1. health and fitness
2. disease

46067
AHFS Essentials
ASHPI
BATCH
RIGHT
Minocycline (Systemic)
Minocycline (Systemic)
Antibacterial; semisynthetic tetracycline antibiotic.
Class: Tetracyclines 8:12.24 (AHFS primary); AM250 (VA primary)
Brands*: Dynacin; Minocin; Myrac
*also available generically
21
sider that anti-infectives may not eliminate C. trachomatis in all cases of chronic
trachoma.
Treatment of lymphogranuloma venereum (genital, inguinal, or anorectal infections)
caused by C. trachomatis. Doxycycline is the preferred tetracycline for these infections.
Treatment of psittacosis (ornithosis) caused by C. psittaci. Doxycycline and tetracycline are drugs of choice. For initial treatment of severely ill patients, use IV
doxycycline.
top of rh
base of rh
cap height
base of text
Clostridium Infections
Alternative for treatment of infections caused by Clostridium. Tetracyclines are alternatives to metronidazole or penicillin G for adjunctive treatment of C. tetani infections.
Uses
Respiratory Tract Infections
Treatment of respiratory tract infections caused by Mycoplasma pneumoniae.
Treatment of respiratory tract infections caused by Haemophilus influenzae, Streptococcus pneumoniae, or Klebsiella. Should only be used for treatment of infections caused by these bacteria when in vitro susceptibility tests indicate the organism is susceptible.
Acinetobacter Infections
Alternative to imipenem or meropenem for treatment of infections caused by Acinetobacter.
Acne
Adjunctive treatment of moderate to severe inflammatory acne. Not indicated for
Enterobacteriaceae Infections
Treatment of infections caused by susceptible Escherichia coli, Enterobacter aerogenes, Klebsiella, or Shigella. Should only be used for treatment of infections
caused by these common gram-negative bacteria when other appropriate anti-infectives are contraindicated or ineffective and when in vitro susceptibility tests
indicate the organism is susceptible.
Fusobacterium Infections
Alternative to penicillin G for treatment of infections caused by Fusobacterium fusiforme (Vincent’s infection).
Gonorrhea and Associated Infections
Alternative for treatment of uncomplicated gonorrhea (including urethritis) caused
by susceptible Neisseria gonorrhoeae. Tetracyclines are considered inadequate
therapy and are not recommended by CDC for treatment of gonorrhea.
treatment of noninflammatory acne.
Actinomycosis
Treatment of actinomycosis caused by Actinomyces israelii; oral tetracyclines
used as follow-up after initial parenteral penicillin G.
Amebiasis
Adjunct to amebicides for treatment of acute intestinal amebiasis. Tetracyclines
generally not recommended for treatment of amebiasis caused by Entamoeba.
Anthrax
Alternative to doxycycline for postexposure prophylaxis to reduce the incidence or
progression of disease following a suspected or confirmed exposure to aerosolized
Bacillus anthracis spores (inhalational anthrax). Initial drug of choice for such prophylaxis is ciprofloxacin or doxycycline; doxycycline is the preferred tetracycline
because of ease of administration and proven efficacy in monkey studies.
Alternative to doxycycline for treatment of inhalational anthrax when a parenteral
regimen is not available (e.g., supply or logistic problems because large numbers
of individuals require treatment in a mass casualty setting). A multiple-drug parenteral regimen (ciprofloxacin or doxycycline and 1 or 2 other anti-infectives predicted to be effective) is preferred for treatment of inhalational anthrax that occurs
as the result of exposure to anthrax spores in the context of biologic warfare or
bioterrorism.
Bartonella Infections
Treatment of infections caused by Bartonella bacilliformis.
Brucellosis
Treatment of brucellosis; tetracyclines considered drugs of choice. Used in conjunction with other anti-infectives (e.g., streptomycin or gentamicin and/or rifampin), especially for severe infections or when there are complications (e.g., endocarditis, meningitis, osteomyelitis).
Campylobacter Infections
Treatment of infections caused by Campylobacter. Tetracyclines are alternatives,
not drugs of choice.
Chancroid
Treatment of chancroid caused by Haemophilus ducreyi. Not included in CDC recommendations for treatment of chancroid.
