Minocycline
MINOCIN
Pronunciation: mi-noe-SYE-kleen
“Mini Cyclone”
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
Available strengths
- cap 50, 75, 100 mg
- inj 100 mg
- tab 50, 75, 100 mg
- ER cap 40 mg
- ER tab 45, 55, 65, 80, 90, 105, 115, 135 mg
- powder 1 mg
- foam 1.5, 4 %
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
Cost
Generic entry1990
NO BOXED WARNINGS
Principal riskVestibular effects and skin hyperpigmentation
Classes and tags
Clinical profile
Legacy pregnancy categoryD
Defining liabilityAllergy, gastrointestinal effects and agent-specific renal, hepatic, hematologic or interaction risks.