[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Tetracyclines](https://durgical.com/en/pharmacology/classes/tetracyclines/) › Omadacycline # Omadacycline ## Tetracyclines? Tetracyclines Aminomethylcycline derived from minocycline, oral or IV, for community pneumonia and skin infections; taken fasting and away from minerals. Updated Nov 1, 2026 ## Quick facts **Group** [Tetracyclines](https://durgical.com/en/pharmacology/classes/tetracyclines/) **Target** Bacterial ribosome, 30S subunit (16S rRNA, A site) **Used for** Acute bacterial skin **Key effects** Nausea · Constipation · Insomnia and headache **Monitor** Clinical response of the pneumonia **ATC** J01AA15 No doses: the clinician sets them by the current guideline. On this page - The basics Mechanism of action - Indications - Adverse effects - Pharmacokinetics - Memory aid - Safety Contraindications - Key interactions - What is monitored - Administration and safety - Pregnancy and breastfeeding - Nursing care - Study Test yourself - Connections Connections ## Mechanism of action ◆**Bacterial ribosome, 30S subunit (16S rRNA, A site)**Omadacycline ⓘ The figure shows omadacycline bound to the head of the Escherichia coli 30S ribosomal subunit; the same crystal has spectinomycin at another site. **Target in 3D:** Bacterial ribosome, 30S subunit (16S rRNA, A site). PDB structure 8CA7 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/8CA7) · Drag to rotate · pinch to zoom Omadacycline binds the 30S subunit and keeps aminoacyl-tRNA out of the A site. It is an aminomethylcycline derived from minocycline: its bulky substituent hinders ribosomal protection proteins and the common Tet pumps do not expel it, so it acts against many tetracycline-resistant strains. - Binds the 30S at the tetracycline site - Aminoacyl-tRNA cannot enter the A site - Evades Tet pumps and ribosomal protection - Protein synthesis stops ## Indications - Community-acquired bacterial pneumonia in adults [Community-acquired pneumonia →](https://durgical.com/en/conditions/community-acquired-pneumonia/) - Acute bacterial skin and skin-structure infections in adults ## Adverse effects ### Common - Nausea, vomiting and diarrhoea - Constipation - Insomnia and headache ### Serious (rare, important) - Permanent tooth staining and effects on bone growth if used in pregnancy or before age 8 - Intracranial hypertension (severe headache, blurred or double vision) - Severe skin and allergic reactions - Clostridioides difficile diarrhoea ## Contraindications - Allergy to omadacycline or other tetracyclines ## Key interactions **Antacids, calcium, magnesium, iron and multivitamins with minerals** Chelate omadacycline and lower absorption; separated by 4 hours. **Food and dairy** Greatly reduce absorption of the oral form. ## What is monitored - Clinical response of the pneumonia or skin infection - Headache or visual change - Diarrhoea during and after treatment ## Administration and safety - Oral on an empty stomach, with water, at least 4 hours after eating; then only water for 2 hours and no dairy for 4 hours - Separate by 4 hours from antacids, iron and vitamins with iron ## Pregnancy and breastfeeding It can harm the fetus: like the other tetracyclines, it stains teeth and affects bone growth; pregnancy is avoided during treatment. ## Nursing care - Schedule the dose away from meals, dairy and mineral supplements - Ask about pregnancy; breastfeeding is avoided during treatment and for 4 days after - Teach to report severe headache or visual change - Teach to finish the course ## Pharmacokinetics **Absorption** Oral (bioavailability about one third) or IV; food and cations (calcium, magnesium, aluminium, iron) greatly reduce absorption. **Distribution** Wide; unlike other tetracyclines, it binds little to plasma proteins. **Elimination** Mostly unchanged, in bile and urine. **Half-life** Long, about 16 hours, allowing one dose a day. ## Memory aid «OMA-DAY, once a day»: omadacycline is a remodelled minocycline that lasts all day, but it demands an empty stomach. ## Test yourself Think of the answer, then tap the question to see it. ## Which tetracycline is omadacycline derived from, and what sets it apart? Minocycline; it is oral and IV, binds little to proteins and keeps activity against tetracycline-resistant strains. ## How is oral omadacycline taken so that it is absorbed well? Fasting, with water, at least 4 hours after eating, with no food, dairy or minerals in the hours after. ## Which infections is omadacycline approved for? Community-acquired bacterial pneumonia and acute skin and skin-structure infections in adults. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/omadacycline/) [More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology) ## Connections ## Related drugs 4 - [Doxycycline](https://durgical.com/en/pharmacology/doxycycline/) - [Minocycline](https://durgical.com/en/pharmacology/minocycline/) - [Tigecycline](https://durgical.com/en/pharmacology/tigecycline/) - [Eravacycline](https://durgical.com/en/pharmacology/eravacycline/) ## Related conditions 1 - [Community-acquired pneumonia](https://durgical.com/en/conditions/community-acquired-pneumonia/) [← Back to the class: Tetracyclines](https://durgical.com/en/pharmacology/classes/tetracyclines/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Omadacycline: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a618066.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [Omadacycline and spectinomycin bound to the 30S ribosomal subunit head](https://www.rcsb.org/structure/8CA7) (RCSB Protein Data Bank, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/omadacycline/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/omadacycline/