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Antibiotic Doxycycline☤ – a characteristic of the drug

Antibiotics of the tetracycline series, which include Doxycycline☤, have a wide spectrum of action.
This semisynthetic antibiotic has a bacteriostatic effect on microorganisms – it inhibits the ability of microbes to multiply in the body. The antibiotic penetrates into the cells of microorganisms and blocks the synthesis of proteins there.
Doxycycline☤ has an effect on a large number of microbes – pathogens of aerobic (requiring oxygen for development) and anaerobic (can develop without access to oxygen) infections.
Doxycycline☤ is sensitive to streptococci and staphylococcus, E. coli and Salmonella, dysenteric rod, Klebsiella and Clostridia, pathogens of especially dangerous infections (cholera, plague, anthrax and tularemia), sexually transmitted infections (syphilis, gonorrhea, chlamydia, ureaplasmosis), malarial plasmodium and other pathogens.
A wide range of effects of the drug is particularly important in cases where the causative agent of the disease was not established for one reason or another. And some diseases, for example, pneumonia, can be caused by various microorganisms. Doxycycline☤ has no effect on fungi and viruses. When ingested, the drug is almost completely absorbed into the stomach. Eating does not affect the absorption of the medicine.
After 2 hours after taking the antibiotic reaches the maximum concentration in the blood plasma and binds with plasma proteins (up to 95%). The therapeutic concentration in the blood plasma after a single dose is kept for 15-16 hours, with repeated – 18-24 hours. This allows you to take Doxycycline☤ once a day.
It is excreted unchanged in urine (40%) and with feces (40%). It accumulates in bone tissue and in dentin (the main tissue of the teeth).

To assert that Doxycycline☤ is the best drug for any disease, it is impossible, because the choice of antibiotic depends on the pathogen and its sensitivity, and on the severity of the course of the disease, and on the presence of concomitant pathology in the patient, and sometimes on the patient’s financial capabilities.
When taking Doxycycline☤, you should refrain from work that requires a fast motor or mental reaction and increased attention.

Indications for use
A wide spectrum of action of Doxycycline☤ allows using it for the treatment of a large number of infections, the causative agents of which are sensitive to this antibiotic:
➲respiratory diseases (acute and chronic bronchitis, pneumonia, lung abscess and pleural empyema, pleurisy);
➲urinary tract infection (urethritis, pyelonephritis);
➲infection of the ENT organs (otitis, sinusitis or inflammation of the paranasal sinuses, tonsillitis);
➲intestinal infections (dysentery, salmonellosis, typhoid fever, cholera and others);
➲diseases of the pelvic organs in men and women (endometritis, salpingoophoritis, epididymitis, prostatitis);
➲inflammatory diseases of the gastrointestinal tract (cholecystocholangitis, proctitis, peritonitis);
➲infections of soft tissues and skin (furunculosis, carbuncle, acne);
➲Sexually transmitted infections (syphilis primary and secondary, gonorrhea, ureaplasmosis, chlamydia);
➲many infectious diseases (brucellosis, typhus, rickettsiosis, fever Ku, yersiniosis, borreliosis, tularemia, whooping cough, leptospirosis and others);
➲eye diseases (trachoma, ulcerative keratitis);
➲osteomyelitis, etc.

With preventive purpose, Doxycycline☤ is prescribed:
⓵For the prevention of malaria with a short (up to 4 months) stay in the area where the resistance of the malarial plasmodium to pyrimethamine sulfadoxine and Chloroquine is noted;
⓶To prevent complications after surgery on the large intestine and after a medical abortion.

Contraindications for the appointment of Doxycycline☤ are:
➢hypersensitivity to Doxycycline☤ or other tetracyclines;
➢severe hepatic impairment;
➢systemic lupus erythematosus;
➢decreased number of leukocytes in the blood;
➢increased amount of porphyrins in the blood (a special pigment that is part of the hemoglobin);
➢lactose intolerance;
➢glucose-galactose malabsorption (a violation of absorption of galactose and glucose, inherited);
➢deficiency of lactase (congenital pathology);
➢pregnancy (may be prescribed only for vital signs);
➢children’s age till 8 years;
➢children age over 12 years with a body weight of less than 45 kg.

