaction which causes fever, chills, headache, muscle pain, and skin rash that is usually self-limiting. This occurs shortly after starting Doxycycline Taj Pharma treatment for infections with spirochete such as Lyme disease.

Tell your doctor if you notice any of the following side effects or notice any other effects not listed:

• Glands and hormones: discolouration of thyroid tissue (does not affect thyroid function).
• Central nervous system: headache, increased pressure in the skull (severe headaches, blurred and/or double vision, blind spots), permanent loss of vision, bulging fontanelles (soft spot on head) of infants.
• Gastrointestinal tract: stomach pain, loss of appetite, feeling or being sick, heartburn, diarrhoea, difficulty in swallowing, sore or painful tongue or mouth, inflammation and/or ulcers of the gullet, discolouration and underdevelopment of teeth.
• Liver: changes in liver function tests
• Skin: detachment of the nail from the nail bed.
• Muscles and bones: muscle or joint pain.
• Kidneys: an increase in urea in the blood.
• Psychiatric Disorders: Anxiety

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet.

By reporting side effects you can help provide more information on the safety of this medicine.

5. HOW TO STORE DOXYCYCLINE

Keep out of the sight and reach of children.

This medicinal product does not require any special storage conditions.

Do not use Doxycycline Taj Pharma after the expiry date which is stated on the blister and carton. The expiry date refers to the last day of that month.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

6. CONTENTS OF THE PACK AND OTHER INFORMATION

What Doxycycline Taj Pharma contains

• The active substance (the ingredient that makes the capsule work) is Doxycycline Taj Pharma hyclate.

Each Doxycycline Taj Pharma 50mg and 75mg Capsule contains 50mg of the active substance Doxycycline Taj Pharma.

• The other ingredients are microcrystalline cellulose, talc, magnesium stearate, colloidal anhydrous silica and sodium lauryl sulphate. The capsule shell is made of gelatin. The colouring agents used in the capsule shell are titanium dioxide, quinoline yellow and sunset yellow.
• The active substance (the ingredient that makes the capsule work) is Doxycycline Taj Pharma hyclate.

Each Doxycycline Taj Pharma 100 mg Capsule contains 100mg of the active substance Doxycycline Taj Pharma.

• The other ingredients are microcrystalline cellulose, talc, magnesium stearate, colloidal anhydrous silica and sodium lauryl sulphate. The capsule shell is made of gelatin. The colouring agents used in the capsule shell are titanium dioxide, erythrosine and indigo carmine.

What Doxycycline Taj Pharma looks like and the contents of the pack

Doxycycline Taj Pharma 50mg, 75mg and 100 mg Capsules are white and yellow.

Pack size:
Each pack contains:8, 10, 14 and 50 capsule.

Each box contains: 50, 100, 250, 350, 400, 500 and 1000 capsules.

Not all pack sizes may be marketed.

Manufactured in India by:
TAJ PHARMACEUTICALS LTD.
Mumbai, India
Unit No. 214.Old Bake House,
Maharashtra chambers of Commerce Lane,
Fort, Mumbai – 400001
at:Gujarat, INDIA.
Customer Service and Product Inquiries:
1-800-TRY-FIRST (1-800-222-434 & 1-800-222-825)
Monday through Saturday 9:00 a.m. to 7:00 p.m. EST
E-mail: tajgroup@tajpharma.com