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Minocin
minocycline
Adult Dosing .
Dosage forms: INJ
Dosage Form Details
- [CAP form discontinued in US for this brand; see generic]
infections, bacterial
- [100 mg PO/IV q12h]
- Start: 200 mg PO/IV x1; Max: 400 mg/24h; Alt: start 100-200 mg PO x1, then 50 mg PO qid; Info: duration varies with infection type, severity; give cap with adequate fluid to decr. esophageal irritation/ulceration
severe acne vulgaris, adjunct tx
- [50-100 mg PO qd]
- Start: 50-100 mg PO bid x2-3mo; Info: give with adequate fluid to decr. esophageal irritation/ulceration
leprosy (Hansen disease), multibacillary (off-label)
- [patients who cannot take clofazimine]
- Dose: 100 mg PO qd x12mo; Info: not 1st-line agent; part of multi-drug regimen; give with adequate fluid to decr. esophageal irritation/ulceration; may continue tx beyond 12mo in refractory cases
- [patients who cannot take rifampin]
- Dose: 100 mg PO qd x24mo; Info: not 1st-line agent; part of multi-drug regimen; give with adequate fluid to decr. esophageal irritation/ulceration; may continue tx beyond 24mo in refractory cases
leprosy (Hansen disease), paucibacillary (off-label)
- [patients who cannot take rifampin]
- Dose: 100 mg PO qd x24mo; Info: not 1st-line agent; part of multi-drug regimen; give with adequate fluid to decr. esophageal irritation/ulceration; may continue tx beyond 24mo in refractory cases
renal dosing
- [see below]
- renal impairment: decr. usual dose and/or frequency, amount not defined, max 200 mg/24h
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: INJ
Dosage Form Details
- [CAP form discontinued in US for this brand; see generic]
infections, bacterial
- [>8 yo]
- Dose: 2 mg/kg/dose PO/IV q12h; Start: 4 mg/kg/dose PO/IV x1; Max: 200 mg/24h; Info: duration varies with infection type, severity; give cap with adequate fluid to decr. esophageal irritation/ulceration
severe acne vulgaris, adjunct tx
- [>8 yo]
- Dose: 50-100 mg PO qd; Start: 50-100 mg PO bid x2-3mo; Info: give with adequate fluid to decr. esophageal irritation/ulceration
leprosy (Hansen disease), multibacillary (off-label)
- [15 yo and older, patients who cannot take clofazimine]
- Dose: 100 mg PO qd x12mo; Info: not 1st-line agent; part of multi-drug regimen; give with adequate fluid to decr. esophageal irritation/ulceration; may continue tx beyond 12mo in refractory cases
- [15 yo and older, patients who cannot take rifampin]
- Dose: 100 mg PO qd x24mo; Info: not 1st-line agent; part of multi-drug regimen; give with adequate fluid to decr. esophageal irritation/ulceration; may continue tx beyond 24mo in refractory cases
leprosy (Hansen disease), paucibacillary (off-label)
- [15 yo and older, patients who cannot take rifampin]
- Dose: 100 mg PO qd x24mo; Info: not 1st-line agent; part of multi-drug regimen; give with adequate fluid to decr. esophageal irritation/ulceration; may continue tx beyond 24mo in refractory cases
renal dosing
- [see below]
- renal impairment: decr. usual dose and/or frequency, amount not defined, max 200 mg/24h
- HD/PD: not defined
hepatic dosing
- [not defined]
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- hypersensitivity to tetracyclines
- pregnancy
- avoid: breastfeeding (>3wk tx duration)
- avoid: sun exposure
- avoid: UV light exposure, artificial
- caution: hypersensitivity to tartrazine (some generic forms)
- caution: patients of childbearing potential
- caution: male patients of reproductive potential
- caution: overweight patients of childbearing potential
- caution: patients of childbearing potential with intracranial HTN history
- caution: renal impairment
- caution: myocardial damage (IV use)
- caution: heart block (IV use)
- caution: SLE
- caution: antibiotic-associated colitis history, recent
- caution: botulism
Drug Interactions .
