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Tetracycline

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDDRUG-TETRACYCLINE
TypeDrug
Aliases
AchromycinPylera (component, with bismuth + metronidazole)SumycinTetracycline hydrochlorideTetrosanТетрациклін
Statusreviewed 2026-05-18
DiseasesDIS-GASTRIC
SourcesSRC-NCCN-BCELL-2025

Drug Facts

ClassFirst-generation tetracycline antibiotic (broad-spectrum bacteriostatic)
MechanismTetracycline binds reversibly to the 30S ribosomal subunit at the A site, preventing aminoacyl-tRNA from associating with the ribosome and blocking the elongation step of bacterial protein synthesis. Bacteriostatic. Broad spectrum: Gram-positives, Gram-negatives, atypicals (Mycoplasma, Chlamydia, Rickettsia), spirochetes, Helicobacter pylori (including metronidazole- and clarithromycin-resistant strains in PBMT quadruple therapy). Distinct from doxycycline (semi-synthetic, longer half-life, better tissue penetration) — but cheaper and historically the canonical PBMT component.
Typical dosingH. pylori PBMT quadruple therapy (adult): 500 mg PO QID × 10-14 days, with PPI (omeprazole 20 mg BID) + bismuth subcitrate 120 mg QID + metronidazole 500 mg TID-QID. Take on empty stomach (1 hour before or 2 hours after meals) — food and dairy substantially reduce absorption. Separate from polyvalent cations (antacids, iron, calcium, dairy) by ≥2-3 hours. Renal adjustment: AVOID in renal impairment (CrCl <60) — tetracycline (unlike doxycycline) is renally excreted and accumulates; use doxycycline instead. Hepatic: caution in severe hepatic impairment; hepatotoxicity risk with high doses. Pediatric: contraindicated in children <8 years (permanent tooth discoloration, enamel hypoplasia, bone...
Ukraine registeredTrue
NSZU reimbursedFalse
Ukraine last verified2026-05-18

Notes

STUB — v0.2 prevention-workstream authoring; pending two-Clinical-Co-Lead signoff per CHARTER §6.1 dev-mode. Standard tetracycline component of PBMT (PPI + bismuth + metronidazole + tetracycline) — the preferred H. pylori regimen in regions with clarithromycin resistance >15% or after prior triple-therapy failure. Tetracycline (not doxycycline) is the evidence-based PBMT component per Maastricht VI / Florence consensus — doxycycline substitution has lower cure rates and is not equivalent. Pylera fixed-dose capsule (US/EU) bundles bismuth + metronidazole + tetracycline at lower per-component doses, taken QID × 10 days with PPI. Major patient adherence challenge: QID dosing × 10-14 days with meal-timing constraints and food/dairy/antacid spacing. Photosensitivity counseling required. In Ukraine, tetracycline aptechna availability has been spotty in some regions — verify supply before prescribing or use Pylera if available. Two-Co-Lead signoff queued for v0.2-A clinical review.

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