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Periostat (doxycycline hyclate) is used following a dental procedure called scaling and root planing, in which plaque and tartar (also called calculus) are removed from teeth and root surfaces are smoothed. Periostat promotes gum health, promotes tooth attachment, and reduces periodontal pockets (also called gum pockets).

The active ingredient in Periostat, doxycycline, is a tetracycline antibiotic used to prevent or combat a very wide range of bacterial infections, though it takes relatively high doses to be effective in these applications. The brand name Periostat contains a low dose of 20 mg per tablet.

Periostat for Periodontitis

Periodontitis is a gum disease caused by the buildup of plaque and tartar on the teeth, which harbors bacteria. Unchecked, the bacteria irritate and infect the gums, causing redness, swelling, pain, and bleeding, among other symptoms.

In advanced periodontitis an enzyme called collagenase is released into the gums, which breaks down gum tissue and causes or contributes to periodontal pockets and loosening of teeth. Scaling and root planing is a dental procedure in which the plaque and tarter are removed from the teeth, which eliminates bacteria and irritants on the teeth but does not address damaged gums. Periostat works by inhibiting the action of the collagenase enzyme, allowing gum tissue to heal.

In this application Periostat is administered in 20 mg tablets. Treatment typically starts shortly after the scaling and root planing procedure:

• Take one tablet (20 mg) twice per day, spaced 12 hours apart.
• Tablets should be taken on an empty stomach; one hour before or two hours after a meal.
• A full glass of water should be consumed with each dose.
• Treatment typically continues for 3 to 9 months, depending on the severity of the condition.
• Treatment should not exceed 12 months without explicit doctor approval.

Taking tablets with food---particularly foods containing calcium, like milk---can impair absorption of Periostat, which is why it should be taken on an empty stomach. Antacids also often contain ingredients that may impair absorption, and should be avoided shortly before or after taking a Periostat tablet.

Bacterial Infections

The 20 mg doses used in periodontitis are too low to fight bacterial infections. However, at higher doses it is effective; these levels can be achieved by taking multiple smaller-dose tablets or, more ideally, by taking fewer higher-dose tablets, often available in generic formulas.

Doxycycline is often used when penicillin cannot be used, but it is also a highly-effective antibiotic in its own right. It can be used to treat or prevent:

• Lyme disease and other tick fevers
• Rocky Mountain spotted fever
• Respiratory tract infections
• Urinary tract infections
• Pelvic inflammatory disease
• Typhus
• Cholera
• Q fever
• Brucellosis
• Trachoma
• Chancroid
• Granuloma
• Bubonic plague
• Anthrax
• Acne
• Rosacea
• Malaria
• Leptospirosis

In bacterial infections dosage and administration will ideally be determined by a doctor, as there are numerous factors which can influence dosage and duration of treatment. However, treatment does tend to share some similarities in most cases. Rough guidelines for otherwise healthy adults are as follows:

• For mild infections, start with 200 mg on the first day (two 100 mg doses taken 12 hours apart), followed by 100 mg once per day for 7 to 14 days.
• For severe infections, take 200 mg per day (two 100 mg doses taken 12 hours apart) for 7 to 14 days.
• As a preventive measure for malaria, take 100 mg once per day starting several days prior to exposure, continuing throughout exposure and for 4 weeks after exposure.
• As a preventive measure for leptospirosis, take 200 mg once per week, starting 1 or 2 days prior to exposure and continuing throughout exposure.
• After exposure to anthrax, take 100 mg per day for at least 60 days.

As with periodontitis, tablets should be taken on an empty stomach with a full glass of water.