Overview
minocycline
tetracycline
- affected by altered gastrointestinal motility
- alters GI flora
- bacteriostatic agent
- binds to anion exchange resin/polymer
- binds to polyvalent cations
- impairs immunomodulatory bacterial infective agent
- photosensitivity
- potentiates neuromuscular blockade
- pseudotumor cerebri
Contraindicated
- acitretin
Avoid/Use Alternative
- aminolevulinic acid topical
- BCG live intravesical
- bremelanotide
- cholera vaccine, live
- fecal microbiota, live
- isotretinoin
- methotrexate
- palovarotene
- porfimer
- tretinoin topical
- typhoid vaccine, live
Monitor/Modify Tx
- aluminum hydroxide
- atracurium
- bismuth subsalicylate
- calcium acetate
- calcium carbonate
- calcium citrate
- calcium gluconate
- cholestyramine
- chromium
- ciprofloxacin
- cisatracurium
- colestipol
- cyclosporine
- cysteamine
- danazol
- delafloxacin
- exenatide
- ferric citrate
- ferric maltol
- ferrous fumarate
- ferrous gluconate
- ferrous sulfate
- goserelin
- histrelin
- lanthanum
- leuprolide
- levofloxacin
- lithium
- lixisenatide
- magnesium carbonate
- magnesium citrate
- magnesium hydroxide
- magnesium oxide
- magnesium supplement
- mecasermin
- molindone
- moxifloxacin
- nafarelin nasal
- ofloxacin
- pramlintide
- quinapril
- rocuronium
- somapacitan
- somatrogon
- somatropin
- succinylcholine
- sucralfate
- sucroferric oxyhydroxide
- sulfate bowel prep
- tretinoin
- triptorelin
- vecuronium
- warfarin
- zinc oral
Caution Advised
- amoxicillin
- ampicillin
- cefaclor
- cefadroxil
- cefazolin
- cefdinir
- cefepime
- cefiderocol
- cefixime
- cefotaxime
- cefotetan
- cefoxitin
- cefpodoxime
- cefprozil
- ceftaroline
- ceftazidime
- ceftobiprole
- ceftolozane
- ceftriaxone
- cefuroxime axetil
- cefuroxime sodium
- cephalexin
- dicloxacillin
- dihydroergotamine
- dulaglutide
- ergotamine
- lactulose
- liraglutide
- lomitapide
- methoxsalen
- methylergonovine
- nafcillin
- orforglipron
- oxacillin
- penicillin G
- penicillin V
- piperacillin
- pivmecillinam
- sodium picosulfate
- tirzepatide
- verteporfin
Adverse Reactions .
Serious Reactions
- pseudotumor cerebri
- hepatotoxicity
- photosensitivity
- autoimmune disorder
- lupus erythematosus
- vasculitis
- serum sickness-like reaction
- hypersensitivity reaction
- anaphylaxis
- angioedema
- skin reaction, severe
- erythema multiforme
- toxic epidermal necrolysis
- Stevens-Johnson syndrome
- drug reaction with eosinophilia and systemic symptoms
- acute febrile neutrophilic dermatosis
- thrombocytopenia
- neutropenia
- hemolytic anemia
- thyroid CA
- C. difficile-associated diarrhea
- pancreatitis
- esophagitis (PO use)
- esophageal ulcer (PO use)
Common Reactions
- fatigue
- dizziness
- pruritus
- malaise
- somnolence
- urticaria
- tinnitus
- BUN incr.
- tooth discoloration, reversible
- lightheadedness
- vertigo
- photosensitivity
- skin hyperpigmentation
- tissue hyperpigmentation
- injection site reaction (IV use)
Safety/Monitoring .
Monitoring Parameters
BUN/Cr at baseline, then periodically; CBC; LFTs; Mg if renal impairment with IV use
Look/Sound-Alike Drug Names
Minocin confused with: minoxidil
minocycline confused with: doxycycline
Pregnancy/Lactation .
Pregnancy
Clinical Summary
avoid use during pregnancy; inadequate human data available, though possible risk of spontaneous abortion; risk of permanent fetal teeth discoloration, abnormal bone development, and enamel hypoplasia based on human data with tetracycline class; possible risk of embryo-fetal toxicity based on conflicting animal data with tetracycline class
Individuals of Reproductive Potential
avoid pregnancy by using 2 forms of contraception during tx in patients of childbearing potential; avoid use in male patients trying to conceive
Lactation
Clinical Summary
avoid breastfeeding if >3wk tx duration, otherwise may use short-term while breastfeeding; no human data available, though no known risk of infant harm with short-term use based on limited human data with other tetracyclines; possible risk of milk discoloration based on limited human data; theoretical risk of permanent infant teeth discoloration and abnormal bone development with prolonged use based on drug's mechanism of action; inadequate human data available to assess effects on milk production
Pharmacology .
Metabolism: for minocycline: liver partially; CYP450: unknown
Excretion: for minocycline: urine, feces; Half-life: 11-23h
Subclass: Acne, Systemic Agents ; Leprosy (Hansen Disease) ; Tetracyclines
Mechanism of Action
for minocycline: exact mechanism of action in acne vulgaris unknown; binds to 30S and possibly 50S ribosomal subunit(s), inhibiting protein synthesis
Formulary .
No Formulary Selected
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