Side effects and precautions
Doxycycline☤ can cause such adverse reactions:
➠On the part of the digestive system – nausea, vomiting, abdominal pain, loss of appetite, stool disorders (constipation or diarrhea), swallowing, inflammation of the tongue, inflammation in the intestinal outlet, less often – inflammation or ulceration of the esophagus , stomach and duodenum, transient increase in blood levels of bilirubin, alkaline phosphatase and liver transaminases.
➠From the side of the nervous system – increased intracranial pressure, which manifests itself as headache, dizziness, vomiting, and visual impairment.
➠On the part of blood – a decrease in the number of neutrophilic forms of leukocytes, a decrease in the number of platelets, an increase in the number of eosinophils in the blood (indicating an allergic mood of the body); hemolytic anemia (anemia due to the destruction of erythrocytes or red blood cells).
➠Allergic reactions – itching, rashes on the skin; rarely – shortness of breath, Quincke’s edema or angioedema (suddenly developing limited or diffuse swelling of the mucous membranes and subcutaneous fat); anaphylactic shock (very severe form of allergy manifestation with a life threat), photosensitization (sensitivity of the mucous membranes and skin to ultraviolet rays), Lyell syndrome (severe manifestation of allergic dermatitis with tissue necrosis), pericarditis (inflammation of the outer cardiac membrane).

Development of superinfection caused by fungi (candidiasis, thrush), or insensitive to Doxycycline☤ bacteria.
Dysbacteriosis (violation of the ratio between microorganisms in the intestine).
Children up to 8 years of age may have discoloration and stunting of the skeleton.
In case of severe adverse reactions, Doxycycline☤ should be discontinued immediately.

Measures to prevent complications:
▶Take the drug only for the doctor’s prescription and, preferably, after determining the sensitivity to Doxycycline☤ of the isolated microbes.
▶Drink with a large amount of water.
▶During treatment, regularly take a control general blood test, liver tests, blood tests for residual nitrogen and urea.
▶Avoid direct sunlight exposure during taking the drug and 5 days after the end of treatment.
▶In order to prevent dysbiosis, take eubiotics (any drugs containing lactobacilli and bifidobacteria), observe the prescribed dose of the drug and the duration of treatment, use sour-milk products.
▶To prevent fungal infections take nystatin or levorin.

Dosage
The dose of the drug, the optimal frequency of medication and the length of treatment is determined by the doctor.
A single dose for oral administration and intravenous drip introduction is 100-200 mg, the daily maximum dose is 300-600 mg for oral administration and 300 mg for intravenous administration. Doses depend on the type of pathogen and the severity of the patient’s condition. Usually prescribed on the first day of treatment 200 mg, then 100 mg per day. In some cases, 200 mg per day is prescribed for the entire treatment period.
For teenagers, doses of Doxycycline☤ are the same as for adults.
Children with body weight over 45 kg are prescribed on the first day of treatment a dose of 4 mg per 1 kg of body weight, regardless of the route of administration of the drug, and in the following days – at a rate of 2-4 mg per 1 kg of body weight.

How to Take Doxycycline☤
The prescribed dosage of the drug should be strictly observed. The daily dose can be taken only once at the same time of day, and can be divided into 2 doses after 12 hours.
The drug should be taken after a meal and washed down with plenty of liquid (preferably water). Drinking plenty is recommended for the entire period of taking the drug.

Some scientists recommend that you take the drug with milk to prevent side effects from the stomach. But other researchers hold the opposite view, explaining this by the fact that Doxycycline☤ forms an insoluble compound with calcium from milk, and thereby the effect of its action is reduced.
It is undesirable to use fresh fruit during the use of Doxycycline☤. they can irritate the mucous membrane of the stomach and contribute to the occurrence of side effects from the digestive system. Even some microelements and vitamins can affect the effectiveness of Doxycycline☤.
Therefore, one should be careful with the simultaneous use of dietary supplements (biologically active additives) during treatment with Doxycycline☤; it is best to discuss this issue with your doctor.

Compatibility with other medicinal products
Doxycycline☤ is not compatible with alkaline preparations (sodium bicarbonate or baking soda, antacids containing magnesium, bismuth, aluminum salts) and with preparations that are unstable in an acid medium (Erythromycin, Hydrocortisone, Aminophylline).
Doxycycline☤ is not taken together with other antibiotics of the tetracycline group. Preparations of calcium and iron reduce the absorption of Doxycycline☤, form with it inactive compounds (chelates), so they are not assigned simultaneously.
Carbamazepine, barbiturates, phenytoin, Rifampicin reduce the effectiveness of Doxycycline☤ in connection with the production of enzymes that reduce the concentration of antibiotic in the blood plasma. Doxycycline☤ is not prescribed concomitantly with antibiotics of bactericidal action (cause death of microorganisms).
they are antagonists to bacteriostatics, one of which is Doxycycline☤. Therefore, it is not prescribed simultaneously with penicillin, antibiotics of cephalosporin series. Cholestyramine, Cholestipol also reduce the absorption of Doxycycline☤, they should not be used simultaneously, the interval between doses should be at least 3 hours.
Doxycycline☤ inhibits the intestinal microflora, which leads to a decrease in the prothrombin index. In this regard, the effect of drugs that reduce blood coagulability is enhanced. These drugs include Warfarin, Phenylin, and others; Doxycycline☤ treatment requires a correction of their dosage. The effectiveness of estrogen-containing contraceptives is reduced with Doxycycline☤; the frequency of bleeding increases.
It is necessary to change the method of contraception. Simultaneous administration of Doxycycline☤ and Retinol leads to an increase in intracranial pressure. Doxycycline☤ can be combined with the appointment of Metronidazole. This combination is often used in the treatment of pelvic infections.

