Posology : מינונים

4.2. Posology and Method of Administration
Posology
Adults
The usual dose of Doxylin for the treatment of acute infections in adults is 200 mg on the first day (administered as a single dose or divided into two equal doses with a 12 hour interval), followed by a maintenance dose of 100 mg/day. In the management of more severe infections (particularly chronic infections of the urinary tract) 200 mg daily should be given throughout the treatment period.
Method of administration
Doxylin should be taken with adequate amounts of fluid (at least 100 ml of water). This should be done in the sitting or standing position and the patient should be advised to remain upright for at least thirty minutes after taking a dose. Doxylin should be taken well before bedtime to reduce the risk of oesophageal irritation and ulceration. If gastric irritation occurs, it is recommended that Doxylin be given with food or milk. Studies indicate that the absorption of Doxycycline is not notably influenced by simultaneous ingestion of food or milk.
The tablet must not be divided, chewed or crushed, to prevent irritation to the throat and esophagus.
Exceeding the recommended dosage may result in an increased incidence of side effects. Therapy should be continued at least 24 to 48 hours after symptoms and fever have subsided.
When used in streptococcal infections, therapy should be continued for 10 days to prevent the development of rheumatic fever or glomerulonephritis.

Dosage recommendations in specific infections:
Sexually transmitted diseases 100 mg twice daily for 7 days is recommended in the following infections: uncomplicated urethral, endocervical or rectal infection caused by Chlamydia trachomatis, non-gonococcal urethritis caused by Ureaplasma urealyticum.
Uncomplicated gonococcal infections (except anorectal infections in men) Doxycycline 100 mg twice daily for 7 days together with intramuscular ceftriaxone.
Acute epididymo-orchitis caused by Chlamydia trachomatis or Neisseria gonorrhoea Doxycycline 100 mg twice daily for 10 days together with intramuscular ceftriaxone.
Primary and secondary syphilis Non-pregnant penicillin-allergic patients who have primary or secondary syphilis can be treated with the following regimen: doxycycline 100 mg orally twice daily for two weeks, as an alternative to penicillin therapy.
Louse and tick-borne relapsing fevers and louse borne typhus A single dose of 100 to 200 mg according to severity.
Early Lyme Disease (stage 1 and 2) 100 mg twice daily for 10-30 days according to clinical signs, symptoms and response.
Chloroquine-resistant falciparum malaria 200 mg daily for at least 7 days. Due to the potential severity of the infection, a rapid-acting schizonticide such as quinine should always be given in conjunction with Doxylin; quinine dosage recommendations vary in different areas.
Anthrax due to Bacillus anthracis, including inhalational anthrax (post exposure): 100 mg twice a day for 60 days.
Prophylaxis of Malaria 100 mg daily in adults. Prophylaxis can begin one or two days before travel to malarious areas. It should be continued daily during travel in the malarious areas and for 4 weeks after the traveler leaves the malarious area.
For the treatment and selective prophylaxis of cholera in adults 300 mg as a single dose.
For the prevention of scrub typhus 200 mg as a single dose, once weekly.



For the prevention of travelers' diarrhoea in adults 200 mg on the first day of travel (administered as a single dose or as 100 mg every 12 hours) followed by 100 mg daily throughout the stay in the area. Data on the use of the drug prophylactically are not available beyond 21 days.
For the treatment of leptospirosis 100 mg twice daily for 7 days.
For the prevention of leptospirosis 200 mg once each week throughout the stay in the area and 200 mg at the completion of the trip. Data on the use of the drug prophylactically are not available beyond 21 days.
Paediatric population See section 4.3.
Use in the elderly Doxylin may be prescribed in the usual dose with no special precautions. No dosage adjustment is necessary in the presence of renal impairment.
Use in patients with impaired hepatic function Doxylin should be administered with caution to patients with hepatic impairment or those receiving potentially hepatotoxic drugs.
Use in patients with renal impairment Studies to date have indicated that administration of Doxycycline at the usual recommended doses does not lead to accumulation of the antibiotic in patients with renal impairment.