Floxin
Common brand names: Cipro, Floxin
Related drug: Ofloxacin
Description: Ciprofloxacin and ofloxacin are members of the quinolone class of antibiotics and are used in medicine to treat infections of the urinary, intestinal and lower respiratory tracts, plus infections of the skin, bones and joints.
Dental uses: Ciprofloxacin is not commonly employed to treat dental infections, although its use among dentists is rising, especially among periodontists for various periodontal infections. Rare dental infections caused by the Pseudomonas species of bacteria are effectively treated by ciprofloxacin and ofloxacin.
Dosages for dental purposes: The typical adult dose of ciprofloxacin is 500 milligrams to 750 milligrams every 12 hours for seven to 10 days. Ciprofloxacin and ofloxacin (like tetracyclines) should not be ingested with dairy products (milk, yogurt), antacids (Tums, Rolaids, Maalox, Mylanta, Pepto-Bismol), or iron and zinc supplements, because these products greatly inhibit the absorption of the drugs from the gastrointestinal tract into the bloodstream.
Concerns and possible side effects: Nausea occurs more frequently with ciprofloxacin than penicillin VK. Other side effects include occasional diarrhea, abdominal pain, headache, dizziness and rash. Also severe sunburn (photosensitivity) can occur in up to 1 percent of patients prescribed this drug (or any quinolone) if adequate measures of sun protection, including avoiding prolonged sun exposure and using sunscreens, are not undertaken. In patients taking the asthma drug theophylline (Theodur), ciprofloxacin and other quinolones may increase theophylline blood levels and toxicity. This interaction is potentially serious and life threatening. It is imperative to inform your dentist of all medications you are currently taking to avoid serious drug interactions.
Flagyl
Metronidazole
Common brand names: Flagyl, Metryl.
Dental uses: Metronidazole is a synthetic antimicrobial agent originally introduced in the 1960s for the treatment of vaginitis. Its primary use in dentistry is in the treatment of infections caused by anaerobic bacteria (bacteria that do not require oxygen to survive). It is used alone in the treatment of a periodontal infection known as acute necrotizing ulcerative gingivitis (ANUG). It is combined with penicillin VK, amoxicillin or other antibiotics for the treatment of infected jaw fractures, various periodontal infections and endodontic infections.
Dosages for dental purposes: The typical adult dose of metronidazole is 250 milligrams to 750 milligrams every eight hours for seven to 10 days.
Concerns and possible side effects: Metronidazole produces a higher incidence of nausea, possibly accompanied by diarrhea, vomiting, and abdominal pain than does penicillin VK. It also produces a sharp, unpleasant metallic taste in some patients. Irritation and ulcers of the tongue, gingiva and other oral soft tissues occasionally occur in patients taking metronidazole.
Metronidazole should not be taken with alcohol or within three days of alcohol ingestion because the combination can produce headaches, facial flushing, heart palpitations, nausea and vomiting.
Metronidazole can increase the toxicity of certain drugs, including the manic-depressive medication lithium (Eskalith) and the blood-thinning agent warfarin (Coumadin). These interactions can be serious, so it is imperative to inform your dentist of all medications you are taking.
Evoxac
Cevimeline
Common brand names: Evoxac
Dental uses: Cevimeline is approved for the symptomatic treatment of dry mouth (xerostomia) in patients with Sjogren’s syndrome (an immune system disease).
Dosages for dental purposes: The recommended dose of cevimeline is 30 milligrams three times per day.
Concerns and possible side effects: Patients with a chronic dry mouth are at increased risk for dental decay and should see their dentist for treatment. The most common side effects from cevimeline are sweating, runny nose, nausea, chills and excess salivation. Patients with severe asthma should not take cevimeline because cevimeline may precipitate an asthmatic attack in these individuals. Cevimeline should not be taken by patients with narrow-angle glaucoma (increased eye pressure) or acute iritis (inflammation of the iris), because cevimeline may precipitate a glaucoma attack in these individuals. Certain drugs may cause cevimeline to accumulate in the body and increase its risks of side effects. These include the antibiotics erythromycin (Eryc) and clarithromycin (Biaxin); azole antifungal drugs such as ketoconazole (Nizoral) and fluconazole (Diflucan); the ulcer medication cimetidine (Tagamet); and the antidepressants fluoxitene (Prozac), sertraline (Zoloft) and paroxitene (Paxil). This list is not complete, and it continues to grow. These interactions can be serious, so it is imperative to inform your dentist of all medications you are taking. In addition, the ingestion of grapefruit juice can also cause the accumulation of and increase the risks of side effects from cevimeline.
Erythromycin
Common brand names: E-mycin, Eryc
Description: Erythromycin is a macrolide-type antibiotic most often prescribed to patients with penicillin allergies.
Dental Uses: Erythromycin is used in the treatment of dental abscesses, infections around wisdom teeth, infections that develop after dental surgery, and periocoronitis. It is not used in the treatment of periodontal disease because the disease-causing bacteria often are not susceptible to it.
