[e-drug] Doxycycline induced oesophagitis (3)

["AbdurRafiu A. Idris" <idrisra@yahoo.com>]

E-DRUG: Doxycycline Induced Oesophagitis (3)
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dear E-druggers,

I have encountered one patient (in 1998) who had this problem after taking the medicine (for another indication, not malaria or acne) on an empty stomach as would be expected with most tetracyclines. This prompted my  internist medical director to advise that the medicine be taken after meals thereafter and the patient did not have the condition again after following this latest advise. My internist's argument then was that the benefit of preventing oesophagitis outweighs the risk of reduced bioavailability when taken after meals. What we did not know then is the effect that lying down immediately after administration of the medicine has on the patient. 

Since it is now known that it's bioavailability is not significantly reduced by the presence of food in the stomach (Martindale, 34th Edition) i suppose the Pharmacist may include the advice that it may be taken after meals in the directions to the patient in addition to taking plenty fluids and not lying down immediately after administration in order to prevent this condition.

It will definitely be interesting to know the result of this study, not just in patients with malaria but in all patients who have taken the medicine for other indications.

regards

Idris, R. A
ART Logistics Pharmacist,
Ministry of Health and Social Services,
Namibia
Email: idrisra@yahoo.com