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Ввиду этого, а также повышенного риска поражения печени у матери, тетрациклины не используются при беременности за исключением случаев, когда препарат является единственным средством для лечения или профилактики особо опасных и тяжелых инфекций (пятнистая лихорадка скалистых гор, ингаляционное воздействие Bacillus anthracis и других). До назначения доксициклина женщинам детородного возраста, следует предварительно исключить наличие беременности. Доксициклин проникает в грудное молоко. Ввиду неблагоприятного действия на плод, доксициклин, как и другие тетрациклины, не используются во время грудного вскармливания. В случае, если назначение тетрациклинов необходимо, грудное вскармливание следует прекратить."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Таблетки диспергируют (растворяют) в небольшом количестве воды (около 20 мл) с получением суспензии. Таблетки можно также проглотить целиком, разделить на части или разжевать, запивая водой. Препарат предпочтительно принимать во время еды. Принимают таблетки сидя или стоя, что уменьшает вероятность развития эзофагита и язвы пищевода. Препарат не следует принимать непосредственно перед сном. Обычно продолжительность лечения составляет 5-10 дней. Взрослым и детям старше 8 лет с массой тела более 50 кг в первый день лечения назначают 200 мг/сут в 1 или 2 приема, в последующие дни лечения - по 100 мг/сут в 1 прием. В случае тяжелых инфекций назначают по 200 мг/сут в течение всего периода лечения. Для детей в возрасте 8-12 лет с массой тела менее 50 кг средняя суточная доза - 4 мг/кг в первый день, далее - по 2 мг/кг/сут (в 1-2 приема). В случаях тяжелых инфекций препарат назначают в дозе 4 мг/кг ежедневно в течение всего лечения. При инфекции, вызванной Streptococcus pyogenes, продолжительность лечения составляет не менее 10 дней. При неосложненной гонорее (за исключением аноректальных инфекций у мужчин) взрослым назначают по 100 мг 2 раза/сут до полного излечения (в среднем в течение 7 дней), либо в течение одного дня назначают 600 мг - по 300 мг в 2 приема (второй прием через 1 ч после первого). При первичном сифилисе назначают по 100 мг 2 раза/сут в течение 14 дней, при вторичном сифилисе - по 100 мг 2 раза/сут в течение 28 дней. При неосложненных урогенитальных инфекциях, вызванных Chlamydia trachomatis, цервиците, негонококковом уретрите, вызванных Ureaplasma urealiticum, назначают по 100 мг 2 раза/сут в течение 7 дней. При угревой сыпи назначают по 100 мг/сут, курс лечения 6-12 недель. Для профилактики малярии назначают по 100 мг 1 раз/сут за 1-2 дня до поездки, затем - ежедневно во время поездки и в течение 4 недель после возвращения; детям старше 8 лет - по 2 мг/кг 1 раз/сут. Длительность профилактики не должна превышать 4 мес. Для профилактики диареи путешественников - 200 мг в первый день поездки в 1 или 2 приема, далее - по 100 мг 1 раз/сут в течение всего пребывания в регионе (не более 3 недель). Для лечения лептоспироза - по 100 мг внутрь 2 раза/сут в течение 7 дней; для профилактики лептоспироза - по 200 мг 1 раз/неделю в течение пребывания в неблагополучном районе и по 200 мг - в конце поездки. С целью профилактики инфекций при медицинском аборте назначают 100 мг за 1 ч до и 200 мг после вмешательства. Максимальные суточные дозы для взрослых - до 300 мг/сут или до 600 мг/сут в течение 5 дней при тяжелых гонококковых инфекциях. Для детей старше 8 лет с массой тела более 50 кг - до 200 мг, для детей 8-12 лет с массой тела менее 50 кг - 4 мг/кг ежедневно в течение всего лечения. При почечной (КК менее 60 мл/мин) и/или печеночной недостаточности требуется снижение суточной дозы доксициклина, поскольку при этом происходит постепенное накопление его в организме (риск гепатотоксического действия)."