Tetracycline in patient with renal impairment

Dear Ask The Doctor: Why I can't give tetracycline to patiet of renal failure?

Dear Hussein: Tetracycline is eliminated by the kidney to various extent. Patients with renal impairment may be at a greater risk for tetracycline-associated renal toxicity (increased BUN with consequent azotemia, hyperphosphatemia, and acidosis) due to decreased drug clearance. In patients with renal impairment, therapy with tetracycline should be administered cautiously at reduced dosages. Clinical monitoring of renal function is recommended, and serum tetracycline levels may be necessary during prolonged therapy.