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minocycline

A01AB23

Forms & Strengths

Oral capsule: 50 mg, 75 mg, 100 mg
Oral tablet: 50 mg, 75 mg, 100 mg, 55 mg, 65 mg, 80 mg, 105 mg, 115 mg, 135 mg
Oral suspension: 50 mg/5 mL
Intravenous injection: 100 mg
Periodontal systemic/local: 1 mg microspheres

Adult Dosing

Acne vulgaris: 50 mg to 100 mg orally every 12 hours or extended-release formulations weight-based (1 mg/kg/day)
Infections (susceptible organisms): 200 mg initially, then 100 mg every 12 hours orally or IV
Rheumatoid arthritis: 100 mg orally once daily or twice daily
Periodontitis: 1 mg subgingival microspheres into periodontal pockets

Pediatric Dosing

Children 8 years and older (Infections): 4 mg/kg initially, followed by 2 mg/kg every 12 hours orally or IV (max 200 mg/dose)
Children 12 years and older (Acne vulgaris): 50 mg orally every 12 hours or extended-release weight-based dosing
Not recommended in children under 8 years due to tooth discoloration and enamel hypoplasia

Indications

Treatment of inflammatory acne vulgaris
Infections caused by susceptible gram-negative and gram-positive organisms (respiratory, urinary, skin)
Adjunctive treatment in severe rheumatoid arthritis
Periodontitis as an adjunct to scaling and root planing

Mechanism of Action

Bacteriostatic tetracycline antibiotic
Binds to the 30S ribosomal subunit, inhibiting bacterial protein synthesis
Possesses anti-inflammatory and immunomodulatory properties beneficial in acne and rheumatoid arthritis

Contraindications

Hypersensitivity to minocycline or any tetracycline-class drug
Pregnancy (risk of permanent tooth discoloration and bone growth inhibition in the fetus)
Children under 8 years of age
Severe hepatic impairment

Adverse Reactions

Dizziness, lightheadedness, vertigo (vestibular side effects common with minocycline)
Nausea, vomiting, diarrhea, gastrointestinal upset
Hyperpigmentation of skin, mucous membranes, and nails with chronic use
Photosensitivity and rash
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, lupus-like syndrome, hepatotoxicity

Drug Interactions

Antacids, iron supplements, calcium, and magnesium decrease oral absorption
Enhances anticoagulant effect of vitamin K antagonists (warfarin), increasing bleeding risk
May reduce the efficacy of oral contraceptives
Increases plasma concentrations and toxicity risk of digoxin
Concomitant isotretinoin increases risk of pseudotumor cerebri (benign intracranial hypertension)

Curated Content: Needs Vetting Before Put to Clinical Use