Chlamydial Infections
Treatment of uncomplicated urethral, endocervical, or rectal infections caused by
Chlamydia trachomatis. Doxycycline is the preferred tetracycline for treatment of
these infections, including presumptive treatment of chlamydial infections in patients with gonorrhea.
Treatment of trachoma and inclusion conjunctivitis caused by C. trachomatis. Con-
Granuloma Inguinale (Donovanosis)
Treatment of granuloma inguinale (donovanosis) caused by Calymmatobacterium
granulomatis. Doxycycline is the tetracycline recommended as drug of choice by
CDC.
Listeria Infections
Alternative for treatment of listeriosis caused by Listeria monocytogenes. Not usually considered a drug of choice or alternative for these infections.
Malaria
Other tetracyclines (doxycycline) used for prevention of malaria, but efficacy of
minocycline not fully determined. CDC recommends that individuals receiving longterm minocycline therapy (e.g., for acne) who also require doxycycline malaria
prophylaxis should discontinue minocycline 1– 2 days prior to travel and initiate
doxycycline for such prophylaxis; minocycline can be reinitiated after doxycycline
malaria prophylaxis is finished.
Mycobacterial Infections
Alternative for use in multiple-drug regimens for treatment of multibacillary leprosy†. WHO recommends minocycline as an alternative for multibacillary leprosy
regimens in patients who will not accept or cannot tolerate clofazimine and when
rifampin cannot be used because of adverse effects, intercurrent disease (e.g.,
chronic hepatitis), or infection with rifampin-resistant Mycobacterium leprae.
Component of a single-dose rifampin-based multiple-drug regimen (ROM) for treatment of single-lesion paucibacillary leprosy† (i.e., a single skin lesion with definite
loss of sensation but without nerve trunk involvement). A ROM regimen of a single dose of rifampin, single dose of ofloxacin, and single dose of minocycline is
recommended by WHO as an acceptable and cost-effective alternative regimen in
antileprosy programs that have detected a large number of patients (e.g., more
than 1000 annually) with single-lesion paucibacillary leprosy.
Treatment of cutaneous infections caused by M. marinum; a drug of choice.
Neisseria meningitidis Infections
Elimination of nasopharyngeal carriage of Neisseria meningitidis. CDC and AAP
recommend use of rifampin, ceftriaxone, or ciprofloxacin for such carriers and no
longer recommend use of minocycline.
Should not be used for treatment of infections caused by N. meningitidis.
Nocardiosis
Alternative to co-trimoxazole for treatment of nocardiosis† caused by Nocardia.
Nongonococcal Urethritis
Treatment of nongonococcal urethritis (NGU) caused by Ureaplasma urealyticum,
C. trachomatis, or Mycoplasma. Doxycycline usually is the tetracycline of choice
for NGU.
short
stand
46067
AHFS Essentials
22
ASHPI
BATCH
LEFT
top of rh
base of rh
Minocycline (Systemic)
Consider that some cases of recurrent urethritis following treatment may be
caused by tetracycline-resistant U. urealyticum.
Plague
Treatment of plague caused by Yersinia pestis. Regimen of choice is streptomycin
or gentamicin (with or without doxycycline).
Relapsing Fever
Treatment of relapsing fever caused by Borrelia recurrentis. Tetracyclines are
drugs of choice.
Pediatric Patients
General Pediatric Dosage
Oral or IV: Children ⬎8 years of age: 4 mg/kg initially followed by 2 mg/
kg every 12 hours.
Mycobacterial Infections
⬎Leprosy†
Oral: Children 5– 14 years of age: for treatment of single-lesion paucibacillary leprosy† in certain patient groups, WHO recommends a single-dose
ROM regimen that includes a single 300-mg dose of rifampin, a single
200-mg dose of ofloxacin, and a single 50-mg dose of minocycline.
Children ⬍5 years of age: WHO recommends that an appropriately adjusted dose of each drug in the single-dose ROM regimen be used.
Rheumatoid Arthritis
Treatment of rheumatoid arthritis†. One of several disease-modifying antirheumatic
drugs (DMARDs) that can be used when DMARD therapy is appropriate.
