Minocycline
MINOCIN
What it isTetracycline inhibiting the 30S ribosomal subunit; acne, MRSA skin infection and rosacea.
Why this oneThe most lipophilic tetracycline, so it penetrates sebaceous glands and the CNS better than doxycycline.
What limits itVestibular effects, and irreversible blue-gray skin and scleral pigmentation with prolonged use. Drug-induced lupus.
FDA-approved for
- acne (1971)
- bacterial infections (1971)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Susceptible infections (general) | Adult | 200 mg ×1 | 100 mg BID (q12h) | 200 mg/24 h |
| Susceptible infections | Peds >8 yr | 4 mg/kg ×1 | 2 mg/kg q12h | usual adult dose |
| Uncomplicated gonococcal urethritis (men) | Adult | 100 mg BID ×5 days | ||
| Other gonococcal infections (men) | Adult | 200 mg ×1 then 100 mg q12h ≥4 days | ||
| Syphilis | Adult | usual dose over 10–15 days | ||
| Meningococcal carrier state | Adult | 100 mg q12h ×5 days | ||
| Chlamydia/Ureaplasma (urethral/endocervical/rectal) | Adult | 100 mg q12h ≥7 days | ||
| Mycobacterium marinum | Adult | 100 mg q12h ×6–8 wk |
Renal Do not exceed 200 mg/24 h; monitor BUN/creatinine (antianabolic effect); specific adjustment not characterized
Hepatic Undefined
Total daily dose should not exceed 200 mg in 24 h
Instructions
- Take with or without food; swallow capsules whole with adequate fluid to reduce esophageal irritation/ulceration
- Avoid taking immediately before bedtime
Contraindications
- Hypersensitivity to any of the tetracyclines
Cautions
- Photosensitivity
- Intracranial hypertension (pseudotumor cerebri)
- Hepatotoxicity, incl. autoimmune hepatitis/liver failure
- Tooth discoloration (children <8 yr and with fetal exposure); enamel hypoplasia
- Hypersensitivity/DRESS, lupus-like and serum sickness-like syndromes
- C. difficile / pseudomembranous colitis
- Thyroid discoloration and reported thyroid cancer with prolonged use
- Antianabolic effect → ↑BUN
Adverse reactions
- Nausea/vomiting/diarrhea, dyspepsia
- Dizziness, vertigo
- Skin/tooth/mucosal pigmentation
- Photosensitivity
- Headache
- Esophagitis/esophageal ulceration
- Rare hepatic, hematologic and hypersensitivity reactions
Pregnancy Undefined
Lactation Undefined
NO BOXED WARNINGS
Principal riskVestibular effects and skin hyperpigmentation
Cost, est. cash$300–$2,500/month
Generic entry1990
Classes and tags
Clinical profile
Legacy pregnancy categoryD
Defining liabilityAllergy, gastrointestinal effects and agent-specific renal, hepatic, hematologic or interaction risks.
Mechanism of action: Minocycline ballicule
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