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Со стороны пищеварительной системы: анорексия, тошнота, рвота, дисфагия, диарея, энтероколит, псевдомембранозный колит, эзофагит, язва пищевода, темное окрашивание языка, поражение печени (во время длительного приема или у пациентов с почечной или печеночной недостаточностью), холестаз. Дерматологические реакции: фотосенсибилизация, макуло-папулезная и эритематозная сыпь, эксфолиативный дерматит. Аллергические реакции: крапивница, ангионевротический отек, анафилактические реакции, обострение системной красной волчанки, перикардит, синдром, сходный с сывороточной болезнью, многоформная эритема. Со стороны системы кроветворения: гемолитическая анемия, тромбоцитопения, нейтропения, эозинофилия, снижение активности протромбина. Со стороны эндокринной системы: у пациентов, длительно получавших доксициклин, возможно обратимое темно-коричневое прокрашивание ткани щитовидной железы. Со стороны ЦНС: доброкачественное повышение внутричерепного давления (анорексия, рвота, головная боль, отек зрительного нерва), вестибулярные нарушения (головокружение или неустойчивость), нечеткость зрения, двоение в глазах. Со стороны мочевыделительной системы: увеличение остаточного азота мочевины (за счет антианаболического эффекта). Со стороны костно-мышечной системы: доксициклин замедляет остеогенез, нарушает нормальное развитие зубов у детей (необратимо изменяет цвет зубов, развивается гипоплазия эмали). Прочие: кандидоз (глоссит, стоматит, проктит, вагинит) как проявления суперинфекции."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Симптомы: усиление побочных реакций, вызванных повреждением печени - рвота, лихорадочное состояние, желтуха, азотемия, повышение уровня трансаминаз, увеличение протромбинового времени. Лечение: сразу после приема больших доз рекомендуют промывание желудка, обильное питье, при необходимости - индуцирование рвоты. Принимают активированный уголь и осмотические слабительные. Гемодиализ и перитонеальный диализ не рекомендуется ввиду низкой эффективности."}}]},{"id":9,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Существует возможность перекрестной устойчивости и гиперчувствительности с другими препаратами тетрациклинового ряда. Тетрациклины могут увеличивать протромбиновое время, назначение тетрациклинов у пациентов с коагулопатиями должно тщательно контролироваться. Антианаболический эффект тетрациклинов может привести к повышению уровня остаточного азота мочевины в крови. Как правило, это не имеет существенного значения для пациентов с нормальной функцией почек. Однако у пациентов с почечной недостаточностью может наблюдаться нарастание азотемии. Применение тетрациклинов у пациентов с нарушением функции почек требует врачебного контроля. При длительном применении препарата требуется периодический контроль лабораторных показателей крови, функции печени и почек. В связи с возможным развитием фотодерматита необходимо ограничение инсоляции во время лечения и в течение 4-5 дней после него. При применении препарата, как на фоне приема, так и через 2-3 недели после прекращения лечения возможно развитие диареи вызванной Clostridium dificile. В легких случаях достаточно отмены лечения и применения ионообменных смол (колестирамин, колестипол), в тяжелых случаях показано возмещение потери жидкости, электролитов и белка, назначение ванкомицина или метронидазола. Нельзя применять лекарственные средства, тормозящие перистальтику кишечника. Длительное применение препарата может