Rickettsial Infections
Treatment of rickettsial infections including Rocky Mountain spotted fever, typhus
fever and the typhus group, Q fever, rickettsialpox, and tick fevers caused by
Rickettsiae. Tetracyclines are drugs of choice for treatment of most rickettsial infections; doxycycline usually is the preferred tetracycline.
cap height
base of text
Adults
General Adult Dosage
Oral or IV: 200 mg initially followed by 100 mg every 12 hours.
Alternatively, if more frequent doses are preferred, 100– 200 mg initially
followed by 50 mg 4 times daily.
Acne
Oral: 50 mg 1– 3 times daily.
Syphilis
Alternative to penicillin G for treatment of primary, secondary, latent, or tertiary
syphilis (not neurosyphilis) in nonpregnant adults and adolescents hypersensitive
to penicillins. Doxycycline and tetracycline are the preferred tetracyclines in patients hypersensitive to penicillins. Use tetracyclines only if compliance and follow-up can be ensured since efficacy not well documented.
Tularemia
Treatment of tularemia caused by Francisella tularensis. Tetracyclines considered
alternatives to streptomycin (or gentamicin); risk of relapse and primary treatment
failure may be higher than with aminoglycosides.
Vibrio Infections
Treatment of cholera caused by Vibrio cholerae. Doxycycline and tetracycline are
drugs of choice; used as an adjunct to fluid and electrolyte replacement in moderate to severe disease.
Yaws
Alternative to penicillin G for treatment of yaws caused by Treponema pertenue.
Dosage and Administration
Administration
Administer orally or by slow IV infusion.
IV route recommended only when oral therapy is not indicated or feasible; oral
should replace IV as soon as possible. Risk of thrombophlebitis should be considered
when minocycline is given IV.
Oral Administration
Tablets and pellet-filled capsules should be administered at least 1 hour before or
2 hours after meals. Capsules may be administered with or without food.
Administer capsules, pellet-filled capsules, and tablets with adequate amounts of
fluid to reduce the risk of esophageal irritation and ulceration.
The pellet-filled capsules should be swallowed whole.
IV Infusion
For solution and drug compatibility information, see Compatibility under Stability.
Reconstitution
Reconstitute vial containing 100 mg with 5 mL of sterile water for injection to
provide a solution containing 20 mg/mL.
Dilution
Each 100 mg of reconstituted minocycline solution must be further diluted prior to
administration with 500 mL to 1 L of compatible IV solution (see Compatibility under
Stability) to provide solutions containing 100– 200 mcg/mL. These diluted IV solutions
should be administered immediately after preparation.
Rate of Administration
Usually infused IV over 6 hours.
Dosage
Available as minocycline hydrochloride; dosage expressed in terms of minocycline.
Chlamydial Infections
⬎Uncomplicated Urethral, Endocervical, or Rectal Infections
Oral: 100 mg every 12 hours given for ⱖ7 days.
Gonorrhea and Associated Infections
⬎Uncomplicated Gonorrhea (except Urethritis or Anorectal in Men)
Oral: 200 mg initially followed by 100 mg every 12 hours given for ⱖ 4
days; follow-up cultures should be done within 2– 3 days after completion
of therapy.
No longer recommended for gonorrhea by CDC or other experts.
⬎Gonococcal Urethritis in Men
Oral: 100 mg every 12 hours given for 5 days.
No longer recommended for gonorrhea by CDC or other experts.
Mycobacterial Infections
⬎Leprosy†
Oral: For treatment of multibacillary leprosy† in those who cannot receive
rifampin because of adverse effects, intercurrent disease (e.g., chronic
hepatitis), or infection with rifampin-resistant M. leprae, WHO recommends supervised administration of a regimen of clofazimine (50 mg
daily), ofloxacin (400 mg daily), and minocycline (100 mg daily) given for
6 months, followed by a regimen of clofazimine (50 mg daily) and minocycline (100 mg daily) given for at least an additional 18 months.
For treatment of multibacillary leprosy in adults who will not accept or
cannot tolerate clofazimine, WHO recommends supervised administration
of a once-monthly ROM regimen that includes rifampin (600 mg once
monthly), ofloxacin (400 mg once monthly), and minocycline (100 mg
once monthly) given for 24 months.
For treatment of single-lesion paucibacillary leprosy† in certain patient
groups, WHO recommends a single-dose ROM regimen that includes a
single 600-mg dose of rifampin, a single 400-mg dose of ofloxacin, and a
single 100-mg dose of minocycline.
