Minocycline

By Medically reviewed by hellodoktor

Generic Name: Minocycline Brand Name(s): Generics only. No brands available.

Uses

What is Minocycline used for?

Minocycline is used to treat a wide variety of infections. It may also be used along with other medications to treat severe acne. This medication belongs to a class of drugs known as tetracycline antibiotics. It works by stopping the growth of bacteria.

This antibiotic treats only bacterial infections. It will not work for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.

How should I take Minocycline?

This medication is best taken on an empty stomach. Take this medication by mouth as directed by your doctor, usually every 12 hours, at least 1 hour before or 2 hours after a meal. Take this medication with a full glass of water (8 ounces/240 milliliters) unless your doctor directs you otherwise. If stomach upset occurs, taking it with food or milk may help. However, minocycline may not work as well if you take it with food or milk, so ask your doctor or pharmacist if you may take it that way. If you are taking the capsules, swallow them whole. Do not lie down for at least 10 minutes after taking this medication. For this reason, do not take it right before bedtime.

Take this medication 2 to 3 hours before or after taking any products containing aluminum, calcium, iron, magnesium, or zinc. Some examples include antacids, didanosine solution, quinapril, vitamins/minerals, dairy products (such as milk, yogurt), and calcium-enriched juice. These products bind with minocycline, preventing your body from fully absorbing the drug.

The dosage and length of treatment are based on your medical condition and response to treatment.

For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same times every day.

Continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.

Tell your doctor if your condition lasts or gets worse.

How do I store Minocycline?

Minocycline is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Minocycline in the bathroom or the freezer. There may be different brands of Minocycline that may have different storage needs. 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 Minocycline down the toilet or pour them into a drain unless instructed to do so. 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 taking minocycline, tell your doctor or pharmacist if you are allergic to it; or to other tetracyclines (such as doxycycline); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems, liver problems, trouble swallowing, esophagus problems (such as hiatal hernia or reflux/heartburn).

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.

Minocycline may cause live bacterial vaccines (such as typhoid vaccine) to not work as well. Do not have any immunizations/vaccinations while using this medication unless your doctor tells you to.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Children younger than 8 years may be more sensitive to the side effects of minocycline, especially tooth discoloration. Tooth discoloration has also occurred in older children and in young adults. Discuss the risks and benefits of this medication with the doctor.

Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using minocycline. Minocycline may harm an unborn baby. If you become pregnant, talk to your doctor right away about the risks and benefits of this medication.

This medication passes into breast milk in small amounts but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Minocycline during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Minocycline. Minocycline is pregnancy risk category D according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Minocycline?

Nausea, vomiting, diarrhea, lightheadedness, dizziness, or a feeling of spinning may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: painful/difficult swallowing, hearing changes (such as ringing in the ears, decreased hearing), joint stiffness/pain/swelling, signs of kidney problems (such as change in the amount of urine, pink urine), signs of liver problems (such as loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark urine), yellow-gray-brown tooth discoloration, blue-gray skin/tongue/lips/gums).

Minocycline may rarely cause a serious increase in pressure inside the skull (intracranial hypertension-IH). The risk of this side effect is greater for women of childbearing age who are overweight or who have had IH in the past. If IH develops, it usually goes away after minocycline is stopped; however, there is a chance of permanent vision loss or blindness. Get medical help right away if you have: severe/lasting headache, vision changes (such as blurred/double vision, decreased vision, sudden blindness), nausea/vomiting that doesn’t stop.

This medication may rarely cause a severe intestinal condition (Clostridium difficile-associated diarrhea) due to a type of resistant bacteria. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn’t stop, abdominal or stomach pain/cramping, blood/mucus in your stool.

Do not use anti-diarrhea products or narcotic pain medications if you have any of these symptoms because these products may make them worse.

Use of this medication for prolonged or repeated periods may result in oral thrush or a new yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever that doesn’t go away, new or worsening lymph node swelling, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Minocycline?

Some products that may interact with this drug are: retinoid medications taken by mouth (such as acitretin, isotretinoin), strontium.