вызвать дисбактериоз и, вследствие этого, развитие гиповитаминоза (особенно витаминов группы В). Для предотвращения диспептических явлений рекомендуется принимать препарат во время еды. Во избежание развития эзофагита или язвы пищевода необходимо принимать препарат с большим количеством воды и избегать применения препарата непосредственно перед сном. Влияние на способность к вождению автотранспорта и управлению механизмами О влиянии на способность управлять транспортными средствами, машинами и механизмами неизвестно. В случае развития головокружения, нечеткости зрения или двоения в глазах, управление автотранспортом или механизмами не рекомендуется."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Антибиотик - длительно действующий тетрациклин широкого спектра действия. Действует бактериостатически, подавляет синтез белка в микробной клетке путем взаимодействия с 30S субъединицей рибосом. Активен в отношении грамположительных и грамотрицательных аэробных и анаэробных бактерий: Streptococcus spp., Staphylococcus spp., Klebsiella spp., Enterobacter spp. (включая Enterobacter aerugenes), Neisseria gonorrhoeae, Neisseria meningitidis, Haemophilus influenzae, Chlamydia spp., Mycoplasma spp., Ureaplasma urealyticum, Listeria monocytogenes, Rickettsia spp., Escherichia coli, Shigella spp., Campylobacter fetus, Vibrio cholerae, Yersinia spp. (включая Yersinia pestis), Brucella spp., Francisella tularensis, Bacillus anthracis, Bartonella bacilliformis, Pasteurella multocida, Borrelia recurrentis, Clostridium spp. (кроме Clostridium difficile), Actinomyces spp., Fusobacterium fusiforme, Calymmatobacterium granulomatosis, Propionibacterium acnes, Treponema spp., Typhus exanthematicus; некоторых простейших: Entamoeba spp., Plasmodium falciparum. Как правило, не активен в отношении Acinetobacter spp., Proteus spp., Pseudomonas spp., Serratia spp., Providencia spp., Enterococcus spp. Следует принимать во внимание возможность приобретенной устойчивости к доксициклину у ряда возбудителей, которая часто является перекрестной внутри группы (т.е. штаммы, устойчивые к доксициклину, одновременно будут устойчивыми ко всей группе тетрациклинов).","substance":[{"id":776,"title":"Доксициклин","title_latin":"Doxycyclinum","slug":"doksitsiklin_776"}],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":false,"comments":{"count":25,"url":"/review/4678-unidox_solutab/"},"image_alt":"Юнидокс Солютаб - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/15081/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/15081/share_default/"}},"diseases":[{"id":"3","title":"Холера","slug":"3-holera"},{"id":"4","title":"Тиф и паратиф","slug":"4-tif_i_paratif"},{"id":"6","title":"Шигеллез","slug":"6-shigellez"},{"id":"10","title":"Энтерит, вызванный Yersinia enterocolitica","slug":"10-enterit_vyzvannyy_yersinia_enterocolitica"},{"id":"15","title":"Амебиаз","slug":"15-amebiaz"},{"id":"20","title":"Диарея и гастроэнтерит предположительно инфекционного происхождения","slug":"20-diareya_i_gastroenterit_predpolozhitelno_infektsionnogo_proishozhdeniya"},{"id":"27","title":"Чума","slug":"27-chuma"},{"id":"28","title":"Туляремия","slug":"28-tulyaremiya"},{"id":"29","title":"Сибирская язва","slug":"29-sibirskaya_yazva"},{"id":"30","title":"Бруцеллез","slug":"30-brutsellez"},{"id":"31","title":"Лептоспироз","slug":"31-leptospiroz"},{"id":"39","title":"Коклюш","slug":"39-koklyush"},{"id":"42","title":"Стрептококковая септицемия","slug":"42-streptokokkovaya_septitsemiya"},{"id":"43","title":"Другая септицемия","slug":"43-drugaya_septitsemiya"},{"id":"44","title":"Актиномикоз","slug":"44-aktinomikoz"},{"id":"46","title":"Бартонеллез","slug":"46-bartonellez"},{"id":"50","title":"Болезнь