⬎Mycobacterium marinum Infections
Oral: Manufacturers state optimum dosage has not been established, but
100 mg every 12 hours for 6– 8 weeks has been effective.
100 mg twice daily for ⱖ3 months recommended by ATS for treatment of
cutaneous infections. A minimum of 4– 6 weeks of treatment usually is
necessary to determine whether the infection is responding.
Neisseria meningitidis Infections
⬎N. meningitidis Carriers
Oral: 100 mg every 12 hours given for 5 days.
Nocardiosis†
Oral: 200 mg initially followed by 100 mg every 12 hours given for 12– 18
months.
Nongonoccocal Urethritis
Oral: 100 mg every 12 hours given for ⱖ 7 days.
Rheumatoid Arthritis†
Oral: 100 mg twice daily. A benefit may be evident within 1– 3 months.
Syphilis
Oral: 200 mg initially followed by 100 mg every 12 hours given for 10– 15
days. Close follow-up and laboratory tests are recommended.
short
stand
46067
AHFS Essentials
ASHPI
BATCH
RIGHT
Minocycline (Systemic)
Vibrio Infections
⬎Cholera
Oral: 200 mg initially followed by 100 mg every 12 hours given for 2– 3
days.
Prescribing Limits
Pediatric Patients
Oral or IV: Do not exceed usual adult dosage.
Adults
IV: Maximum 400 mg daily.
Special Populations
Renal Impairment
Adjust dosage by decreasing doses or increasing dosing interval. Dosage
should not exceed 200 mg daily in patients with impaired renal function.
Cautions
Contraindications
•
Known hypersensitivity to minocycline, any tetracycline, or any component in the
preparation.
Warnings/Precautions
Warnings
Dental and Bone Effects
Use during tooth development (e.g., pregnancy, children ⬍8 years of age) may
cause permanent yellow-gray to brown discoloration of teeth and enamel hypoplasia.
Effects are most common following long-term use, but may occur following repeated
short-term use.
Tetracyclines form a stable calcium complex in any bone-forming tissue. Reversible decrease in fibula growth rate has occurred in prematures receiving tetracycline.
Use not recommended in children ⬍8 years of age unless other appropriate drugs
are ineffective or are contraindicated or unless the benefits in certain indications (e.g.,
anthrax) outweigh the risks. (See Pediatric Use under Cautions.)
Fetal/Neonatal Morbidity
Animal studies indicate possible fetal toxicity (e.g., retardation of skeletal development) and embryotoxicity. If used during pregnancy or if patient becomes pregnant
while receiving minocycline, patient should be apprised of the potential hazard to the
fetus. (See Pregnancy under Cautions.)
Nervous System Effects
Possiblility of adverse CNS effects (light-headedness, dizziness, vertigo) that may
impair ability to drive vehicles or operate hazardous machinery. Vestibular reactions
occur more frequently with minocycline than with other tetracyclines. Symptoms may
disappear during therapy and usually rapidly disappear when the drug is discontinued.
Benign intracranial hypertension (pseudotumor cerebri) in adults reported with tetracyclines; usually manifested as headache and blurred vision. Bulging fontanels reported in infants. Effects usually resolve when drug discontinued, but possibility for
permanent sequelae exists.
Renal Effects
Tetracyclines have antianabolic effects and may increase BUN.
In patients with impaired renal function, high serum minocycline concentrations
may result in azotemia, hyperphosphatemia, and acidosis. Excessive drug accumulation and possible liver toxicity may occur if usual dosage is used in patients with
renal impairment. (See Renal Impairment under Dosage and Administration.)
Laboratory Monitoring
Periodically assess organ system function, including renal, hepatic and hematopoietic, during long-term therapy.
Sensitivity Reactions
Photosensitivity Reactions
Photosensitivity, manifested by an exaggerated sunburn reaction, reported with
tetracyclines.
Photosensitivity reactions may develop within a few minutes to several hours after sun exposure and usually persist 1– 2 days after discontinuance of the drug. Most
reactions result from accumulation of tetracyclines in skin and are phototoxic in nature; photoallergic reactions may also occur.
