Abnormal functioning of the liver
Doxt S should be taken cautiously in patients with abnormal functioning of the liver.
Monitoring of laboratory tests while long-term therapy with Doxt S
In patients for whom long-term therapy is prescribed, laboratory examination of organ systems, including blood, kidney, and liver should be performed at regular time intervals.
Ulceration and irritation in food pipe (oesophageal irritation and ulceration)
Such patients are at an increased risk to develop
ulcers and irritation in food pipe when using this medicine. These patients should take adequate fluids so as to avoid the risk of developing ulcers and irritation of food pipe.
Patients with history of fungal infection in the mouth (oral candidosis)
Such patients are at an increased risk of having a fungal infection in the vagina when using this medicine. Take necessary precautions while using this medicine in patients with the history of fungal infection in the mouth.
Syphilis testing
If
syphilis along with existing bacterial disease is suspected during the treatment with this medicine, then follow dark-field examinations (laboratory test) before starting the treatment. Another method of laboratory testing (blood serology) should be done repeatedly for at least four months.
Growth and development
Patients who are on treatment with tetracyclines such as Doxt S have increased chances for the formation of
calcium complex with tetracyclines, and therefore the complex does not allow for the growth of bones in the unborn child (premature). These changes are reversible on discontinuation of the drug. In case any tetracycline such as Doxt S is used during
pregnancy or if any patient becomes pregnant while taking such medicine, the patient should be informed about potential harmful effects to the fetus.
Prevention of cell division process (antianabolic action)
The antianabolic action of the tetracyclines may cause an increase in the amount of urea nitrogen in the blood (blood urea nitrogen, BUN). Studies have indicated that this change is not found to occur with the use of Doxt S in patients with the damaged functioning of kidneys.
Surgical procedures (incision and drainage)
The surgical procedures such as incision and drainage should only be performed when indicated.
Malaria
The use of Doxt S does not entirely prevent the suppression of asexual blood stages of malaria-causing organisms (Plasmodium parasites).
Drug resistance
The use of Doxt S in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication does not provide any benefit to the patients and increases the risk of the development of drug-resistant bacteria.
Antibiotics should only be prescribed when the bacterial infection has been proven to be present.
Discoloration of teeth
Children up to the age of 8 years are at an increased risk when using this medicine. Such patients have an increased risk of developing permanent discoloration of teeth (yellow-grey-brown) and tooth defect (enamel hypoplasia). These
side-effects occur more commonly during long-term use of the medicine. The use of this drug should not be prescribed for children up to 8 years except for a rare and severe bacterial illness (
anthrax) until and unless any other effective treatment is not available.
Inflammation of the colon due to the bacteria (pseudomembranous colitis)
Patients who are on treatment with antibacterial agents including Doxt S are at an increased risk when using this medicine. Such patients may have an increased risk of developing mild
diarrhea to fatal
colitis due to the disturbed
balance of useful bacteria in the intestine which results in overgrowth of bacteria responsible for diarrhea. In case any symptom appears, ongoing treatment with an
antibiotic should be discontinued. Supplementation with protein, appropriate fluid and electrolyte management, antibiotic treatment of bacteria responsible for diarrhea (Clostridium difficile), and surgical evaluation if it is clinically indicated should be undertaken.
Increased sensitivity to sun (photosensitivity)
Patients who are on treatment with antibacterial agents including Doxt S are at an increased risk to develop an enhanced
sunburn reaction. Such patients should discontinue the use of the drug in case if they experience an allergic skin reaction (erythema).
Second infection which is superimposed on an earlier infection (superinfection)
Patients who are on treatment with antibacterials including Doxt S are at an increased risk of developing superinfection by other organisms such as
fungi. Such patients should discontinue the use of Doxt S if superinfection occurs and should start an appropriate therapy.
Brain disorder due to increased pressure inside the skull (benign intracranial high blood pressure)
Patients using tetracyclines such as Doxt S may develop a condition affecting the brain (bulging fontanels) in infants and benign intracranial high blood pressure in adults. The patients should discontinue the use of the drug after the appearance of these symptoms.