Lymecycline 300mg Capsules

What is Lymecycline (Tetralysal)?

Lymecycline, marketed under the brand name Tetralysal, is a tetracycline-class antibiotic derived from tetracycline. It belongs to the broader class of medications known as bacteriostatic antibiotics, which work by inhibiting bacterial protein synthesis.

Mechanism of Action

Lymecycline works by binding to the 30S ribosomal subunit of bacteria, preventing the attachment of aminoacyl-tRNA to the RNA-ribosome complex. This inhibition of protein synthesis stops bacterial growth and replication, allowing the body's immune system to eliminate the bacteria.

Biological Pathway Explanation

In acne treatment, Lymecycline specifically targets Propionibacterium acnes (now called Cutibacterium acnes), the bacteria that colonise hair follicles and contribute to inflammatory acne. By reducing the population of these bacteria, Lymecycline decreases the production of pro-inflammatory fatty acids and chemotactic factors that attract white blood cells to the follicle, thereby reducing inflammation, papules, and pustules associated with acne.

What is Lymecycline (Tetralysal) Used For?

Tetralysal is primarily prescribed for the treatment of moderate to severe inflammatory acne vulgaris when topical treatments have proven insufficient. According to the NHS acne treatment guidelines, it may also be used for other bacterial infections as determined by a healthcare professional.

Approved Indications

*Note: For acne treatment specifically, Tetralysal is prescribed at lower doses (300mg once daily) compared to other infections (600mg daily in divided doses).

Before Using Lymecycline (Tetralysal)

Before starting treatment with Lymecycline, it's important to discuss your medical history with your healthcare provider to ensure this medication is appropriate for you.

Medical History Assessment Checklist

Inform your doctor if you have or have had any of the following:

• Allergy to tetracycline antibiotics or any ingredients in Tetralysal
• Kidney disease or impaired renal function
• Liver disease or hepatic impairment
• Systemic lupus erythematosus (SLE)
• Myasthenia gravis
• History of intracranial hypertension (pseudotumor cerebri)
• History of yeast infections or fungal overgrowth
• History of inflammatory bowel disease or colitis

Required Baseline Tests

1. Renal function tests: Blood urea nitrogen (BUN) and creatinine levels may be checked if kidney impairment is suspected
2. Liver function tests: May be recommended for those with known hepatic issues or during prolonged treatment
3. Pregnancy test: Should be performed in women of childbearing potential before starting treatment

Lymecycline (Tetralysal) Contraindications

Absolute Contraindications (DO NOT USE)

• Hypersensitivity: Known allergy to lymecycline, other tetracyclines, or any excipients in Tetralysal
• Pregnancy: All trimesters - tetracyclines cross the placenta and can affect fetal development
• Breastfeeding: Tetracyclines are excreted in breast milk and may affect infant bone and tooth development
• Children under 8 years: Risk of permanent tooth discolouration and enamel hypoplasia
• Severe renal impairment: May lead to drug accumulation and increased toxicity
• Concurrent use with oral retinoids: Increased risk of intracranial hypertension
• Concurrent use with methoxyflurane: Risk of fatal renal toxicity

Relative Contraindications (Use with Caution)

Special Population Considerations

Elderly Patients

Elderly patients may have reduced renal function, increasing the risk of tetracycline accumulation. Renal function should be assessed before prescribing, and dosage adjustments may be necessary. Monitoring for gastrointestinal side effects is particularly important in this population.

Renal Impairment

In patients with renal impairment, tetracyclines may accumulate leading to increased toxicity. Lymecycline is contraindicated in severe renal impairment. For mild to moderate impairment, reduced dosage or extended dosing intervals may be required, with regular monitoring of renal function.

Hepatic Impairment

Tetracyclines can cause hepatotoxicity, particularly at high doses or in patients with pre-existing liver disease. Liver function should be monitored during treatment, and the drug should be used with caution in patients with hepatic impairment.

Pediatric/Adolescent Restrictions

Children under 8 years: Absolutely contraindicated due to risk of permanent tooth discolouration (yellow-grey-brown) and enamel hypoplasia.

Children 8-12 years: Use only if no alternative antibiotics are available and benefits outweigh risks. Shortest effective course should be used.

Adolescents 12-18 years: Can be used for acne treatment at standard adult doses. Dental effects are still possible if used during permanent tooth development.

Lymecycline (Tetralysal) and Other Medicines

Lymecycline can interact with several medications, which may affect its effectiveness or increase the risk of side effects.

High-Risk Medication Combinations

Pregnancy & Breastfeeding

Pregnancy

Lymecycline is CONTRAINDICATED during all trimesters of pregnancy. Tetracyclines cross the placenta and can have several adverse effects on the developing fetus:

• Discoloration of developing teeth (yellow-grey-brown)
• Enamel hypoplasia (defective tooth enamel formation)
• Retarded skeletal development
• Potential hepatotoxicity in the pregnant woman

If pregnancy occurs during treatment, Lymecycline should be discontinued immediately, and the patient should consult her healthcare provider.