Dosages for dental purposes: The typical adult dosage is 250 milligrams to 500 milligrams every six hours for seven to 10 days. Dosing for children is based on body weight.
Concerns and possible side effects: Side effects including nausea, vomiting, abdominal pain and diarrhea are more common with erythromycin than with penicillin VK.
Erythromycin causes the accumulation of a number of drugs in the body if taken concurrently. These include:
The asthma drug theophylline (brand name, Theo-dur)
The non-sedating antihistamines terfenadine (brand name, Seldane) and astemizole (brand name, Hismanal)
The blood-thinning agents warfarin and dicumarol (brand name, Coumadin)
The “statin” cholesterol-lowering drugs such as lovastatin (brand name, Mevacor), simvastatin (brand name, Zocor) and atorvastatin (brand name, Lipitor)
This list is not complete and it continues to grow. These interactions with erythromycin are potentially serious and life threatening. It is imperative to inform your dentist of all medications you are currently taking.
Eryc
Erythromycin
Common brand names: E-mycin, Eryc
Description: Erythromycin is a macrolide-type antibiotic most often prescribed to patients with penicillin allergies.
Dental Uses: Erythromycin is used in the treatment of dental abscesses, infections around wisdom teeth, infections that develop after dental surgery, and periocoronitis. It is not used in the treatment of periodontal disease because the disease-causing bacteria often are not susceptible to it.
Dosages for dental purposes: The typical adult dosage is 250 milligrams to 500 milligrams every six hours for seven to 10 days. Dosing for children is based on body weight.
Concerns and possible side effects: Side effects including nausea, vomiting, abdominal pain and diarrhea are more common with erythromycin than with penicillin VK.
Erythromycin causes the accumulation of a number of drugs in the body if taken concurrently. These include:
The asthma drug theophylline (brand name, Theo-dur)
The non-sedating antihistamines terfenadine (brand name, Seldane) and astemizole (brand name, Hismanal)
The blood-thinning agents warfarin and dicumarol (brand name, Coumadin)
The “statin” cholesterol-lowering drugs such as lovastatin (brand name, Mevacor), simvastatin (brand name, Zocor) and atorvastatin (brand name, Lipitor)
This list is not complete and it continues to grow. These interactions with erythromycin are potentially serious and life threatening. It is imperative to inform your dentist of all medications you are currently taking.
Elavil
Amitriptyline
Common brand names: Elavil
Description: Amitriptyline is classified as a tricyclic antidepressant.
Dental uses: While its primary medical use is in the treatment of depression, amitriptyline also is effective in treating certain types of chronic pain, including pain around the temporomandibular joint and various types of neuropathic pains involving abnormalities of nerves in the face and mouth. Amitriptyline also improves sleep, which is beneficial to the chronic-pain sufferer.
Dosages for dental purposes: When prescribing chronic pain medications like amitriptyline, the axiom “start low and go slow” applies, to reduce side effects. The typical starting dose of amitriptyline for chronic facial pain may be as low as 10 mg at bedtime, with a gradual increase in the dose until the desired effect are achieved.
Concerns and possible side effects: While amitriptyline is considered a mood elevator, drowsiness is a common side effect. Some patients may be able to take amitripityline only at bedtime and not during the day, thereby reducing the incidence of this common side effect. Patients who experience drowsiness should not operate dangerous machinery or drive automobiles.
Other common side effects include dry mouth, constipation and dizziness on standing. Patients with narrow-angle glaucoma (increased eye pressure) should not take amitriptyline, because amitriptyline may precipitate an acute glaucoma attack in these individuals. Patients should not drink alcohol when taking amitriptyline, because the combination can lead to increased drowsiness and even unconsciousness. Certain drugs can cause amitriptyline to accumulate, leading to more side effects. These include the ulcer medications cimetidine (Tagamet) and omeprazole (Prilosec), the antifungal agents ketoconazole (Nizoral) and fluconazole (Diflucan), and the antidepressants fluoxitene (Prozac) and paroxitene (Paxil). This list is not complete, and it continues to grow. These interactions can be serious, so it is imperative to inform your dentist of all medications you are taking.
Patients taking amitriptyline or other tricyclic antidepressants (imipramine, desipramine) for medical reasons also should inform their dentist. This is because the epinephrine and levonordefrin found in many dental local anesthetic solutions sometimes interact adversely with tricyclic antidepressants, causing increases in blood pressure and disturbances in heart rhythm. Experts recommend that local anesthetic solutions containing levonordefrin not be used in patients taking tricyclic antidepressants. Epinephrine can be used in these patients, but the maximum dose should be reduced.
E-mycin
Erythromycin
Common brand names: E-mycin, Eryc
Description: Erythromycin is a macrolide-type antibiotic most often prescribed to patients with penicillin allergies.
Dental Uses: Erythromycin is used in the treatment of dental abscesses, infections around wisdom teeth, infections that develop after dental surgery, and periocoronitis. It is not used in the treatment of periodontal disease because the disease-causing bacteria often are not susceptible to it.
Dosages for dental purposes: The typical adult dosage is 250 milligrams to 500 milligrams every six hours for seven to 10 days. Dosing for children is based on body weight.
