Minocycline (tetracycline, antibiotic agent)

Minocyclineis a tetracycline-type antibiotic that stops the growth of bacteria. It treats a wide variety of infections and diseases.

Minocycline is only effective against bacterial infections, not viral infections. All antibiotics are only available with a doctor’s prescription.

Uses

What is Minocycline used for?

• Acne
• Periodontitis
• Syphilis
• Gonorrhea
• Nongonococcal urethritis
• Mycobacterium marinum infections
• Asymptomatic meningococcal carriers

How should I take Minocycline?

For oral tablets or capsules, swallow the dose whole without chewing or crushing it. Take it with or without food. Do not eat or drink food that contains iron, calcium, or other similar minerals (e.g. milk, dairy products).

Parenteral (e.g. IV) dosage forms should be administered by licensed healthcare professionals.

How do I store Minocycline?

This product is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store it in the bathroom or the freezer. 

There may be different brands of this drug that may have different storage needs. So, it is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush this product down the toilet or pour them into a drain unless instructed to do so. Additionally, it is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Minocycline?

Before using this drug, tell your doctor if you are/have:

• Pregnant or breastfeeding.
• Receiving a live vaccine.
• Taking any other medicines. This includes any prescription, OTC, and herbal remedies.
• An allergy to any of the ingredients of this product.
• Any other illnesses, disorders, or medical conditions.

Is it safe during pregnancy or breastfeeding?

This drug is pregnancy risk category D according to the US Food and Drug Administration (FDA). There is evidence that tetracyclines, like minocycline, can affect the growth of fetuses and young children. Do not take this medication unless your doctor prescribes it.

FDA pregnancy risk category reference below:

Side effects

What side effects can occur from Minocycline?

Like all drugs, this product may have side effects. If they occur, side effects are generally mild and resolve once treatment is finished or the dose is lowered. Some reported side effects include:

• Allergic reaction
• Diarrhea
• Nausea, vomiting
• Abdominal pain
• Headache
• Tinnitus
• Jaundice
• Blood abnormalities
• Muscle or joint pain
• Vision disturbances
• Skin hyperpigmentation
• Photosensitivity

Seek medical attention if you experience these potentially fatal effects:

• Anaphylactic reactions
• Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN)
• Clostridium difficile-associated disease

However, not everyone experiences these side effects. In addition, some people may experience other side effects. So, if you have any concerns about a side effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Minocycline?

This medication may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. 

To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. 

Drugs with known interactions:

• Isotretinoin
• Oral contraceptives
• Anticoagulants
• Antacids or supplements that contain aluminum, calcium, magnesium, zinc, or iron
• Bismuth preparations
• Carbamazepine
• Phenobarbital
• Phenytoin
• Primidone
• Ciclosporin
• Penicillin
• Rifampicin
• Methoxyflurane

If you experience an adverse drug interaction, inform your doctor immediately to reevaluate your treatment plan. Approaches include dose adjustment, drug substitution, or ending therapy.

Does food or alcohol interact with Minocycline?

This drug may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Do not eat food that is rich in iron or calcium, as it can bind with minocycline and reduce its availability. Avoid drinking caffeine and alcohol as it can decrease its half-life. Also, avoid drinking caffeine.

Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Minocycline?

This drug may interact with underlying conditions. This interaction may worsen your health condition or alter the way the drug works. Therefore, it is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. Therefore, you should always consult with your doctor or pharmacist before using any medication.

What is the dose for an adult?

Susceptible Bacterial Infections

Intravenous

Initially, 200 mg followed by 100 mg twice a day. Max: 400 mg/day.

Oral

200 mg daily in divided doses.

Mycobacterium marinum infections

Take 100 mg twice a day for 6-8 weeks.

Asymptomatic meningococcal carriers

Take 100 mg 12 twice a day for 5 days, followed by a course of rifampicin.

Acne

Take 50 mg twice a day or 100 mg once daily.  ≥45 kg body weight: 1 mg/kg once daily as modified-release preparation.

Syphilis

Take 200 mg initially, followed by 100 mg twice a day for 10-15 days.

Nongonococcal urethritis

Take 100 mg twice a day for at least 7 days.

Uncomplicated gonorrhea

Initially, take 200 mg followed by 100 mg twice a day for a min of 4 days. Follow-up cultures should be done within 2-3 days after completing therapy.

Uncomplicated urethral gonorrhea (in men)

Take 100 mg twice a day for 5 days.

Periodontitis

As extended-release powder: 

Insert the unit-dose cartridge subgingivally into the base of periodontal pocket as an adjunct to scaling and root planing. Each cartridge contains 1 mg of minocycline. This should be done by a dental healthcare provider and is not meant for self administration.

What is the dose for a child?

Susceptible Bacterial Infections

Intravenously

For children older than 8 years, give 4 mg per kg of body weight, then 2 mg per kg every 12 hours (not to exceed the normal adult dose).

Not recommended for use in children under the age of 8 years. Tetracyclines may cause permanent damage to bones and discolor teeth.

How is Minocycline available?

Minocycline is available in the following dosage forms and strengths:

• Capsules: 50 mg, 75 mg, 100 mg
• Tablets: 50 mg, 75 mg, 100 mg
• IV solution: 100 mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to the nearest emergency room.

What should I do if I miss a dose?

If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.