Advisability of Use During Pregnancy. Pregnancy Category: D (tentative)

Pregnancy Category: D (tentative). See Pregnancy Code inside back cover. Animal studies: Tetracycline causes limb defects in rats, rabbits and

chickens. Human studies: Information from studies of pregnant women indicates that this drug can cause impaired development and discoloration of teeth and other developmental defects. It is advisable to avoid this drug completely during entire pregnancy.

Advisability of Use if Breast-Feeding

Presence of this drug in breast milk: Yes. Avoid drug or refrain from nursing.

Habit-Forming Potential: None.

Effects of Overdosage: Dizziness, nausea, vomiting, diarrhea.

Possible Effects of Long-Term Use: Superinfections; rarely, impairment of bone marrow, liver or kidney function.

Suggested Periodic Examinations While Taking This Drug (at physician's

discretion) Complete blood cell counts, liver and kidney function tests.

During extended use, sputum and stool examinations may detect early superinfection due to yeast organisms.

While Taking This Drug, Observe the Following

Foods: No restrictions.

Beverages: No restrictions.

Alcohol: No interactions expected. However, it is best avoided if you have

active liver disease.

Tobacco Smoking: No interactions expected. Other Drugs Tetracyclines may increase the effects of

• oral anticoagulants, and make it necessary to reduce their dosage.

• digoxin (Lanoxin), and cause digitalis toxicity.

• lithium (Eskalith, Lithane, etc.), and increase the risk of lithium toxicity.

Tetracyclines may decrease the effects of

• oral contraceptives, and impair their effectiveness in preventing pregnancy.

• penicillins, and impair their effectiveness in treating infections. Tetracyclines taken concurrently with

• methoxyflurane anesthesia may impair kidney function. The following drugs may decrease the effects of tetracyclines

• antacids (aluminum and magnesium preparations, sodium bicarbonate, etc.) may reduce drug absorption.

• iron and mineral preparations may reduce drug absorption.
Driving, Hazardous Activities: This drug may cause marked dizziness or

incoordination. Restrict activities as necessary. Aviation Note: The use of this drug may be a disqualification for piloting.

Consult a designated Aviation Medical Examiner. Exposure to Sun: Use caution until sensitivity has been determined. Some tetracyclines can cause photosensitivity.

TEXT 11. Read the following text and put questions to it.