Doxycycline☤ during pregnancy
Doxycycline☤ during pregnancy is contraindicated, because the drug can cause liver damage in a pregnant woman; in addition, it penetrates the placenta and can lead to a slowing of the growth of the fetal skeleton, as well as lead to a defect in the teeth of the fetus and to fatty liver infiltration. The process of calcification of baby teeth begins with 14 weeks of pregnancy. Doxycycline☤ can lead to impaired formation of tooth enamel.
Doxycycline☤ in small amounts can penetrate into breast milk.
However, in the blood serum of the child the drug is not determined in the treatment of the mother with Doxycycline☤. Therefore, when breastfeeding a woman, if necessary, you can prescribe Doxycycline☤.

Doxycycline☤ for children
The opinion about the use of Doxycycline☤ in pediatric practice is ambiguous. Until recently, the drug was recommended for the treatment of children after 12 years. This is due to the fact that Doxycycline☤, like other antibiotics of the tetracycline series, inhibits the longitudinal growth of the bones of the skeleton, can cause maldevelopment of tooth enamel and a prolonged yellowish or grayish brown staining of the enamel of the teeth.
Recently, indications for the appointment of Doxycycline☤ for children have been revised for a number of reasons:
➻with some infections it is the most effective antibiotic;
➻the adverse reactions of alternative antibiotics are more serious than cosmetic changes in tooth color;
➻the widespread spread of tick-borne infections in which Doxycycline☤ is the drug of choice, the first-line antibiotic;
➻cases of pneumonia caused by intracellular pathogens (chlamydia and mycoplasma) have become more frequent;
➻an increase in the incidence of inflammatory diseases of the pelvic organs of chlamydial etiology in adolescents;
➻after cases of bioterrorism (infection with anthrax) in the US and Canada, the use of Doxycycline☤ for the treatment of children has expanded, and in some cases it has been used in preschool age.

The degree of severity of tooth lesions depends on the duration of the course of treatment and the number of courses, as well as on the activity at the time of treatment of the calcification process.
Doxycycline☤, compared with other preparations of the tetracycline series with calcium, binds less, and therefore changes in the teeth are less pronounced. The process of calcification of permanent teeth lasts from 4-5 months of age and up to 5-6 years.
Therefore, the risk of adverse reactions from the teeth after 5 years is minimal, especially if the course of treatment is not long and there are no repeated courses. Therefore, the age of up to 9 years, as a contraindication for treatment with Doxycycline☤, is defined with a margin (for probable individual deviations).
Antibiotics of the tetracycline are also deposited in the bones. But these changes are transient and gradually disappear after the drug is discontinued. In Russia, Doxycycline☤ is widely distributed in the form of hydrochloride. It often leads to the formation of ulcers in the digestive organs. Therefore, for children more safe is Doxycycline☤ monohydrate in the form of Unidox Solutab.
This tablet can be swallowed whole, can be chewed, can be dissolved, which is very convenient for pediatric practice. Its effectiveness can be compared with the injection of Doxycycline☤. Doxycycline☤ doses for children are prescribed by a doctor depending on the severity of the disease (up to 200 mg per day), taken internally for 2 meals with fruit juice. For adolescents, the doses are the same as for adults.

Doxycycline☤ and alcohol
Doxycycline☤ has an adverse effect on the central nervous system. It manifests itself in the form of dizziness, headache. Alcohol also has a strong neurotoxic effect. With the simultaneous administration (or with a short period of time) of both Doxycycline☤ and alcohol, their toxic effects inevitably increase.
Doxycycline☤, like other antibiotics, does not combine with alcohol intake. Simultaneous use of alcohol and Doxycycline☤ can cause a migraine headache, a urge to vomit, a violation of coordination.
The effect of alcohol on the effectiveness of Doxycycline☤ can be twofold: sometimes there is a weakening of the therapeutic effect of the drug, sometimes – strengthening it. Since drugs and alcohol are decomposed in the liver, the use of alcohol during treatment leads to an increase in the load on the liver and the risk of reactive hepatitis.
Therefore, taking alcohol on the background of treatment with Doxycycline☤ is clearly prohibited. If Doxycycline☤ is used for prophylactic purposes 1-2 times a week, then you can drink alcohol 35 hours after taking the medicine.