Discontinue drug at first evidence of skin erythema.
Hypersensitivity Reactions
Urticaria, angioneurotic edema, polyarthralgia, anaphylaxis, anaphylactoid purpura,
pericarditis, exacerbation of systemic lupus erythematosus and, rarely, pulmonary infiltrates with eosinophilia have been reported. A transient lupus-like syndrome and serum sickness-like reaction also have been reported.
23
top of rh
base of rh
cap height
base of text
General Precautions
Hepatotoxicity
Hepatotoxicity has been reported. Use with caution in patients with hepatic dysfunction and in those receiving other hepatotoxic drug.
Superinfection
Possible emergence and overgrowth of nonsusceptible bacteria or fungi. Discontinue drug and institute appropriate therapy if superinfection occurs.
Selection and Use of Anti-infectives
To reduce development of drug-resistant bacteria and maintain effectiveness of
minocycline and other antibacterials, use only for treatment or prevention of infections
proven or strongly suspected to be caused by susceptible bacteria.
When selecting or modifying anti-infective therapy, use results of culture and in
vitro susceptibility testing. In the absence of such data, consider local epidemiology
and susceptibility patterns when selecting anti-infectives for empiric therapy.
Because many strains of Acinetobacter, Bacteroides, Enterobacter, E. coli, Klebsiella, Shigella, S. pyogenes (group A ␤-hemolytic streptococci), S. pneumoniae, enterococci, and ␣-hemolytic streptococci are resistant to tetracyclines (including minocycline), in vitro susceptibility tests should be performed if the drug is used for
treatment of infections caused by these bacteria.
Incision and drainage or other surgical procedures should be performed in conjunction with minocycline therapy when indicated.
Specific Populations
Pregnancy
Category D. (See Fetal/Neonatal Morbidity under Cautions.)
Should not be used in pregnant women unless, in the judgment of the clinician, it
is essential for the welfare of the patient and benefits outweigh the risks. CDC and
others state tetracyclines can be used when necessary for treatment of inhalational
anthrax in pregnant women. Since adverse effects on developing teeth and bones are
dose-related, CDC suggests the tetracyclines might be used for a short period (7– 14
days) before 6 months of gestation; some clinicians recommend periodic liver function
testing if used in pregnant women.
Lactation
Distributed into milk; discontinue nursing or the drug.
AAP states maternal use of tetracyclines usually is compatible with breast-feeding
since absorption of the drugs by nursing infants is negligible.
Pediatric Use
Should not be used in children ⬍8 years of age unless benefits outweigh the
risks. (See Dental and Bone Effects under Cautions.)
Geriatric Use
Insufficient experience in those ⱖ65 years of age to determine whether they respond differently than younger adults.
Select dosage with caution because of age-related decreases in hepatic, renal,
and/or cardiac function and concomitant disease and drug therapy; generally initiate
therapy using the low end of the dosing range.
Hepatic Impairment
Use with caution.
Renal Impairment
High serum minocycline concentrations may result in azotemia, hyperphosphatemia, and acidosis. Excessive drug accumulation and possible liver toxicity may occur if usual dosage is used in patients with renal impairment.
Dosage adjustment necessary in patients with impaired renal function. Serum minocycline concentrations should be monitored if therapy is prolonged.
Because usual dosage of doxycycline can be used in patients with impaired renal
function, it may be preferred when a tetracycline is indicated in a patient with impaired renal function.
Common Adverse Effects
GI effects (anorexia, nausea, vomiting, diarrhea); CNS effects (dizziness, vertigo);
hypersensitivity reactions; dose-related BUN increases.
