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Minocycline information from DrugsUpdate  

See Available Brands of Minocycline in India

P - Contraindicated in pregnancy
L - Contraindicated in lactation
FI - Food *
LI - Lab *

Minocycline hydrochloride, also known as minocycline, is a broad spectrum tetracycline antibiotic, and has a broader spectrum than the other members of the group. It is a bacteriostatic antibiotic. As a result of its long half-life it generally has serum levels 2-4 times that of most other tetracyclines (150 mg giving 16 times the activity levels compared to 250 mg of tetracycline at 24–48 hours). Minocycline was originally discovered by Lederle Laboratories and marketed under the brand name Minocin.

Pharmacodynamics

Pharmacokinetics

Minocycline inhibits protein synthesis by binding to 30S and possibly 50S ribosomal subunits of susceptible bacteria. It is active against Streptococcus aureus, streptococci, Neisseria meningitidis, various enterobacteria, Acinetobacter, Bacteroides, Haemophilus and Nocardia spp, M. leprae and some mycobacteria.

Absorption
Absorbed readily from the GI tract (oral); absorption not significantly affected by food and milk.

Distribution
Protein-binding: 70-75%. Widely distributed in body tissues and fluids; high concentrations in hepatobiliary tract, lungs, sinuses, tonsils, tears, saliva, sputum. CSF (poor penetration). Crosses the placenta and enters breast milk.

Metabolism
Some hepatic metabolism; converted to 9-hydroxyminocycline.

Excretion
Via faeces (34%); via urine (5-10%). Elimination half-life: 11-26 hours; prolonged in renal impairment.

Minocycline Indications / Minocycline Uses

Information Not Available

Minocycline Adverse Reactions / Minocycline Side Effects

Oesophageal ulceration; vestibular disturbances e.g. dizziness or vertigo, tinnitus and decreased hearing; hyperpigmentation of the skin; SLE or lupus-like symptoms; GI disturbances; benign intracranial hypertension; abnormal LFTs, hyperbilirubinaemia or jaundice; teeth discolouration in children.

Potentially Fatal: Hypersensitivity syndrome. Hepatitis or liver damage. Pneumonitis.

Precautions

As with other antibiotic preparations, use of this drug may result in overgrowth of non-susceptible organisms, including fungi. If superinfection occurs, the antibiotic should be discontinued and appropriate therapy instituted.
 
Pseudotumor cerebri (benign intracranial hypertension) in adults has been associated with the use of tetracyclines. The usual clinical manifestations are headache and blurred vision. Bulging fontanels have been associated with the use of tetracyclines in infants. While both of these conditions and related symptoms usually resolve after discontinuation of the tetracycline, the possibility for permanent sequelae exists.
 
Hepatotoxicity has been reported with Minocycline; therefore, Minocycline should be used with caution in patients with hepatic dysfunction and in conjunction with other hepatotoxic drugs.
 
Incision and drainage or other surgical procedures should be performed in conjunction with antibiotic therapy when indicated.
 
Prescribing Minocycline hydrochloride capsules in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.

Overdosage
Symptoms: Diabetes insipidus, nausea, anorexia, dizziness, vomiting, diarrhoea. Management: Symptom-directed and supportive; not dialysable.

Special Precautions

May cause photosensitivity; discontinue at the 1st signs of erythema. May impair ability to drive or operate machinery. Monitor renal, hepatic and haematologic functions during therapy. Hepatic and renal impairment. Children ≤8 years. Oral forms should be taken with plenty of fluids with the patient in an upright position.

Other Drug Interactions

Oral absorption may be impaired by calcium-containing antacids and other divalent or trivalent cations. Decreases effectiveness of oral contraceptives. May increase plasma levels of lithium, theophylline. Pseudotumour cerebri may occur when used with isotretinoin. Additive facial pigmentation with ethinylestradiol.

Potentially Fatal: May increase effects of oral anticoagulants.

Other Interactions

Food Interaction
May cause additive photosensitivity reactions with St John's wort and dong quai.

Dosage

Oral
Susceptible infections
Adult: Initially, 200 mg followed by 100 mg every 12 hours. Alternatively, 100-200 mg initially, followed by 50 mg 4 times daily. Max: 400 mg/day.
Child: >8 years: Initially, 4 mg/kg followed by 2 mg/kg every 12 hours.
Renal impairment: Reduce dose or increase dosing interval. Max total daily dose: 200 mg.

Oral
Acne
Adult: 50 mg bid or 100 mg once daily. Alternatively, 1 mg/kg once daily as a modified-release preparation to patients weighing ≥45 kg.
Child: ≥12 years: 45-59 kg: 45 mg once daily; 60-90 kg: 90 mg once daily; 91-136 kg: 135 mg once daily. Continue treatment for 12 weeks.
Renal impairment: Reduce dose or increase dosing interval.

