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Doxycycline counselling — GPhC CRA MCQ

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HardInfectionsDoxycycline counsellingGPhC CRA

A patient treated with doxycycline for acne is about to start oral isotretinoin through dermatology. She reports new daily headache and brief visual obscurations. What is the most appropriate pharmacy response?

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Correct answer: D — Avoid concomitant treatment and arrange urgent assessment for intracranial hypertension

Tetracyclines, including doxycycline, are associated with benign intracranial hypertension, and concomitant systemic retinoids increase that risk. Headache with transient visual obscurations warrants urgent assessment because permanent visual loss can occur. Dose spacing does not prevent the pharmacodynamic interaction, and antacids additionally reduce doxycycline absorption.

Reference: Doxycycline SmPC: https://www.medicines.org.uk/emc/product/13082/smpc