Interactions
Specific Drugs
Drug
Interaction
Comments
Antacids (aluminum-, calcium-, or magnesiumcontaining)
Decreased minocycline absorption
Administer antacids containing aluminum, calcium, or
magnesium 1– 2 hours
before or after minocycline
short
stand
46067
AHFS Essentials
24
ASHPI
BATCH
LEFT
top of rh
base of rh
Minocycline (Systemic)
Possible increased anticoagu- Monitor PT carefully; adjust
lant effect; tetracyclines
anticoagulant dosage as
may impair utilization of
needed
prothrombin or decrease
vitamin K production by
intestinal bacteria
Anticoagulants, oral
Hormonal contraceptives
Possible decreased effective- Use alternative nonhormonal
ness of oral contraceptives
contraceptives
Iron-containing preparations
Possible decreased absorption of minocycline
Administer minocycline 2
hours before or 3 hours
after an oral iron preparation
Possible additive adverse
nervous system effects;
both minocycline and isotretinoin have been associated with pseudotumor
cerebri
Avoid use of isotretinoin
shortly before, during, or
after minocycline therapy
Methoxyflurane
Possible fatal nephrotoxicity
Concomitant use not recommended
Penicillins
Possible antagonism
Concomitant use not recommended
Isotretinoin
cap height
base of text
Parenteral
Powder for Injection
20– 25C. Following reconstitution with sterile water for injection, solutions containing 20 mg/mL are stable for 24 hours at room temperature.
Compatibility
For information on systemic interactions resulting from concomitant use, see Interactions.
Parenteral
Do not mix with IV solutions containing calcium since precipitation can occur.
Solution Compatibility
Compatible
Dextrose 5% in water
Sodium chloride 0.9%
Ringer’s injection
Ringer’s injection, lactated
Drug Compatibility
⬎Admixture Compatibility
Incompatible
Rifampin
Pharmacokinetics
⬎Y-Site Compatibility
Compatible
Absorption
Bioavailability
90– 100% absorbed from GI tract in fasting adults; peak serum concentrations attained within 1– 4 hours.
Food
GI absorption may be reduced up to 20% by food and/or milk; effect not considered clinically important.
Divalent and trivalent cations, including aluminum, calcium, iron, magnesium, and
zinc may decrease oral absorption as a result of chelation with the drug.
Distribution
Extent
Widely distributed into body tissues and fluids.
Only small amounts diffuse into CSF.
Aztreonam
Cyclophosphamide
Docetaxel
Etoposide phosphate
Filgrastim
Fludarabine phosphate
Gemcitabine HCl
Granisetron HCl
Heparin sodium
Hydrocortisone sodium succinate
Linezolid
Magnesium sulfate
Melphalan HCl
Perphenazine
Potassium chloride
Remifentanil HCl
Sargramostim
Teniposide
Vinorelbine tartrate
Vitamin B complex with C
Incompatible
Allopurinol sodium
Amifostine
Hydromorphone HCl
Meperidine HCl
Morphine sulfate
Piperacillin sodium– tazobactam sodium
Propofol
Thiotepa
Plasma Protein Binding
55– 88%.
Actions and Spectrum
Elimination
Metabolism
May be partially metabolized to ⱖ6 metabolites.
Elimination Route
4– 19% of an oral or IV dose excreted in urine and 20– 34% excreted into feces
as active drug.
•
•
•
•
Half-life
Adults with normal renal function: 11– 26 hours.
•
Special Populations
Patients with impaired hepatic function: half-life 11– 16 hours.
Patients with impaired renal function: half-life 12– 30 hours. Half-life up to 69
hours has been reported.
•
Stability
Storage
•
Oral
Capsules
Capsules: 15– 30C. Protect from light, moisture, and excessive heat.
Pellet-filled capsules: 20– 25C. Protect from light, moisture, and excessive heat.
Tablets
20– 25C. Protect from light, moisture, and excessive heat.
•
Usually bacteriostatic, but may be bactericidal in high concentrations or against
highly susceptible organisms.
Inhibits protein synthesis in susceptible organisms by reversibly binding to 30S
and 50S ribosomal subunits.
The complete mechanisms by which tetracyclines reduce acne lesions have not
been fully elucidated. The effects appear to result in part from the antibacterial
activity of the drugs, but other mechanisms also are involved.
Spectrum of activity includes many gram-positive and -negative bacteria and various other organisms (e.g., Rickettsia, Chlamydia, Mycoplasma, spirochetes). Inactive against fungi and viruses.
Gram-positive aerobes and anaerobes: Active against Actinomyces israelii, Bacillus
anthracis, Clostridium perfringens, C. tetani, Nocardia, Propionibacterium acnes,
and some streptococci. Many strains of S. pyogenes and Enterococci are resistant.
