Minocycline


Full Prescribing Info
Dosage/Direction for Use

Oral
Susceptible infections
Adult: 200 mg daily in divided doses.
Renal impairment: Reduce dose or increase dosing interval. Max: 200 mg/day.

Oral

Acne
Adult: 50 mg bid or 100 mg once daily. ≥45 kg: 1 mg/kg once daily as modified-release preparation.
Renal impairment: Reduce dose or increase dosing interval. Max: 200 mg/day.

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: 200 mg/day.

Oral

Nongonococcal urethritis
Adult: 100 mg 12 hrly for at least 7 days.
Renal impairment: Reduce dose or increase dosing interval. Max: 200 mg/day.

Oral

Uncomplicated gonorrhoea
Adult: Initially, 200 mg, followed by 100 mg 12 hrly for a min of 4 days, follow-up cultures should be done w/in 2-3 days after completion of therapy.
Renal impairment: Reduce dose or increase dosing interval. Max: 200 mg/day.

Oral

Uncomplicated urethral gonorrhoea in men
Adult: 100 mg 12 hrly for 5 days.
Renal impairment: Reduce dose or increase dosing interval. Max: 200 mg/day.

Oral

Mycobacterium marinum infections
Adult: 100 mg 12 hrly for 6-8 wk.
Renal impairment: Reduce dose or increase dosing interval. Max: 200 mg/day.

Oral

Syphilis
Adult: 200 mg initially, followed by 100 mg 12 hrly for 10-15 days.
Renal impairment: Reduce dose or increase dosing interval. Max: 200 mg/day.

Intravenous

Susceptible infections
Adult: Initially, 200 mg followed by 100 mg 12 hrly. Max: 400 mg/day.
Child: >8 yr
Initially, 4 mg/kg, then 2 mg/kg 12 hrly not to exceed the usual adult dose.
Renal impairment: Reduce dose or increase dosing interval. Max: 200 mg/day.
Reconstitution:
Add 5 mL of sterile water for inj and immediately further dilute to a vol of 500-1,000 mL w/ NaCl inj, dextrose inj, dextrose and NaCl inj, Ringer's inj, or lactated Ringer's inj.
Incompatibility: Ca-containing soln except lactated Ringer's, allopurinol, amifostine, soln containing ACTH, aminophylline, amobarbital Na, amphotericin B, bicarbonate infusion mixtures, carbenicillin, cephalothin Na, cefazolin Na, chloramphenicol succinate, colistin sulfate, hydromorphone, iodine Na, methicillin Na, meperidine, morphine, novobiocin, pemetrexed, propofol, penicillin, pentobarbital, phenytoin Na, polymyxin, prochlorperazine, Na ascorbate, sulfadiazine, sulfisoxazole, thiotepa, thiopental Na, vitamin K (Na bisulfate or Na salt), whole blood.

Topical/Cutaneous
Periodontitis
Adult: 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.
Administration
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.
Contraindications
Hypersensitivity to minocycline and other tetracyclines. Concurrent use w/ methoxyflurane. Lactation.
Special Precautions
Patient w/ history of predisposition to oral candidiasis, pre-existing SLE and myasthenia gravis. Hepatic and renal impairment. Pregnancy. Patient Counselling May impair ability to drive or operate machinery. Avoid prolonged exposure to sunlight. Monitoring Parameters Monitor LFT, BUN, renal function, CBC. If treatment continues for longer than 6 mth, monitor every 3 mth for hepatotoxicity, pigmentation and SLE.
Adverse Reactions
Haemolytic anaemia, thrombocytopenia, neutropenia, brownish-black microscopic discolouration of thyroid tissue, thyroid cancer, hyperaesthesia, paraesthesia, headache, dizziness, vertigo, ataxia, bulging fontanelles in infants and benign intracranial HTN in adults, discolouration of the conjunctiva and lacrimal secretions, impaired hearing, tinnitus, pericarditis, pulmonary infiltration, pulmonary eosinophilia, anorexia, nausea, vomiting, diarrhoea, dyspepsia, dysphagia, oesophagitis, oesophageal ulceration, increases in LFT values, hepatitis, acute hepatic failure, jaundice, hyperbilirubinaemia, erythema multiforme, exfoliative dermatitis, photosensitivity, alopecia, hyperpigmentation, rash, acute renal failure, discolouration of teeth, buccal mucosa and tongue.
Potentially Fatal: Drug Rash w/ Eosinophilia and Systemic Symptoms (DRESS), Stevens-Johnson syndrome, Clostridium difficile-associated disease, hypersensitivity syndrome (comprising eosinophilia, fever, rash), lupus-like and serum sickness-like syndrome (both comprising arthralgia, fever, joint stiffness or swelling).
Overdosage
Symptoms: Dizziness, nausea and vomiting. Management: Symptomatic and supportive treatment.
Drug Interactions
Impaired absorption by concomitant admin w/ Ca-containing antacids and other divalent or trivalent cations (e.g. Al, bismuth, Fe, Mg, Zn). May decrease effectiveness of oral contraceptives. May interfere w/ the bactericidal action of penicillins. May potentiate the effect of anticoagulants. Increased risk of nephrotoxicity w/ diuretics. Increased risk of pseudotumour cerebri w/ retinoids (e.g. isotretinoin). Increased risk of ergotism w/ ergot alkaloids.
Potentially Fatal: Concurrent use w/ methoxyflurane may result to fatal renal toxicity.
Lab Interference
May cause false elevations in urinary catecholamine levels due to interference w/ fluorescence test.
Action
Minocycline inhibits protein synthesis by binding to 30S and possibly 50S ribosomal subunits of susceptible bacteria. It is active against Streptococcus aureus, Neisseria meningitidis, various enterobacteria, Acinetobacter, Bacteroides, Haemophilus and Nocardia spp., and some mycobacteria.
Absorption: Readily and almost completely absorbed from the GI tract. Time to peak plasma concentration: W/in 1-4 hr.
Distribution: Widely distributed in body tissues and fluids w/ high concentrations in the hepatobiliary tract, lungs, sinuses and tonsils, as well as in tears, saliva and sputum. Relatively poor CSF penetration, crosses the placenta and enters breast milk. Plasma protein binding: Approx 75%.
Metabolism: Undergoes minimal hepatic metabolism, converted mainly to 9-hydroxyminocycline.
Excretion: Via urine (approx 8-13%) and faeces (approx 20-30%) as unchanged drug. Elimination half-life: 15-23 hr (IV), 11-22 hr (oral).
Storage
Intravenous: Store between 20-25°C. Protect from light, moisture and excessive heat. Oral: Store between 20-25°C. Protect from light, moisture and excessive heat. Topical/Cutaneous: Store between 20-25°C. Protect from light, moisture and excessive heat.
ATC Classification
A01AB23 - minocycline ; Belongs to the class of local antiinfective and antiseptic preparations. Used in the treatment of diseases of the mouth.
J01AA08 - minocycline ; Belongs to the class of tetracyclines. Used in the systemic treatment of infections.
Disclaimer: This information is independently developed by CIMS based on minocycline from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 CIMS. All rights reserved. Powered by CIMSAsia.com
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