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Doxycycline absorption is also inhibited by divalent and trivalent cations, such as iron, bismuth, aluminum, calcium and magnesium. [15] Doxycycline forms unstable complexes with metal ions in the acidic gastric environment, which dissociate in the small intestine, allowing the drug to be absorbed.
A classic example of this effect is the interaction between β-lactams, which damage the bacteria cell membrane, and aminoglycosides, which inhibit protein synthesis. [1] The damage dealt to the cell wall by β-lactams allows more aminoglycoside molecules to be taken up into the cell than would otherwise be possible, enhancing cell damage. [ 1 ]
Many drug interactions are due to alterations in drug metabolism. [12] Further, human drug-metabolizing enzymes are typically activated through the engagement of nuclear receptors. [12] One notable system involved in metabolic drug interactions is the enzyme system comprising the cytochrome P450 oxidases.
Doxycycline. Doxycycline is a semi-synthetic tetracycline that has been studied for dental and medical applications. Its effects on diseases like periodontitis and cancer has been investigated. [2] Doxycycline is nearly completely absorbed with a bioavailability about 95% in average and a 20% reduction with co-administration of food.
Partial exceptions to these rules occur for doxycycline and minocycline, which may be taken with food (though not iron, antacids, or calcium supplements). Minocycline can be taken with dairy products because it does not chelate calcium as readily, although dairy products do decrease absorption of minocycline slightly. [39]
In the case of magnesium the UL is set at 350 mg/day. The UL is specific to magnesium consumed as a dietary supplement, the reason being that too much magnesium consumed at one time can cause diarrhea. The UL does not apply to food-sourced magnesium. Collectively the EARs, RDAs and ULs are referred to as Dietary Reference Intakes. [26]
Magnesium salts are available as a medication in a number of formulations. They are used to treat magnesium deficiency, low blood magnesium, eclampsia, and several other conditions. Magnesium is an essential nutrient. Usually in lower dosages, magnesium is commonly included in dietary mineral preparations, including many multivitamin preparations.
The combination of minocycline with dairy, antacids, calcium and magnesium supplements, iron products, laxatives containing magnesium, or bile acid sequestrants may decrease minocycline's effectiveness by forming chelates. Combining it with isotretinoin, acitretin or other retinoids can increase the risk for intracranial hypertension.