Oral Doxycycline in the Management of Acne Vulgaris: Current Perspectives on Clinical Use and Recent Findings with a New Double-scored Small Tablet Formulation

Abstract

Oral antibiotics have been used for the treatment of acne vulgaris for six decades. Among dermatologists, tetracyclines represent at least three-fourths of the oral antibiotics prescribed in clinical practice. Unlike other specialties, antibiotic use in dermatology is predominantly for the treatment of noninfectious disorders, such as acne vulgaris and rosacea, which usually involves prolonged therapy over several weeks to months as compared to short courses used to treat cutaneous infections. At the present time, doxycycline and minocycline are the most commonly prescribed tetracyclines in dermatology, used primarily for treatment of acne vulgaris with a long overall favorable track record of effectiveness and safety. Although both are commonly used, doxycycline may be chosen by clinicians more readily as there is a lower risk of rare yet potentially serious adverse reactions, although doxycycline does warrant preventative measures to reduce the risks of esophagitis and phototoxicity reactions. This article reviews data with a new double-scored small 150mg tablet of doxycycline hyclate that has proven functional scoring, exhibits bioavailability similar to enteric-coated doxycycline, and has been shown to be associated with a low potential for gastrointestinal adverse reactions very comparable to what is achieved with enteric-coated tablets.

Figure 1

Tablet size comparisons of brand doxycycline hyclate formulations DOXY 150-EC—Doxycycline hyclate 150mg Enteric-Coated Tablet; DOXY 150-DS/ST— Doxycycline hyclate 150mg Double-Scored Small Tablet; DOXY 200-EC— Doxycycline hyclate 200mg Enteric-Coated Tablet; DOXY 75-ST—Doxycycline hyclate 75mg Small Tablet

Figure 2

Bioavailability comparison of doxycycline hyclate 150mg double-scored small tablet in fed versus fasted state. Randomized, single-dose, two-period, two sequence crossover study

Figure 3

Doxycycline hyclate 150mg double-scored small tablet comparison of gastrointestinal adverse events in fed versus fasted state. Randomized, single-dose, two-period, two sequence crossover study

Figure 4

Bioavailability comparison in fasted state of doxycycline hyclate 150mg double-scored small tablet (Doxy 150-DS/ST) versus doxycycline hyclate 150mg enteric-coated tablet (Doxy 150-EC). Randomized, single-dose, two-period, two sequence crossover study

Figure 5

Comparison of gastrointestinal adverse events in fasted state of doxycycline hyclate 150mg double-scored small tablet (Doxy 150-DS/ST) versus doxycycline hyclate 150mg enteric-coated tablet (Doxy 150-EC). Randomized, single-dose, two-period, two sequence crossover study