Concerns and possible side effects: Side effects including nausea, vomiting, abdominal pain and diarrhea are more common with erythromycin than with penicillin VK.
Erythromycin causes the accumulation of a number of drugs in the body if taken concurrently. These include:
The asthma drug theophylline (brand name, Theo-dur)
The non-sedating antihistamines terfenadine (brand name, Seldane) and astemizole (brand name, Hismanal)
The blood-thinning agents warfarin and dicumarol (brand name, Coumadin)
The “statin” cholesterol-lowering drugs such as lovastatin (brand name, Mevacor), simvastatin (brand name, Zocor) and atorvastatin (brand name, Lipitor)
This list is not complete and it continues to grow. These interactions with erythromycin are potentially serious and life threatening. It is imperative to inform your dentist of all medications you are currently taking.
Dynacin
Minocycline
Common brand names: Minocin, Dynacin.
Dental uses: Minocycline is a broad-spectrum, tetracycline-type antibiotic. It typically is prescribed for up to two weeks for different types of periodontal (gum) diseases, including periodontal disease in adolescents (juvenile periodontitis).
Dosages for dental purposes: The typical adult dose is 200 milligrams for the first dose followed by 100 milligrams every 12 hours for up to two weeks. Minocycline and all tetracyclines must not be ingested with dairy products (milk, yogurt), antacids (Tums, Rolaids, Maalox, Mylanta, Pepto-Bismol), or iron and zinc supplements because these products greatly inhibit the absorption of tetracyclines from the gastrointestinal tract into the bloodstream.
Concerns and possible side effects: Minocycline, like all tetracyclines, has a much higher incidence of side effects — such as nausea, vomiting, abdominal pain, diarrhea and yeast infections (in women) — than does penicillin VK. Occasionally, minocycline temporarily turns the tongue a black color, a condition known as black hairy tongue.
In addition, minocycline and all tetracyclines should not be prescribed to children under 8 years or to pregnant women, because they can permanently stain the teeth of the growing child or fetus.
Minocycline may produce a permanent grayish color on the gingiva (gums) and teeth in adults. Also, severe sunburn (photosensitivity) can occur in up to 10 percent of patients prescribed a tetracycline if adequate measures of sun protection (avoiding prolonged sun exposure and using sunscreens) are not undertaken.
Doxycycline Regular Dose
Doxycycline (Regular Dose)
Common brand names: Vibramycin, Doxy-Caps.
Description: Doxycycline is a broad-spectrum, tetracycline-type antibiotic.
Dental uses: Doxycycline typically is prescribed for up to two weeks for different types of periodontal (gum) diseases, including periodontal disease in adolescents (juvenile periodontitis).
Dosages for dental purposes: The typical adult dose is 50 milligrams to 100 milligrams every 12 hours for up to two weeks. Doxycycline (and all tetracyclines) must not be ingested with dairy products (milk, yogurt), antacids (Tums, Rolaids, Maalox, Mylanta, Pepto-Bismol), or iron and zinc supplements, because these products greatly inhibit the absorption of tetracyclines from the gastrointestinal tract into the bloodstream.
Concerns and possible side effects: Doxycycline, like all tetracyclines, has a much higher incidence of side effects such as nausea, vomiting, abdominal pain, diarrhea and yeast infections (in women)compared with penicillin VK. Occasionally, doxycycline temporarily turns the tongue a black color, a condition known as black hairy tongue.
In addition, doxycycline and all tetracyclines should not be prescribed to children under 8 years or to pregnant women, because they can permanently stain the teeth of the growing child or fetus. Also, severe sunburn (photosensitivity) can occur in up to 10 percent of patients prescribed tetracyclines, including doxycycline, if adequate measures of sun protection (avoiding prolonged sun exposure and using sunscreens) are not undertaken
Doxycycline (Low Dose)
Common brand names: Periostat
Description: Doxycycline is a broad-spectrum, tetracycline-type antibiotic.
Dental Uses: Doxycycline may be prescribed in a low dosage for up to nine months as an adjunctive therapy to dental scaling and root planing to shrink periodontal pockets and to arrest bone loss in adults with periodontal disease.
The typical dose is 20 milligrams twice each day. Doxycycline (and all tetracyclines) must not be ingested with dairy products (milk, yogurt), antacids (Tums, Rolaids, Maalox, Mylanta, Pepto-Bismol), or iron and zinc supplements because these products greatly inhibit the absorption of tetracyclines from the gastrointestinal tract into the bloodstream.
Concerns and possible side effects: This is a fairly new drug, and so far the typical levels of tetracycline side effects (nausea, vomiting, abdominal pain, diarrhea) have been very low (no more than a sugar pill).
Doxycycline and all tetracyclines should not be prescribed to children under 8 years or to pregnant women, because they can permanently stain the teeth of the growing child or fetus.
Also, severe sunburn (photosensitivity) can occur in up to 10 percent of patients prescribed this drug (or any tetracycline) if adequate measures of sun protection (avoiding prolonged sun exposure and using sunscreens) are not undertaken.