Frågedatum: 1996-04-30
RELIS database 1996; id.nr. 12413, DRUGLINE
www.svelic.se
Utredningen som riktar sig till hälso- och sjukvårdspersonal, har utformats utefter tillgänglig litteratur och resurser vid tidpunkten för utredning. Innehållet i utredningen uppdateras inte. Hälso- och sjukvårdspersonal är ansvarig för hur de använder informationen vid rådgivning eller behandling av patienter.


Information concerning papilloedema as a side-effect of doxycycline treatment is requested./nBackgr



Fråga: Information concerning papilloedema as a side-effect of doxycycline treatment is requested. Background: An otherwise healthy 40-year-old woman was treated with doxycycline 100-200 mg daily for two weeks because of sinuitis. A few days after the treatment was started she noticed a grey spot in her field of vision and slight papilloedema was seen on examination.

Sammanfattning: Benign intracranial hypertension, with headache and papilloedema, is a rare but well described side-effect of tetracycline treatment.

Svar: Benign intracranial hypertension is a known, but rare complication of tetracycline treatment. It most frequently occurs in children, but has also been described in adults. The symptoms may develop at any time during treatment, from within a few days to months after initiation of therapy, and may include headache, nausea, dizziness and visual disturbances (1,2). The symptoms usually disappear within days after withdrawal of the drug, but papilloedema may persist for several months (3).

The files of the Swedish Adverse Drug Reactions Advisory Committee (SADRAC) contain a total of 453 reported side-effects that have been judged as possibly related to doxycycline treatment. Out of 38 reported neurologic side-effects, there are 22 cases of headache, but no certain cases of intracranial hypertension. Nineteen reported ocular side-effects include four cases of papilloedema and single cases of maculopathy, "affected vision", visual disturbances, ocular pain, blindness, blurry vision, myopia and photophobia. In the cases of papilloedema, symptoms occurred after 3 to 9 days of treatment. The doses seem to have been ordinary. The ages of the patients were 7, 16, 25 (three men) and 31 years (one woman).

A Medline search for case reports focusing on all tetracyclines and eye diseases or pseudotumor cerebri has been performed and is enclosed.

We suggest that this case be reported to the regional centre of SADRAC, should no other explanation for the symptoms be apparent.

Referenser: