Doxycycline: Risk of

Jarisch-Herxheimer Reaction (JHR) Prepared by Muhamad Azlan bin Ahmad Suhairun

Doxycycline is a type of antibiotic under the group of

Tetracycline used to treat a wide variety of bacterial

infections such as Acne Vulgaris, Leptospirosis,

Gonorrhea, Chlamydia, Periodontitis, Syphilis and other

diseases.

What is

DOXYCYLINE

Currently

cases was found in the Eudra Vigilance

database. From all 41 cases, 36 case reports

were assessed as possibly related to

doxycycline causing JHR.

7

34

case reports of JHR associated with

doxycycline product has been detected by

Federal Institute for Drugs and Medical

Device, Germany according to European

Medicines Agency (EMA).

PHARMACY BULLETIN

EDITORIAL BOARD

ADVISOR

Ratna Suny binti

Mohamed Esa

EDITORS

Surayya binti Harun

Tan Cai Ting

WRITERS

Muhamad Azlan bin

Ahmad Suhairun

Muhammad Adib bin

Md Tahir

INSIDE THIS ISSUE

Doxycycline:

Risk of JHR Pg.1-2

Measles Pg.3-4

CONTACT US

Pharmacy Resources

Information Center

Hospital Kuala Kubu

Bharu

03-60641333 Ext: 279

VOLUME 2 DECEMBER 2018

HOSPITAL KUALA KUBU BHARU

References:

1.Jarisch-Herxheimer Reaction | Patient.info .Available from https://patient.info/doctor/jarisch-herxheimer-reaction

2.Doxycycline: Risk of Jarisch-Herxheimer Reaction | npra.moh.gov.my/.Available from http://npra.moh.gov.my/index.php/safety-

alert/79-safety-alert-2018/1284-doxycycline-risk-of-jarisch-herxheimer-reaction

What is

JARISH-HERXHEIMER REACTION (JHR)

13 products containing doxycycline have been registered in Malaysia in tablet and

capsule forms.

National Pharmaceutical Regulatory Agency (NPRA) has received a total of 347

reports with 604 adverse events suspected to be related to doxycycline since 2000.

To date, no JHR cases following the use of doxycycline has been reported to NPRA.

The NPRA is currently in communication with the product registration holder to

include this safety information in the package insert of products containing

doxycycline.

In Malaysia

JHR is a systemic reaction usually associated with the treatment of syphilis. It is believed to be caused by the release of endotoxin-like substances when large

numbers of Treponema pallidum are killed by antibiotics. It has been documented in tick-borne diseases like Lyme disease, leptospirosis and

relapsing fever, all of which are caused by spirochetal organisms. JHR can be regarded as an adverse effect of antibiotics, necessary for achieving a cure

of spirochetal infections.

Symptoms occur shortly after treatment is started and may include:

JHR is normally short-lived and rarely fatal, with full recovery within a few hours in most patients given supportive care and adequate fluids.

Symptoms

Treatment

Fever Skin rash Muscle pain Headache Chill

Pg.2

Pg.3

AT RISK:

Pg.4