Breastfeeding

Lymecycline is CONTRAINDICATED during breastfeeding. Tetracyclines are excreted in breast milk and can affect the nursing infant:

• Tooth discolouration in the developing teeth of the infant
• Possible effects on bone growth
• Risk of gastrointestinal disturbance in the infant

Driving & Machine Operation

Lymecycline is not known to directly affect the ability to drive or operate machinery. However, certain side effects may impair these abilities:

• Dizziness: Reported in some patients, which could affect driving safety
• Visual disturbances: Blurred vision or other visual changes may occur, particularly with intracranial hypertension
• Headache: Severe headaches could impair concentration

If you experience any of these symptoms while taking Lymecycline, avoid driving or operating machinery until symptoms resolve.

Lymecycline (Tetralysal) Ingredients

Active Ingredient

• Lymecycline: 408mg per capsule (equivalent to 300mg lymecycline base)

Excipients (Inactive Ingredients)

How to Use Lymecycline (Tetralysal)

Always take Lymecycline exactly as prescribed by your healthcare provider. Do not adjust the dose or stop taking it without medical advice.

Step-by-Step Administration

1. Wash your hands before handling the capsules
2. Remove one capsule from the blister pack by carefully tearing the aluminium strip
3. Take the capsule with a full glass of water (at least 200ml)
4. Swallow the capsule whole - do not chew, crush, or open it
5. Take at the same time each day to maintain consistent blood levels
6. Take while in an upright position and remain upright for at least 30 minutes after swallowing to prevent esophageal irritation

Lymecycline (Tetralysal) Dosage Guidelines

Standard Dosage for Acne

Dosage for Other Infections

Administration Instructions

Optimal Timing

For acne treatment, Tetralysal is typically taken once daily, preferably in the morning. This helps establish a routine and may reduce the risk of gastrointestinal side effects that can occur with bedtime dosing.

Food and Drink Considerations

• Water: Always take with a full glass of water (at least 200ml) to prevent esophageal irritation or ulceration
• Milk: Moderate amounts of milk do not significantly affect absorption, but large amounts of dairy should be avoided around dosing time
• Food: Can be taken with or without food, but taking with food may reduce gastrointestinal upset
• Avoid: Do not take with antacids, calcium supplements, iron supplements, or mineral-rich foods close to dosing time

Position During Administration

Take the capsule while standing or sitting upright, and remain upright for at least 30 minutes after swallowing. This helps ensure the capsule passes through the esophagus completely and reduces the risk of irritation or ulceration.

Missed Dose Management

What to Do If You Miss a Dose

Important Rules for Missed Doses

1. Never double up: Do not take two doses to make up for a missed dose
2. Don't take extra: Taking more than prescribed increases the risk of side effects without improving efficacy
3. Resume normal schedule: After addressing a missed dose, return to your regular dosing schedule
4. Set reminders: If you frequently forget doses, consider setting daily alarms or using a pill organiser

Overdose Information

Symptoms of Overdose

Overdose with Lymecycline may cause:

• Nausea and vomiting
• Abdominal pain
• Diarrhoea
• Dizziness
• Liver toxicity (in severe cases)

What to Do in Case of Overdose

1. Seek immediate medical attention: Contact your doctor, go to the nearest hospital, or call emergency services
2. Bring the medication container: This helps medical staff identify what was taken and in what quantity
3. Do not induce vomiting: Unless instructed by medical professionals
4. Provide information: Tell medical staff how much was taken and when

Lymecycline (Tetralysal) Side Effects

Like all medicines, Lymecycline can cause side effects, although not everybody experiences them. Side effects are categorized by frequency based on clinical trial data and post-marketing surveillance.

Common (1 to 10 in 100 people)

• Nausea (feeling sick)
• Abdominal pain
• Diarrhoea
• Headache

Uncommon (1 to 10 in 1,000 people)

• Vomiting
• Dizziness
• Itchiness, skin rash or hives
• Increased sensitivity of the skin to sunlight

Serious Side Effects Requiring Immediate Medical Attention

How to Store Lymecycline (Tetralysal)

Storage Conditions

• Temperature: Store below 25°C. Do not refrigerate or freeze.
• Container: Keep in the original container to protect from light and moisture
• Location: Store in a cool, dry place away from direct sunlight
• Safety: Keep out of sight and reach of children

Expiry Date

Do not use Tetralysal after the expiry date printed on the carton and blister pack. The expiry date refers to the last day of that month. Expired medicine may not work effectively and could cause harm.

Lymecycline (Tetralysal) Pack Information

What Tetralysal Looks Like

Tetralysal capsules are two-tone red and yellow hard gelatin capsules. The capsules are imprinted with the manufacturer's logo and strength information.

Available Pack Sizes

Marketing Authorisation Holder and Manufacturer

• Marketing Authorisation Holder: Galderma (UK) Limited, Evergreen House North, Grafton Place, London, NW1 2DX, United Kingdom (PL 10590/0019)
• Manufacturer: Laboratoires Sophartex, B.P. 129, 28501 Vernouillet, France or Laboratoires Galderma, ZI-Montdésir, 74540 Alby-sur-Chéran, France

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