Although most antibiotics are unlikely to affect hormonal birth control such as pills, patch, or ring, a few antibiotics (such as rifampin, rifabutin) can decrease their effectiveness. This could result in pregnancy. If you use hormonal birth control, ask your doctor or pharmacist for more details.

This medication may interfere with certain lab tests (such as urine catecholamine levels), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

Minocycline 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. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Minocycline?

Minocycline may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Minocycline?

Minocycline may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. 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. You should ALWAYS consult with your doctor or pharmacist before using this Minocycline.

What is the dose of Minocycline for an adult?

Usual Adult Dose for Bacterial Infection

IV: 200 mg IV initially followed by 100 mg IV every 12 hours

Maximum dose: 400 mg/24 hours

Oral:

Most infections: 200 mg orally initially followed by 100 mg orally every 12 hours

-Alternative regimen (if more frequent dosing preferred): 100 to 200 mg orally initially followed by 50 mg orally 4 times a day

Uncomplicated urethral, endocervical, or rectal infections due to Chlamydia trachomatis or Ureaplasma urealyticum: 100 mg orally every 12 hours for at least 7 days

Comments:

-With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).

-Coadministration with streptomycin recommended for brucellosis.

-For syphilis, the duration of therapy is 10 to 15 days; close follow-up (including laboratory tests) recommended.

Uses:

-For the treatment of the following infections: Rocky Mountain spotted fever, typhus fever, typhus group, Q fever, rickettsialpox, tick fevers due to rickettsiae; respiratory tract infections due to Mycoplasma pneumoniae; lymphogranuloma venereum, trachoma, or inclusion conjunctivitis due to C trachomatis; psittacosis (ornithosis) due to Chlamydophila psittaci; nongonococcal urethritis, endocervical, or rectal infections due to U urealyticum or C trachomatis; relapsing fever due to Borrelia recurrentis; plague due to Yersinia pestis; tularemia due to Francisella tularensis; cholera due to Vibrio cholerae; Campylobacter fetus infections; brucellosis due to Brucella species; bartonellosis due to Bartonella bacilliformis; granuloma inguinale due to Klebsiella granulomatis

-For the treatment of infections due to the following bacteria when bacteriologic testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to Haemophilus influenzae; respiratory tract and urinary tract infections due to Klebsiella species; upper respiratory tract infections due to Streptococcus pneumoniae

-When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Syphilis due to Treponema pallidum subspecies pallidum; yaws due to T pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; anthrax due to Bacillus anthracis; Vincent’s infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; clostridial infections

-As adjunctive therapy for: Acute intestinal amebiasis; severe acne

Usual Adult Dose for Acne

Extended-release formulations:

45 to 49 kg: 45 mg orally once a day

50 to 59 kg: 55 mg orally once a day

60 to 71 kg: 65 mg orally once a day

72 to 84 kg: 80 mg orally once a day

85 to 96 kg: 90 mg orally once a day

97 to 110 kg: 105 mg orally once a day

111 to 125 kg: 115 mg orally once a day

126 to 136 kg: 135 mg orally once a day

Duration of therapy: 12 weeks

Comments:

-Recommended dose is about 1 mg/kg once a day.

-This drug did not show any effect on non-inflammatory acne lesions.

-Safety not established beyond 12 weeks.

Use: To treat only inflammatory lesions of non-nodular moderate to severe acne vulgaris

American Academy of Dermatology (AAD) Recommendations:

Immediate-release formulations: 50 mg orally once to 3 times a day

Comments:

-Recommended as adjunctive treatment of moderate to severe inflammatory acne

-This drug should not be used as monotherapy.

-Use should be limited to the shortest duration possible; reevaluation recommended at 3 to 4 months to minimize resistant bacteria developing.

-Current guidelines should be consulted for additional information.

Usual Adult Dose for Meningitis – Meningococcal

200 mg IV initially followed by 100 mg IV every 12 hours

Maximum dose: 400 mg/24 hours

Use: When penicillin is contraindicated, as an alternative agent for the treatment of meningitis due to Neisseria meningitidis

Usual Adult Dose for Meningococcal Meningitis Prophylaxis

100 mg orally every 12 hours for 5 days

Comments:

-Diagnostic laboratory studies (including serotyping and susceptibility testing) are recommended to establish the carrier state and the appropriate therapy.