Gram-negative aerobes and anaerobes: Active against Bartonella bacilliformis, Brucella, Calymmatobacterium granulomatis, Francisella tularensis, Haemophilus ducreyi, H. influenzae, Neisseria gonorrhoeae, Vibrio cholerae, Y. enterocolitica, and
Y. pestis. Many strains of Acinetobacter, E. aerogenes, E. coli, Klebsiella, and Shigella and nearly all strains of Proteus and Pseudomonas are resistant.
Other organisms: Active against Rickettsia, Coxiella burnetii, Chlamydia psittaci, C.
trachomatis, Helicobacter pylori, Mycoplasma hominis, M. pneumoniae, Ureoplasma urealyticum, Borrelia burgdorferi, B. recurrentis, Leptospira, Treponema pallidum, T. pertenue, and Mycobacterium fortuitum. Active against asexual erythrocytic forms of Plasmodium falciparum, but is not gametocidal and not active
against exoerythrocytic forms of P. falciparum.
Complete cross-resistance usually occurs between minocycline and other tetracyclines (demeclocycline, doxycycline, oxytetracycline, tetracycline).
short
stand
46067
AHFS Essentials
ASHPI
BATCH
Minocycline (Systemic)
RIGHT
25
top of rh
base of rh
cap height
base of text
Advice to Patients
•
•
•
•
•
•
•
•
•
•
•
Advise patients that antibacterials (including minocycline) should only be used to treat
bacterial infections and not used to treat viral infections (e.g., the common cold).
Importance of completing full course of therapy, even if feeling better after a few days.
Advise patients that skipping doses or not completing the full course of therapy may
decrease effectiveness and increase the likelihood that bacteria will develop resistance
and will not be treatable with minocycline or other antibacterials in the future.
Importance of drinking sufficient quantities of fluids when taking capsules or tablets to reduce the risk of esophageal irritation and ulceration.
Advise patients that absorption of some minocycline preparations may be reduced
when taken with foods, especially those containing calcium, and that pellet-filled
capsules or tablets should be taken at least 1 hour before or 2 hours after meals
and/or milk.
Advise patients that adverse CNS effects (light-headedness, dizziness, vertigo)
may occur and caution should be used when driving vehicles or operating hazardous machinery.
Advise patients to avoid excessive sunlight or artificial UV light and to discontinue
the drug at the first sign of skin erythema; consider use of sunscreen or sunblock.
Advise patients that minocycline may decrease effectiveness of oral contraceptives and that alternative nonhormonal contraceptive measures should be used.
Importance of women informing clinicians if they are or plan to become pregnant
or plan to breast-feed. (See Fetal/Neonatal Morbidity under Cautions.)
Importance of informing clinicians of existing or contemplated therapy, including
prescription and OTC drugs.
Importance of informing patients of other important precautionary information.
(See Cautions.)
Preparations
Minocycline Hydrochloride
Oral
Capsules
50 mg (of minocycline)*
75 mg (of minocycline)
100 mg (of minocycline)*
Capsules, pelletfilled
Tablets, film
coated
50 mg (of minocycline)
100 mg (of minocycline)
50 mg (of minocycline)*
75 mg (of minocycline)
100 mg (of minocycline)*
Dynacin, Medicis
Minocycline Hydrochloride
Capsules, Global, Rambaxy,
Teva, Watson
Dynacin, Medicis
Minocycline Hydrochloride
Capsules, Global, Rambaxy,
Teva, Watson
Dynacin, Medicis
Minocycline Hydrochloride
Capsules, Global, Rambaxy,
Teva, Watson
Minocin, Wyeth
Minocin, Wyeth
Dynacin (with povidone), Medicis
Minocycline Hydrochloride
Tablets, Global, Rambaxy
Myrac, Glades
Dynacin (with povidone), Medicis
Minocycline Hydrochloride
Tablets, Global, Rambaxy
Myrac, Glades
Dynacin (with povidone), Medicis
Minocycline Hydrochloride
Tablets, Global, Rambaxy
Myrac, Glades
Parenteral
For injection, for
IV infusion only
100 mg (of minocycline)
Minocin Intravenous, Wyeth
*available generically
†Use is not currently included in the labeling approved by the US Food and Drug Administration
Selected Revisions August 2005, Copyright, May 2004, American Society of Health-System Pharmacists, Inc.
short
stand