Oral
As part of multidrug therapy for multibacillary leprosy
Adult: Patients intolerant to rifampicin: Regimen includes clofazimine (50 mg daily), ofloxacin (400 mg daily), and minocycline (100 mg daily) for 6 mth, followed by a regimen of clofazimine (50 mg daily) and minocycline (100 mg daily) for at least an additional 18 months. Patients intolerant to clofazimine: Once-monthly multiple-drug regimen includes rifampicin (600 mg), ofloxacin (400 mg) and minocycline (100 mg) for 24 months.

Oral
Asymptomatic meningococcal carriers
Adult: 100 mg bid for 5 days followed by a course of rifampicin.
Renal impairment: Reduce dose or increase dosing interval. Max total daily dose: 200 mg.

Oral
As part of multidrug therapy for single-lesion paucibacillary leprosy
Adult: Regimen includes a single 600-mg dose of rifampicin, a single 400-mg dose of ofloxacin, and a single 100-mg dose of minocycline.
Child: 5-14 years: Regimen includes a single 300-mg dose of rifampicin, a single 200-mg dose of ofloxacin, and a single 50-mg dose of minocycline; <5 years: Appropriately adjust dose of each drug.

Oral
Nongonococcal urethritis
Adult: 100 mg every 12 hours for at least 7 days.
Renal impairment: Reduce dose or increase dosing interval. Max total daily dose: 200 mg.

Oral
Uncomplicated gonorrhoea
Adult: Initially, 200 mg, followed by 100 mg every 12 hours for a minute of 4 days; follow-up cultures should be done within 2-3 days after completion of therapy.
Renal impairment: Reduce dose or increase dosing interval. Max total daily dose: 200 mg.

Oral
Uncomplicated urethral gonorrhoea in men
Adult: 100 mg every 12 hr for 5 days.
Renal impairment: Reduce dose or increase dosing interval. Max total daily dose: 200 mg.

Oral

Mycobacterium marinum infections
Adult: 100 mg every 12 hours for 6-8 weeks. Cutaneous infection: 100 mg bid for at least 3 months; a min of 4-6 weeks of therapy is necessary to ascertain whether or not the infection is responding.
Renal impairment: Reduce dose or increase dosing interval. Max total daily dose: 200 mg.

Oral
Nocardiosis
Adult: 200 mg initially, followed by 100 mg every 12 hours in conjunction with a sulfonamide for 12-18 months.
Renal impairment: Reduce dose or increase dosing interval. Max total daily dose: 200 mg.

Oral
Rheumatoid arthritis
Adult: 100 mg bid.
Renal impairment: Reduce dose or increase dosing interval. Max total daily dose: 200 mg.

Oral
Syphilis
Adult: 200 mg initially, followed by 100 mg every 12 hours for 10-15 days.
Renal impairment: Reduce dose or increase dosing interval. Max total daily dose: 200 mg.

Oral
Cholera
Adult: Initially, 200 mg followed by 100 mg every 12 hours for 48-72 hours in conjunction with fluid and electrolyte replacement.
Renal impairment: Reduce dose or increase dosing interval. Max total daily dose: 200 mg.

Intravenous

Susceptible infections
Adult: Initially, 200 mg followed by 100 mg every 12 hours by slow IV infusion.
Renal impairment: Reduce dose or increase dosing interval. Max total daily dose: 200 mg.

Topical/Cutaneous
Periodontitis
Adult: As a modified-release subgingival gel: Insert into the periodontal pocket as an adjunct to scaling and root planing. Total number of cartridges to be used depends on the size, shape and number of pockets being treated.

Topical/Cutaneous

Periodontal infections
Adult: Apply 2% gel to affected area.

Intrapleural
As sclerosing agent to control pleural effusions associated with metastatic tumours
Adult: Dilute 300 mg in 40-50 ml of 0.9% sodium chloride injection and instil into the pleural space through a thoracostomy tube, followed by clamping of the tube and subsequent removal of the fluid.

Food(before/after)

Pellet-filled cap: Should be taken on an empty stomach. (Take w/ a full glass of water on an empty stomach at least 1 hr before or 2 hr after meals.)
May be taken with or without food. (May be taken w/ meals to reduce GI discomfort.)

List of Contraindications

Minocycline and Pregnancy

Contraindicated in pregnancy

Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

Minocycline and Lactation

Contraindicated in lactation

Minocycline and Children

Avoid in children younger than 8 years of age unless other appropriate drugs are ineffective or contraindicated because abnormal bone formation and discoloration of teeth may occur.

Minocycline and Geriatic

Information Not Available

Minocycline and Other Contraindications

Hypersensitivity to minocycline, other tetracyclines. Pregnancy and lactation.

Storage

Oral
Store at 20-25°C. Protect from light, moisture and excessive heat.

Lab interference

Oral
Store at 20-25°C. Protect from light, moisture and excessive heat.

Minocycline brands in India:

Cnn Cynomycin Divaine Minolox Minoz Minoz-OD Nidcyclin

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