-Prophylactic use of this drug is only recommended when risk of meningococcal meningitis is high.

Use: In the treatment of asymptomatic carriers of N meningitidis to eliminate meningococci from the nasopharynx

Usual Adult Dose for Skin or Soft Tissue Infection

IV: 200 mg IV initially followed by 100 mg IV every 12 hours

Maximum dose: 400 mg/24 hours

Oral:

Infection due to Staphylococcus aureus: 200 mg orally initially followed by 100 mg orally every 12 hours

-Alternative regimen (if more frequent dosing preferred): 100 to 200 mg orally initially followed by 50 mg orally 4 times a day

Infection due to Mycobacterium marinum: 100 mg orally every 12 hours for 6 to 8 weeks

Comments:

-Not the drug of choice for any type of staphylococcal infection

-The optimal dose has not been established to treat M marinum infections; the recommended dose has been successful in limited cases.

Uses: For the treatment of skin and skin structure infections due to S aureus when bacteriologic testing shows suitable susceptibility to this drug; for the treatment of infections due to M marinum

Infectious Diseases Society of America (IDSA) Recommendations: 100 mg orally twice a day

Comments:

-Recommended for skin and soft tissue infections due to methicillin-susceptible and methicillin-resistant S aureus

-After an initial dose of 200 mg, recommended for purulent cellulitis (cellulitis associated with purulent drainage/exudate without a drainable abscess) due to methicillin-resistant S aureus

-Current guidelines should be consulted for additional information.

Usual Adult Dose for Skin and Structure Infection

IV: 200 mg IV initially followed by 100 mg IV every 12 hours

Maximum dose: 400 mg/24 hours

Oral:

Infection due to Staphylococcus aureus: 200 mg orally initially followed by 100 mg orally every 12 hours

-Alternative regimen (if more frequent dosing preferred): 100 to 200 mg orally initially followed by 50 mg orally 4 times a day

Infection due to Mycobacterium marinum: 100 mg orally every 12 hours for 6 to 8 weeks

Comments:

-Not the drug of choice for any type of staphylococcal infection

-The optimal dose has not been established to treat M marinum infections; the recommended dose has been successful in limited cases.

Uses: For the treatment of skin and skin structure infections due to S aureus when bacteriologic testing shows suitable susceptibility to this drug; for the treatment of infections due to M marinum

Infectious Diseases Society of America (IDSA) Recommendations: 100 mg orally twice a day

Comments:

-Recommended for skin and soft tissue infections due to methicillin-susceptible and methicillin-resistant S aureus

-After an initial dose of 200 mg, recommended for purulent cellulitis (cellulitis associated with purulent drainage/exudate without a drainable abscess) due to methicillin-resistant S aureus

-Current guidelines should be consulted for additional information.

Usual Adult Dose for Chancroid

200 mg orally initially followed by 100 mg orally every 12 hours

-Alternative regimen (if more frequent dosing preferred): 100 to 200 mg orally initially followed by 50 mg orally 4 times a day

Use: For the treatment of chancroid due to H ducreyi

Usual Adult Dose for Gonococcal Infection – Uncomplicated

Urethritis in men: 100 mg orally every 12 hours for 5 days

Infections other than urethritis and anorectal infections in men: 200 mg orally initially followed by 100 mg orally every 12 hours for at least 4 days

Comments:

-For infections other than urethritis and anorectal infections in men, posttherapy cultures are recommended within 2 to 3 days.

Uses: When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Uncomplicated urethritis in men due to N gonorrhoeae and other gonococcal infections; infection in women due to N gonorrhoeae

Renal Dose Adjustments

Immediate-release formulations:

-CrCl less than 80 mL/min: Dose adjustments may be required; however, no specific guidelines have been suggested.

Maximum dose: 200 mg/24 hours

Extended-release formulations:

-Renal dysfunction: Dose reductions and/or extended dosing intervals are recommended; however, no specific guidelines have been suggested.

