Tetracycline - Cautions, Contraindications, Side Effects

Cautions, Contraindications, Side Effects

See also: List of dental abnormalities associated with cutaneous conditions

Use of the tetracycline antibiotics group is problematic; they can:

• Stain developing teeth (even when taken by the mother during pregnancy)
• Discolor permanent teeth (yellow-gray-brown), from infancy and childhood to eight years old
• Be inactivated by Ca2+ ion, so are not to be taken with milk, yogurt, and other dairy products
• Be inactivated by aluminium, iron and zinc, not to be taken at the same time as indigestion remedies (common antacids and over-the-counter heartburn medicines)
• Cause skin photosensitivity. so exposure to the sun or intense light is not recommended
• Cause drug-induced lupus, and hepatitis
• Cause microvesicular fatty liver
• Cause tinnitus
• Suppress sperm production.
• Interfere with methotrexate by displacing it from the various protein binding sites
• Cause breathing complications, as well as anaphylactic shock, in some individuals
• Affect bone growth of the fetus, so should be avoided during pregnancy

Caution should be exercised in long-term use with breastfeeding. Short-term use is safe; bioavailability in milk is low to nil. In 2010, the FDA added tetracycline to its Adverse Event Reporting System (AERS). The AERS contains a list of medications under investigation by the FDA for potential safety issues. The list is published quarterly and available online. The AERS cites a potential link between the use of tetracycline products and Stevens–Johnson syndrome, toxic epidermal necrolysis and erythema multiforme.