TETRACYCLINES (Topical)

Some commonly used brand names are:

In the U.S.?

• Aureomycin ¹
• Achromycin ³
• Meclan ²
• Topicycline ³

In Canada?

• Achromycin ³
• Aureomycin ¹

Category

• Antiacne agent, topical?Meclocycline; Tetracycline
• Antibacterial, topical?Chlortetracycline; Tetracycline

Description

Tetracyclines belong to the family of medicinescalled antibiotics. The topical ointment forms are used to treat infectionsof the skin. Meclocycline cream and the topical liquid form of tetracyclineare used to help control acne. They may be used alone or with one or moreother medicines that are applied to the skin or taken by mouth for acne.

Topical ointment forms of the tetracyclines are available without a prescription;however, your doctor may have special instructions on the proper use of thesemedicines for your medical problem. Meclocycline cream and the topical liquidform of tetracycline are available only with your doctor's prescription.

Topical tetracycline is available in the following dosage forms:

Topical
• Chlortetracycline
  • Ointment (U.S. and Canada)
• Meclocycline
  • Cream (U.S.)
• Tetracycline
  • Ointment (U.S. and Canada)
  • Topical solution (U.S.)

Before Using This Medicine

In deciding to use a medicine,the risks of using the medicine must be weighed against the good it will do.This is a decision you and your doctor will make. For topical tetracyclines,the following should be considered:

Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to topical tetracyclines or to any related antibiotics,such as chlortetracycline for the eye (e.g., Aureomycin); demeclocycline (e.g.,Declomycin); doxycycline (e.g., Vibramycin); methacycline (e.g., Rondomycin);minocycline (e.g., Minocin); oxytetracycline (e.g., Terramycin); or tetracyclineby mouth or by injection (e.g., Achromycin). In addition, if you are to usethe cream form of meclocycline, tell your doctor if you have ever had anyunusual or allergic reaction to formaldehyde. Also tell your health care professionalif you are allergic to any other substances, such as preservatives or dyes.

Pregnancy?Studies have not been done in humans. In studiesin rats and rabbits, chlortetracycline and tetracycline topical preparationshave not been shown to cause birth defects or other problems. However, studiesin rabbits have shown meclocycline to cause a slight delay in bone formation.

Breast-feeding?It is not known whether tetracycline topical preparationspass into breast milk. Although most medicines pass into breast milk in smallamounts, many of them may be used safely while breast-feeding. Mothers whoare using any of these medicines and who wish to breast-feed should discussthis with their doctor.

Children?Tetracycline topical solution has been tested ona limited number of children 11 years of age or older and has not been shownto cause different side effects or problems in children than it does in adults.Although there is no specific information about the use of topical chlortetracyclineor topical meclocycline in children, they are not expected to cause differentside effects or problems in children than they do in adults.

Older adults?Many medicines have not been tested in older people.Therefore, it may not be known whether they work exactly the same way theydo in younger adults or if they cause different side effects or problems inolder people. There is no specific information about the use of topical tetracyclinesin the elderly.

Other medicines?Although certain medicines should not be usedtogether at all, in other cases two different medicines may be used togethereven if an interaction might occur. In these cases, your doctor may want tochange the dose, or other precautions may be necessary. When you are usingtopical tetracyclines, it is important that your health care professionalknows if you are using any other topical prescription or nonprescription (over-the-counter[OTC]) medicine that is to be applied to the same area of the skin.

Proper Use of This Medicine

For patientsusing the cream form or topical liquid form ofthis medicine for acne:

• The cream or topical liquid form of this medicine will not cure youracne. However, to help keep your acne under control, keep using this medicine for the full time of treatment, even if yoursymptoms begin to clear up after a few days. You may have to continue usingthis medicine every day for months or even longer in some cases. If you stopusing this medicine too soon, your symptoms may return. It is important that you do not miss any doses.

For patients using the cream form of this medicinefor acne:

• Do not get this medicine on your clothing since it may stain.
• Before applying this medicine, thoroughly wash the affected areawith warm water and soap, rinse well, and pat dry.
• To use:
  • Apply a thin film of medicine, using enough to cover the affectedarea lightly. You should apply the medicine to the whole area usually affected by acne, not just to the pimplesthemselves. This will help keep new pimples from breaking out.
  • Do not get this medicine in the eyes, nose, mouth, or on other mucousmembranes. Spread the medicine away from these areas when applying.

For patients using the topical liquid formof this medicine for acne:

• Do not get this medicine on your clothing since it may stain.
• This medicine usually comes with patient instructions. Read theseinstructions carefully before using this medicine.
• The liquid form contains alcohol and is flammable. Do not use near heat, near open flame, or while smoking.
• Do not use after the expiration date on the label. The medicine maynot work properly. Check with your pharmacist if you have any questions aboutthis.
• The presence of the floating plastic plug in the liquid means thatthe medicine has been mixed properly. Do not remove theplastic plug.
• It is important that you do not use this medicine more often thanyour doctor ordered. It may cause your skin to become too dry or irritated.
• Before applying this medicine, thoroughly wash the affected areawith warm water and soap, rinse well, and pat dry. After washing or shaving,it is best to wait 30 minutes before applying this medicine. The alcohol init may irritate freshly washed or shaved skin.
• You should avoid washing the acne-affected areas too often. Thismay dry your skin and make your acne worse. Washing with a mild, bland soap2 or 3 times a day should be enough, unless you have oily skin. If you haveany questions about this, check with your doctor.
• To use:
  • This medicine comes in a bottle with an applicator tip that may beused to apply the medicine directly to the skin. Use the applicator with adabbing motion instead of a rolling motion (not like a roll-on deodorant,for example). Tilt the bottle and press the tip firmly against your skin.If needed, you can make the medicine flow faster from the applicator tip byslightly increasing the pressure against the skin. If the medicine flows toofast, use less pressure.
  • Apply a generous amount of medicine, using enough so that the skinfeels wet all over. After applying the medicine with the applicator, use yourfingertips to spread the medicine around evenly and rub it into your skin.A second coat may be needed to completely cover the affected areas. Be sureto wash the medicine off your hands afterward.
  • You should apply the medicine to the whole areausually affected by acne, not just to the pimples themselves. Thiswill help keep new pimples from breaking out.
  • Since this medicine contains alcohol, it will sting or burn. Therefore, do not get this medicine in the eyes, nose, mouth, oron other mucous membranes. Spread the medicine away from these areaswhen applying. If this medicine does get in the eyes, wash them out immediately,but carefully, with large amounts of cool tap water. If your eyes still burnor are painful, check with your doctor.
• The bottle contains about an 8-week supply of medicine if used onlyon the face and neck or about a 4-week supply if used on the face and neckplus other affected areas.

For patients using the topical ointment formof this medicine:

• To help clear up your infection completely, keep using this medicine for the full time of treatment, even if yoursymptoms begin to clear up after a few days. If you stop using this medicinetoo soon, your symptoms may return. Do not miss any doses.
• Do not get this medicine on your clothing since it may stain.
• If you are using this medicine without a prescription, do not useit to treat deep wounds, puncture wounds, or serious burns without first checkingwith your health care professional.
• Do not get this medicine in the eyes.
• Before applying this medicine, thoroughly wash the affected areawith warm water and soap, rinse well, and dry completely.
• After applying this medicine, you may cover the treated area witha gauze dressing if you wish.

Dosing?The dose of these medicines will be differentfor different patients. Follow your doctor's orders orthe directions on the label. The following information includes onlythe average doses of these medicines. If your dose isdifferent, do not change it unless your doctor tells you to do so.

For chlortetracycline
• For ointment dosage form:
  • For skin infections:
    • Adults and children?Use one or two times a day.

For meclocycline
• For cream dosage form:
  • For acne:
    • Adults and children?Use two times a day, morning and evening.

For tetracycline
• For ointment dosage form:
  • For skin infections:
    • Adults and children?Use one or two times a day.
• For topical solution dosage form:
  • For acne:
    • Adults and children over 11 years of age?Use two times a day,morning and evening.
    • Infants and children up to 11 years of age?Use and dose mustbe determined by the doctor.

Missed dose?If you miss a dose of this medicine, apply it assoon as possible. However, if it is almost time for your next dose, skip themissed dose and go back to your regular dosing schedule.

Storage?To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Keep the medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be surethat any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

For patientsusing either the cream form or the topical liquid form of this medicine for acne:

• Some people may notice improvement in their acne within 4 to 6 weeks.However, if there is no improvement in your acne after you have used thismedicine for 6 to 8 weeks or if it becomes worse, check with your health careprofessional. The treatment of acne may take up to 8 to 12 weeks before fullimprovement is seen.
• If your doctor has ordered another medicine to be applied to theskin along with this medicine, it is best to wait at least 1 hour before youapply the second medicine. This may help keep your skin from becoming tooirritated. Also, if the medicines are used too close together, they may notwork properly.
• The liquid form of this medicine may also cause the skin to becomeunusually dry, even with normal use. If this occurs, check with your doctor.
• This medicine may cause faint yellowing of the skin, especially aroundhair roots. This may be more easily seen in people with light complexions.The color may be removed by washing. However, the medicine should be lefton the skin as long as possible. Do not wash immediately after applying themedicine. To do so will keep the medicine from working properly. If the yellowcolor is bothersome during the daytime, the medicine may be applied afterschool or work and again at bedtime, unless otherwise directed by your doctor.
• Treated areas of the skin may glow bright yellow under ``black''(ultraviolet or UV) light such as that used in some discos. To help reduceor avoid this, apply the medicine later in the evening or wash it off beforeexposure to ``black'' light.
• You may continue to use cosmetics (make-up) while you are using thismedicine for acne. However, it is best to use only ``water-base'' cosmetics.Also, it is best not to use cosmetics too heavily or too often. They may makeyour acne worse. If you have any questions about this, check with your doctor.

For patients using the topical ointment formof this medicine:

• If your skin infection does not improve within 2 weeks, or if itbecomes worse, check with your health care professional.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects.Although not all of these side effects may occur, if they do occur they mayneed medical attention.

Check with your doctor as soon as possible if any of the following sideeffects occur:

Less common

Pain, redness, swelling, or other sign of irritation not presentbefore use of this medicine

Other side effects may occur that usually donot need medical attention. These side effects may go away during treatmentas your body adjusts to the medicine. However, check with your doctor if anyof the following side effects continue or are bothersome:

More common?For topical liquid form only

Dry or scaly skin; stinging or burningfeeling

More common?For cream and topical liquid forms only

Faint yellowing of the skin, especially around hair roots

Other side effects not listed abovemay also occur in some patients. If you notice any other effects, check withyour doctor.