Liver Dose Adjustments

Liver dysfunction: Caution recommended.

Other Comments

Administration advice:

-IV: Infuse over 60 minutes; avoid rapid administration.

-IV: If the same IV line is used for sequential infusion of other drugs, flush the line with a compatible infusion solution before and after infusion of this drug.

-Only use parenteral therapy when oral therapy is not adequate/tolerated; start oral therapy as soon as possible.

-Oral: May administer without regard to food

-Oral: Administer immediate-release formulations with adequate amounts of fluids to reduce risk of esophageal irritation and ulceration; for extended-release formulations, this risk may be reduced when administered with food.

-Oral: Swallow capsules or tablets whole; do not chew, crush, or split.

-Since decomposed tetracyclines may cause potentially fatal nephrotoxicity (Fanconi’s syndrome), discard outdated or decomposed medications.

Storage requirements:

-IV injection: Prior to reconstitution, store at 20C to 25C (68F to 77F); after dilution, may store at room temperature up to 4 hours or refrigerated at 2C to 8C (36F to 46F) up to 24 hours

-Oral formulations: Store at 20C to 25C (68F to 77F); protect from light, moisture, and excessive heat.

Reconstitution/preparation techniques:

-IV: The manufacturer product information should be consulted.

IV compatibility:

-Compatible solutions: Sterile Water for Injection USP; Sodium Chloride Injection USP; Dextrose Injection USP; Dextrose and Sodium Chloride Injection USP; Lactated Ringers Injection USP

-Incompatible: Other solutions containing calcium (especially neutral and alkaline solutions); additives or other medications

General:

-This drug is for the treatment of infections due to susceptible isolates of the designated bacteria.

-Extended-release formulations have not been evaluated for the treatment of infections.

-The usual dose and dosing frequency of this drug are different from other tetracyclines; side effects may occur more often if recommended dose exceeded.

-Thrombophlebitis may occur if IV therapy prolonged.

-Incision and drainage or other surgical procedures may be indicated in addition to antibiotic therapy.

Monitoring:

-General: Organ systems (periodically); serum magnesium levels in patients with renal dysfunction using IV injection

-Hematologic: Hematopoietic studies (periodically)

-Hepatic: Hepatic studies (periodically)

-Renal: Renal studies (periodically); BUN and creatinine in patients with renal dysfunction

Patient advice:

-Read the US FDA-approved patient labeling (Patient Information).

-Drink plenty of fluids.

-Avoid missing doses and complete the entire course of therapy.

-Lightheadedness, dizziness, and vertigo reported; do not drive or operate machinery if these symptoms develop.

-Avoid or minimize exposure to natural or artificial sunlight; use sun protection (e.g., protective clothing, sunscreen) if sun exposure cannot be avoided. Stop therapy at first sign of skin erythema.

-Consult physician at once if watery and bloody stools (with or without stomach cramps and fever) develop.

-Do not use this drug if it is outdated or decomposed; discard this drug by the expiration date.

What is the dose of Minocycline for a child?

Usual Pediatric Dose for Bacterial Infection

Older than 8 years: 4 mg/kg orally or IV initially followed by 2 mg/kg orally or IV every 12 hours

Maximum dose: 200 mg/dose initially followed by 200 mg/day

Comments:

-With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).

-Coadministration with streptomycin recommended for brucellosis.

-For syphilis, the duration of therapy is 10 to 15 days; close follow-up (including laboratory tests) recommended.

Uses:

-For the treatment of the following infections: Rocky Mountain spotted fever, typhus fever, typhus group, Q fever, rickettsialpox, tick fevers due to rickettsiae; respiratory tract infections due to M pneumoniae; lymphogranuloma venereum, trachoma, or inclusion conjunctivitis due to C trachomatis; psittacosis (ornithosis) due to C psittaci; relapsing fever due to B recurrentis; plague due to Y pestis; tularemia due to F tularensis; cholera due to V cholerae; C fetus infections; brucellosis due to Brucella species; bartonellosis due to B bacilliformis; granuloma inguinale due to K granulomatis

