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Take the missed dose as soon as you rememberSkip the missed dose if it is almost time for your next scheduled doseDo not take extra medicine to make up the missed dose.

Renal side effects have included increased BUN and Fanconi’s syndromeIn patients with preexisting renal impairmenttetracycline may cause azotemiahyperphosphatemiaand acidosisPatients with dehydration are particularly vulnerableRef]

Musculoskeletal side effects have included adult tooth discolorationenamel hypoplasiaand a decrease in linear skeletal growth rateTetracyclinethe active ingredient contained in Panmycinshould not be administered to pregnant women or children less than 12 years of ageRef]

Tetracycline is used to treat a wide variety of infectionsincluding acneIt is an antibiotic that works by stopping the growth of bacteria.

Fanconi’s syndrome is characterized by renal glycosuriaphosphaturiaaminoaciduriaand acidosis with or without proteinuria and ricketsIt is associated with the ingestion of outdated or degraded tetracyclineAdditionallyprevious formulations of tetracycline contained citric acid which may contribute to metabolic acidosishowevercurrent formulations of the drug do notPatients generally require hospitalization with intravenous medication to correct the accompanying metabolic abnormalitiesMost cases resolve over time after discontinuation of tetracycline without permanent sequelaePatients should be instructed to discard any unused portions of tetracycline at the end of therapy and to never use tetracycline remaining from a previous prescriptionRef]

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