Doxycycline (Subgingival)

Doxycycline is used to help treat periodontal disease (a disease of your gums). Periodontal disease is caused by bacteria growing beneath the gum line. Doxycycline works by preventing the number of bacteria from increasing. Reducing the amount of bacteria helps to decrease inflammation and swelling in your mouth, as well as the amount of bleeding around the teeth. Doxycycline is placed in deep gum pockets next to your teeth to help reduce the depth of the pockets.

This medicine will be applied by your dentist or other oral health care professional.

It is very important that your dentist check your progress while you are receiving this medicine. Do not miss any dental appointments.

Using this medicine while you are pregnant (especially during the last half of your pregnancy) can harm your unborn baby. Use an effective form of birth control to prevent pregnancy. If you think you have become pregnant while using the medicine, tell your doctor right away.

Check with your dentist as soon as possible if you have pain or swelling or other problems in the treated areas.

Oral contraceptives (birth control pills) that contain estrogen may not work properly if you take them while you are using doxycycline periodontal system. To prevent pregnancy, use another form of birth control (e.g., condoms, diaphragms, or contraceptive foams or jellies) while doxycycline periodontal system is in place. If you have any questions about this, check with your doctor.

For 7 days after receiving doxycycline periodontal system, do not floss or brush around the teeth that have been treated. Brushing or flossing may loosen the system or cause it to fall out.

Tetracyclines, such as doxycycline, may make your skin more sensitive to sunlight than usual. Exposure to sunlight, even for short periods of time, may cause a skin rash, itching, redness or other discoloration of the skin, or a severe sunburn. For a period of 7 days after receiving doxycycline periodontal system:

• Stay out of direct sunlight, especially between the hours of 10:00 a.m. and 3:00 p.m., if possible.
• Wear protective clothing, including a hat. Also, wear sunglasses.
• Apply a sunblock product that has a skin protection factor (SPF) of at least 15. Some patients may need a product with a higher SPF number, especially if they have a fair complexion. If you have any questions about this, check with your doctor.
• Apply a sunblock lipstick that has an SPF of at least 15 to protect your lips.
• Do not use a sunlamp or tanning bed or booth.

You may still be sensitive to sunlight or sunlamps for 2 weeks to several months or more after the 7-day treatment period of doxycycline periodontal system. If you have a severe reaction, check with your dentist or doctor.

In deciding to use a medicine, you must consider the risks of taking it compared to the benefits it may provide. This is a choice you and your doctor will make together. For this medicine, the following should be taken into account:

Allergies

Inform your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also, let your healthcare professional know if you have any other allergies, like to foods, dyes, preservatives, or animals. For non-prescription products, carefully read the label or package ingredients.

Pediatric

This medicine is not recommended for infants and children younger than 8 years old. Tetracyclines, such as doxycycline, may cause permanent discoloration of teeth and slow down bone growth. The safety and effectiveness of doxycycline have not been established in children 8 years old or older.

Geriatric

There is no information available on how age affects the effects of doxycycline in older patients.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medication during breastfeeding. Consider the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Some medicines should never be used together, while others may be used together even if an interaction could occur. In these situations, your doctor may need to adjust the dose or take other precautions. It is very important that your healthcare professional knows if you are taking any of the medicines listed below. The following interactions have been chosen based on their potential significance and are not necessarily a complete list.

Using this medicine with any of the following medicines is not recommended. Your doctor may choose not to treat you with this medicine or change some of the other medicines you take.

• Acitretin

Using this medicine with any of the following medicines is usually not recommended but may be necessary in some cases. If both medicines are prescribed together, your doctor may adjust the dose or frequency of one or both of the medicines.

• Amoxicillin
• Ampicillin
• Ascorbic Acid
• Bacampicillin
• Bexarotene
• Cholera Vaccine, Live
• Cloxacillin
• Desogestrel
• Dicloxacillin
• Dienogest
• Drospirenone
• Estradiol
• Ethinyl Estradiol
• Ethynodiol
• Etretinate
• Gestodene
• Isotretinoin
• Levonorgestrel
• Magnesium Sulfate
• Mestranol
• Methicillin
• Methotrexate
• Methoxyflurane
• Nafcillin
• Nomegestrol
• Norethindrone
• Norgestimate
• Norgestrel
• Oxacillin
• Palovarotene
• Penicillin G
• Penicillin G Benzathine
• Penicillin G Procaine
• Penicillin V
• Piperacillin
• Pivampicillin
• Porfimer
• Quizartinib
• Sultamicillin
• Temocillin
• Tretinoin

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both drugs might be the best treatment for you. If both medicines are prescribed together, your doctor may adjust the dose or frequency of one or both of the medicines.

• Aminolevulinic Acid
• Rifampin
• Rifapentine

Interactions with Food/Tobacco/Alcohol

Some medicines should not be used at or around the time of eating food or certain types of food due to possible interactions. Using alcohol or tobacco with certain medicines may also cause interactions. Discuss with your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical problems may affect how you can use this medicine. Be sure to tell your doctor if you have any other medical issues, especially:

• Candidiasis (yeast infection) of the mouth, or history of—Use with caution. This condition may get worse.

• Conditions with severe periodontal defects or
• Dental implants or
• Weak immune system (caused by diabetes, HIV infection, or patients receiving cancer or radiation treatments)—Atridox® has not been tested or evaluated in patients with these conditions.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Less common

• High blood pressure
• looseness of tooth
• tooth or gum pain (severe or continuing)

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Common cold–like symptoms
• gum discomfort, pain, or soreness
• headache
• pressure sensitivity of the tooth
• toothache

Less common

• Abdominal or stomach bloating or pelvic pain
• cough
• diarrhea
• gum redness
• indigestion, upset stomach, or stomachache
• influenza-like symptoms
• mouth pain or soreness
• muscle aches
• sensitivity of the tooth to heat or cold
• shortness of breath
• sleeplessness
• sore throat
• stuffy head, postnasal drip, or nasal congestion

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Chemical Class: Tetracycline (class)

Doxycycline periodontal system is placed by your dentist into one or more deep gum pockets next to your teeth. A dental dressing or adhesive will be placed on top to help keep the system in place. The treatment may be repeated four months later.

The treatment period for the doxycycline periodontal system is seven days after your dentist inserts it. If the system comes loose or falls out before the 7 days are up, check with your dentist.

Doxycycline periodontal system does not have to be removed by the dentist; it will dissolve. The dental dressing or adhesive that holds the system in place may fall out naturally. However, if the dental dressing or adhesive is still present after 7 days, it should be removed by the dentist.

After the medicine is placed in your mouth, try to avoid any actions that may cause the medicine to come out. For example:

• Do not brush around the teeth that have been treated for 7 days.
• Do not use dental floss or any other cleaning tools that go between the teeth for 7 days after treatment.