-For the treatment of infections due to the following bacteria when bacteriologic testing shows suitable susceptibility to this drug: E coli; E aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae; respiratory tract and urinary tract infections due to Klebsiella species; upper respiratory tract infections due to S pneumoniae

-When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Syphilis due to T pallidum subspecies pallidum; yaws due to T pallidum subspecies pertenue; listeriosis due to L monocytogenes; anthrax due to B anthracis; Vincent’s infection due to F fusiforme; actinomycosis due to A israelii; clostridial infections

-As adjunctive therapy for: Acute intestinal amebiasis; severe acne

American Academy of Pediatrics Recommendations: 2 mg/kg orally or IV twice a day

Maximum dose: 200 mg/day

Comments:

-Routine use only recommended for children 8 years or older.

-Recommended for mild, moderate, or severe infections

-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Acne

12 years or older:

Extended-release formulations:

45 to 49 kg: 45 mg orally once a day

50 to 59 kg: 55 mg orally once a day

60 to 71 kg: 65 mg orally once a day

72 to 84 kg: 80 mg orally once a day

85 to 96 kg: 90 mg orally once a day

97 to 110 kg: 105 mg orally once a day

111 to 125 kg: 115 mg orally once a day

126 to 136 kg: 135 mg orally once a day

Duration of therapy: 12 weeks

Comments:

-Recommended dose is about 1 mg/kg once a day.

-This drug did not show any effect on non-inflammatory acne lesions.

-Safety not established beyond 12 weeks.

Use: To treat only inflammatory lesions of non-nodular moderate to severe acne vulgaris

AAD Recommendations:

Immediate-release formulations:

-Children older than 8 years: 4 mg/kg orally initially followed by 2 mg/kg orally every 12 hours

Comments:

-Recommended as adjunctive treatment of moderate to severe inflammatory acne

-This drug should not be used as monotherapy.

-Use should be limited to the shortest duration possible; reevaluation recommended at 3 to 4 months to minimize resistant bacteria developing.

-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Skin or Soft Tissue Infection

Older than 8 years: 4 mg/kg orally or IV initially followed by 2 mg/kg orally or IV every 12 hours

Maximum dose: 200 mg/dose initially followed by 200 mg/day

Comments:

-Not the drug of choice for any type of staphylococcal infection

Use: For the treatment of skin and skin structure infections due to S aureus when bacteriologic testing shows suitable susceptibility to this drug

IDSA Recommendations: 4 mg/kg orally initially followed by 2 mg/kg orally every 12 hours

Maximum dose: 200 mg/dose initially followed by 200 mg/day

Comments:

-Recommended for purulent cellulitis (cellulitis associated with purulent drainage/exudate without a drainable abscess) due to methicillin-resistant S aureus

-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Skin and Structure Infection

Older than 8 years: 4 mg/kg orally or IV initially followed by 2 mg/kg orally or IV every 12 hours

Maximum dose: 200 mg/dose initially followed by 200 mg/day

Comments:

-Not the drug of choice for any type of staphylococcal infection

Use: For the treatment of skin and skin structure infections due to S aureus when bacteriologic testing shows suitable susceptibility to this drug

IDSA Recommendations: 4 mg/kg orally initially followed by 2 mg/kg orally every 12 hours

Maximum dose: 200 mg/dose initially followed by 200 mg/day

Comments:

-Recommended for purulent cellulitis (cellulitis associated with purulent drainage/exudate without a drainable abscess) due to methicillin-resistant S aureus

-Current guidelines should be consulted for additional information.

Precautions

This drug is not recommended for use in patients younger than 8 years unless the expected benefits outweigh the risks.

-Extended-release: Safety and efficacy have not been established in patients younger than 12 years.

How is Minocycline available?

Minocycline is available in the following dosage forms and strengths:

  • Oral suspension,
  • Oral capsule,
  • Oral tablet,
  • Oral tablet, extended release,
  • Intravenous powder for injection,
  • Oral capsule, extended release,
  • Oral and topical kit.

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 your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Minocycline, 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.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: March 29, 2018 | Last Modified: September 12, 2019

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