lymecycline: clinical use

Prescribing considerations

• Confirm that the indication is licensed for the chosen product and consider antimicrobial susceptibility and stewardship.
• Assess renal and hepatic history, pregnancy or breastfeeding, lupus, myasthenia gravis and concurrent retinoid use.
• Counsel on adequate water, photosensitivity, interaction with mineral-containing products and symptoms of intracranial hypertension.
• Prolonged broad-spectrum antibiotic exposure can select resistant organisms or cause superinfection.

Contraindications and cautions

• Hypersensitivity to lymecycline, another tetracycline or a product excipient
• Overt renal insufficiency
• Children younger than eight years because of permanent dental staining and enamel hypoplasia
• Concurrent oral retinoid treatment

Monitoring

• Review promptly if severe headache, vomiting or visual disturbance develops.
• Consider renal and hepatic assessment where impairment or toxicity is suspected.
• Monitor anticoagulant effect or lithium concentration if an interacting combination cannot be avoided.
• Review for photosensitivity, hepatotoxicity, severe diarrhoea, candidiasis or other superinfection.

Clinical pharmacology

Lymecycline is a bacteriostatic tetracycline that inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit. Its benefit in acne also includes anti-inflammatory activity.

Formulation and product differences

• Both selected products are hard gelatin capsules, but excipients and packaging differ.
• The selected generic capsule contains tartrazine, which may cause allergic reactions; the Tetralysal capsule shell instead contains quinoline yellow among its colourants.
• The selected generic and Tetralysal products have different listed pack configurations and shelf lives.

Capsule

Route: Oral

Strengths: 408 mg