Doxycycline☤ and smoking
The effectiveness of Doxycycline☤ is affected by smoking. Substances that are part of cigarette smoke, affect the liver, and drugs are faster decomposed in the liver, which leads to a decrease in the effectiveness of the drug.
At the smoker medicines begin to render action with delay. Some scientists consider it necessary to assign smokers higher dosages of drugs.

Doxycycline☤ in chlamydia
Recent studies indicate the effective use for the treatment of chlamydia, 3 groups of antibiotics: tetracyclines, fluoroquinolones and macrolides.
With uncomplicated forms of chlamydia (urethritis, cervicitis and carriage of chlamydia without manifestations of the disease), Doxycycline☤ is the most preferred of all tetracyclines, is prescribed in lower dosages (100 mg) and only in 1 or 2 doses per day.
Even more effective in chlamydia and is convenient in taking the analogue of Doxycycline☤ – Unidox Solutab.
When chlamydia is combined with other infections, the selection of antibiotics is carried out individually in accordance with the sensitivity of the isolated flora. A good result of treatment of inflammatory manifestations in the organs of the small pelvis is noted with the combined administration of Doxycycline☤ (100 mg per day) and Metronidazole (500 mg 2 times a day).
Currently, with chlamydia, Doxycycline☤ is prescribed at any stage of the disease. Doses of the drug, treatment regimen, duration of the course are selected individually depending on the features of the manifestation of the process.
The problem of therapy for Chlamydia infection is that if the treatment is not properly administered, the disease becomes chronic. Therefore, do not change the dose or duration of treatment. Chronicle of the process is also facilitated by a decrease in immunity. Therefore, treatment should be comprehensive and include immunomodulators (Decaris, Timalin, Metuluracil, Pantocrinum and other drugs).

Doxycycline☤ with ureaplasmosis
Ureaplasma is sensitive to Doxycycline☤. The antibiotic penetrates into the cell of the pathogen, blocks the synthesis of protein in it, and the ureaplasma loses its ability to reproduce and soon perishes.
The dose of the drug, the treatment regimen, the duration of the course of treatment are selected by the doctor individually, depending on the dissemination of the pathogen, clinical manifestations and individual characteristics of the patient’s body. Usually, the cure comes with a 10-14 day course of treatment.
Analog Doxycycline – Unidox Solutab – is the drug of choice for the treatment of ureaplasmosis. To reduce the likelihood of side effects Doxycycline☤ should simultaneously take antifungal drugs, eubiotics and hepatoprotectors (drugs to reduce toxic effects on the liver, for example, Essentiale forte, Geparsil, etc.). After treatment, a checkup of both sex partners is mandatory.

Doxycycline☤ for acne
Acne rash (acne) is a disease of the sebaceous glands and hair pouches. Young people and adolescents often meet with this disease (80%). With abundant eruption of pimples antibacterial therapy is indicated.
One of the drugs prescribed for acne is Doxycycline☤ with its broad spectrum of action. Its effectiveness in the treatment of acne is also due to the fact that it dissolves well in fats and is able to penetrate the ducts of the sebaceous gland and the hair follicle.
Therefore, Doxycycline☤ has advantages in choosing an antibiotic for the treatment of acne. It is also important and low price of the drug. A dermatologist should treat a severe form of acne.
He will select the dose of the drug and will observe during the treatment, if necessary, prescribe an external treatment. More often intermittent antibiotic courses are used for a long time. The use of Doxycycline☤ with acne gives a persistent and prolonged remission of the disease.

Doxycycline☤ with tick bite
The causative agent of tick-borne recurrent typhoid (Borrelia) is transmitted by mites when bitten. Therefore, it is recommended to take it out of the body of the tick to the laboratory for research – whether it is a bearer of Borrelia.
Given that the incidence of borreliosis is high, then with a positive response from the laboratory (i.e., infection of the tick with Borrelia), a preventive course of Doxycycline☤ is given for 3-5 days at 200 mg per day for 2 doses.
Children older than 8 years – 4 mg per 1 kg of body weight. Children up to 8 years are prescribed a preventive course of Augmentin or Azithromycin. The preventive course should be conducted no later than three days (72 hours) after the tick bite.
With a timely and properly conducted course, Doxycycline☤ is effective for the prevention of borreliosis. Pregnant women and lactating mothers do not undergo antibiotic therapy.

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