[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/) › Tigecycline

[Pharmacology](https://durgical.com/en/pharmacology/) · [Tetracyclines](https://durgical.com/en/pharmacology/classes/tetracyclines/)

# Tigecycline

An IV glycylcycline that escapes the usual tetracycline resistance. Kept for complicated infections because of a boxed warning on mortality.

Updated 2026-11-01

- Class: [Tetracyclines](https://durgical.com/en/pharmacology/classes/tetracyclines/)
- Target: Bacterial ribosome, 30S subunit (16S rRNA, A site)
- ATC code: J01AA12

◆**Bacterial ribosome, 30S subunit (16S rRNA, A site)**Tigecycline

ⓘ The figure shows tigecycline bound to the Escherichia coli 70S ribosome.

**Target in 3D:** Bacterial ribosome, 30S subunit (16S rRNA, A site). PDB structure 5J91 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/5J91) · Drag to rotate · pinch to zoom

## Mechanism of action

Tigecycline, a minocycline derivative, binds the 30S subunit more tightly than older tetracyclines and blocks aminoacyl-tRNA from the A site. It is little affected by the two main tetracycline resistance mechanisms, efflux pumps and ribosomal protection, nor by β-lactamases.

- Given IV and spreads widely into tissues
- Binds the 30S subunit tightly
- Aminoacyl-tRNA is blocked from the A site
- Even resistant bacteria stop growing

## Pharmacokinetics

**Distribution**
Large volume of distribution, with low blood levels.

**Elimination**
Mainly bile, as unchanged drug and metabolites; kidney excretion is minor.

## Indications

- Complicated skin and skin-structure infections
- Complicated intra-abdominal infections [Peritonitis →](https://durgical.com/en/conditions/peritonitis/)
- Community-acquired bacterial pneumonia (not hospital-acquired or ventilator-associated pneumonia) [Community-acquired pneumonia →](https://durgical.com/en/conditions/community-acquired-pneumonia/)

## Adverse effects

### Common

- Nausea and vomiting, usually in the first days
- Diarrhoea
- Raised liver enzymes

### Serious (rare, important)

- Higher all-cause mortality than comparators in trials (boxed warning): reserved for when alternatives are unsuitable
- Pancreatitis
- Low fibrinogen and coagulation changes
- Liver injury; tetracycline-class effects on teeth and bone

## Contraindications

- Allergy to tigecycline or its excipients

## Key interactions

**Warfarin**
Prothrombin time is checked.

## What is monitored

- Liver tests and coagulation, including fibrinogen, at baseline and during treatment
- Abdominal pain (pancreatitis)
- Clinical response

## Administration and safety

- IV infusion only
- Reconstituted and diluted as the product describes; the solution is checked for colour and particles

## Nursing care

- Give antiemetics as ordered and watch fluid balance
- Watch for bleeding or bruising
- Report severe abdominal pain

## Pregnancy and breastfeeding

Can cause fetal harm; like other tetracyclines it is avoided in the second half of pregnancy.

## Memory aid

«Tige escapes the pumps but not the warning»: beats efflux and ribosomal protection, yet carries a mortality box.

## Test yourself

Think of the answer, then tap the question to see it.

## Which resistance mechanisms does tigecycline largely escape?

Tetracycline efflux pumps and ribosomal protection proteins.

## What is its boxed warning?

An increase in all-cause mortality compared with other antibiotics.

## Which pneumonia is tigecycline not used for?

Hospital-acquired and ventilator-associated pneumonia.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/tigecycline/)

## Related drugs

- [Minocycline](https://durgical.com/en/pharmacology/minocycline/)
- [Doxycycline](https://durgical.com/en/pharmacology/doxycycline/)

## Related conditions

- [Peritonitis](https://durgical.com/en/conditions/peritonitis/)
- [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: [DailyMed - TIGECYCLINE injection, powder, lyophilized, for solution](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=50605463-2dc2-4b27-bc51-4d87bb9a8539) (DailyMed (U.S. National Library of Medicine), 2026); [Tigecycline Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a614002.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [Structure of the Wild-type 70S E coli ribosome bound to Tigecycline](https://www.rcsb.org/structure/5J91) (RCSB Protein Data Bank, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/tigecycline/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/tigecycline/