легионеров","slug":"50-bolezn_legionerov"},{"id":"53","title":"Ранний сифилис","slug":"53-ranniy_sifilis"},{"id":"54","title":"Поздний сифилис","slug":"54-pozdniy_sifilis"},{"id":"55","title":"Гонококковая инфекция","slug":"55-gonokokkovaya_infektsiya"},{"id":"57","title":"Хламидийная лимфогранулема (венерическая)","slug":"57-hlamidiynaya_limfogranulema_venericheskaya"},{"id":"59","title":"Хламидийные инфекции нижних отделов мочеполового тракта","slug":"59-hlamidiynye_infektsii_nizhnih_otdelov_mochepolovogo_trakta"},{"id":"61","title":"Хламидийный фарингит","slug":"61-hlamidiynyy_faringit"},{"id":"68","title":"Фрамбезия","slug":"68-frambeziya"},{"id":"72","title":"Болезнь Лайма","slug":"72-bolezn_layma"},{"id":"74","title":"Инфекция, вызываемая Chlamydia psittaci (пситтакоз)","slug":"74-infektsiya_vyzyvaemaya_chlamydia_psittaci_psittakoz"},{"id":"75","title":"Трахома","slug":"75-trahoma"},{"id":"79","title":"Сыпной тиф","slug":"79-sypnoy_tif"},{"id":"80","title":"Пятнистая лихорадка [клещевые риккетсиозы]","slug":"80-pyatnistaya_lihoradka_kleschevye_rikketsiozy"},{"id":"81","title":"Лихорадка Ку","slug":"81-lihoradka_ku"},{"id":"162","title":"Малярия, вызванная Plasmodium falciparum","slug":"162-malyariya_vyzvannaya_plasmodium_falciparum"},{"id":"692","title":"Наружный отит","slug":"692-naruzhnyy_otit"},{"id":"696","title":"Гнойный и неуточненный средний отит","slug":"696-gnoynyy_i_neutochnennyy_sredniy_otit"},{"id":"698","title":"Мастоидит и родственные состояния","slug":"698-mastoidit_i_rodstvennye_sostoyaniya"},{"id":"735","title":"Острый и подострый эндокардит","slug":"735-ostryy_i_podostryy_endokardit"},{"id":"790","title":"Острый синусит","slug":"790-ostryy_sinusit"},{"id":"791","title":"Острый фарингит","slug":"791-ostryy_faringit"},{"id":"792","title":"Острый тонзиллит","slug":"792-ostryy_tonzillit"},{"id":"793","title":"Острый ларингит и трахеит","slug":"793-ostryy_laringit_i_traheit"},{"id":"795","title":"Острые инфекции верхних отделов дыхательных путей множественной и неуточненной локализации","slug":"795-ostrye_infektsii_verhnih_otdelov_dyhatelnyh_putey_mnozhestvennoy_i_neutochnennoy_lokalizatsii"},{"id":"802","title":"Бактериальная пневмония, не классифицированная в других рубриках","slug":"802-bakterialnaya_pnevmoniya_ne_klassifitsirovannaya_v_drugih_rubrikah"},{"id":"815","title":"Хронический ринит, назофарингит и фарингит","slug":"815-hronicheskiy_rinit_nazofaringit_i_faringit"},{"id":"816","title":"Хронический синусит","slug":"816-hronicheskiy_sinusit"},{"id":"821","title":"Хронический ларингит и ларинготрахеит","slug":"821-hronicheskiy_laringit_i_laringotraheit"},{"id":"823","title":"Хронический бронхит неуточненный","slug":"823-hronicheskiy_bronhit_neutochnennyy"},{"id":"825","title":"Другая хроническая обструктивная легочная болезнь","slug":"825-drugaya_hronicheskaya_obstruktivnaya_legochnaya_bolezn"},{"id":"839","title":"Абсцесс легкого и средостения","slug":"839-abstsess_legkogo_i_sredosteniya"},{"id":"840","title":"Пиоторакс (эмпиема плевры)","slug":"840-piotoraks_empiema_plevry"},{"id":"886","title":"Другие уточненные болезни заднего прохода и прямой кишки (в т.ч. проктит)","slug":"886-drugie_utochnennye_bolezni_zadnego_prohoda_i_pryamoy_kishki_v_tch_proktit"},{"id":"890","title":"Острый перитонит (в т.ч. абсцесс)","slug":"890-ostryy_peritonit_v_tch_abstsess"},{"id":"902","title":"Холецистит","slug":"902-holetsistit"},{"id":"903","title":"Острый холецистит","slug":"903-ostryy_holetsistit"},{"id":"904","title":"Хронический 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