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|genericName=Minocycline
|genericName=Minocycline
|aOrAn=a
|aOrAn=a
|drugClass=[[tetracycline]] [[antiobiotic]]
|drugClass=[[tetracycline]] antiobiotic
|indicationType=treatment
|indicationType=treatment
|indication=is indicated as an adjunct to scaling and root planing procedures for reduction of pocket depth in patients with adult [[periodontitis]]. Minocycline may be used as part of a periodontal maintenance program which includes good [[oral]] hygiene, and scaling and root planing
|indication=is indicated as an adjunct to scaling and root planing procedures for reduction of pocket depth in patients with adult [[periodontitis]]. Minocycline may be used as part of a periodontal maintenance program which includes good [[oral]] hygiene, and scaling and root planing
* Protect from light, moisture and excessive heat.
* Protect from light, moisture and excessive heat.
|packLabel=[[File:DailyMed - MINOCYCLINE HYDROCHLORIDE- minocycline hydrochloride tablet, film coated .png|thumb|none|400px|This image is provided by the National Library of Medicine.]]
|alcohol=Alcohol-Minocycline interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.
|alcohol=Alcohol-Minocycline interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.
|brandNames=*MINOCYCLINE HYDROCHLORIDE ®<ref>{{Cite web | title = MINOCYCLINE HYDROCHLORIDE- minocycline hydrochloride tablet, film coated | url =http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4f243e45-a1e6-4246-95f8-196f2b491185 }}</ref>
|brandNames=*MINOCYCLINE HYDROCHLORIDE ®<ref>{{Cite web | title = MINOCYCLINE HYDROCHLORIDE- minocycline hydrochloride tablet, film coated | url =http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4f243e45-a1e6-4246-95f8-196f2b491185 }}</ref>
| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X -->
| pregnancy_US = <!-- A / B / C / D / X -->
| pregnancy_category=
| legal_AU = S4
| legal_CA = <!-- / Schedule I, II, III, IV, V, VI, VII, VIII -->
| legal_UK = <!-- GSL / P / POM / CD / Class A, B, C -->
| legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V -->
| legal_status =
| routes_of_administration = oral
}}
{{SI}}
'''Minocycline hydrochloride''', also known as '''minocycline''', is a member of the broad spectrum [[tetracycline antibiotics]], and has a broader spectrum than the other members. It is a [[bacteriostatic]] antibiotic. As a result of its long half-life it generally has [[blood plasma|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 [[American Cyanamid|Lederle Laboratories]] and marketed under the brand name ''Minocin''.<ref>[http://www.scripps.edu/chem/baran/images/grpmtgpdf/Lin_Mar_05revised.pdf]Lin, DW The Tetracyclines March 2005</ref>
==Indications==
<!--Label Display Image-->
It is primarily used to treat [[Acne vulgaris|acne]] and other skin infections as the one pill twice daily 100 mg dosage is far easier for patients than the four times a day required with tetracycline or [[oxytetracycline]].
Although minocycline's broader spectrum of activity, compared to other members of the group, includes activity against [[Neisseria meningitidis]], its use as a [[prophylaxis]] is no longer recommended because of side effects (dizziness and [[vertigo (medical)|vertigo]]).
It may be used to treat certain strains of [[Methicillin-resistant Staphylococcus aureus|MRSA]] infection and disease caused by drug resistant [[Acinetobacter]].
For other uses of minocycline see [[Tetracycline antibiotics]] and [[oxytetracycline]] as the uses are much the same between Tetracyclines with only minor exceptions.
==Cautions==
}}
Contrary to all the other tetracycline antibiotics ([[Doxycyclin]] excluded), minocycline may be used in renal impairment, but may be aggravating [[systemic lupus erythematosus]].<!--
<!--Category-->
--><ref name="Note1">{{cite journal | author=Gough A, Chapman S, Wagstaff K, Emery P, Elias E | title=Minocycline induced autoimmune hepatitis and systemic lupus erythematosus-like syndrome | journal=BMJ | year=1996 | pages=169-72 | volume=312 | issue=7024 | id=PMID 8563540 |url=http://bmj.bmjjournals.com/cgi/content/full/312/7024/169}}</ref>
Also, more so than other tetracyclines, minocycline can cause the rare condition of [[idiopathic intracranial hypertension|secondary intracranial hypertension]] which has initial symptoms of headache, visual disturbances, and confusion. [[Meningitis]] and [[cerebral edema]] are rare side effects of minocycline.<!--
--><ref>{{cite journal|title=Minocycline-induced hypersensitivity syndrome presenting with meningitis and brain edema: a case report|author=Lefebvre N, Forestier E, Farhi D, ''et al.''|journal=Journal of Medical Case Reports|year=2007|volume=1|pages=22|url=http://www.jmedicalcasereports.com/content/1/1/22}}</ref>
Minocycline, like all tetracyclines, becomes dangerous past its expiration date. While most prescription drugs lose potency after their expiration dates, tetracyclines are known to become toxic over time; expired tetracyclines can cause serious damage to the kidneys.
Minocycline's absorption is impaired if taken at the same time of day as calcium or iron supplements. Unlike some of the other tetracycline group antibiotics, it can be taken with calcium rich foods such as milk, although this does reduce the absorption slightly (by ~5%).{{Fact|date=February 2007}}
==Side effects==
This medication may cause upset stomach, [[diarrhea]], [[dizziness]], unsteadiness, [[somnolence|drowsiness]], [[headache]] or [[vomiting]]. If these symptoms persist or worsen, one should notify their doctor. Minocycline increases [[photophobia|sensitivity to sunlight]]. Prolonged sun exposure should be avoided. Wear protective clothing and use a [[sunscreen]] if needed. Very unlikely but should be reported: [[fever]], [[jaundice|yellowing of the eyes or skin]], stomach pain, sore throat, vision changes and mental changes.
In those cases where this drug must be used for extended periods, blue-gray skin discoloration may occur. In the unlikely event one has an [[allergic reaction]] to this drug, immediate medical attention should be sought. Symptoms of an allergic reaction include [[rash]], itching, swelling, severe [[dizziness]], trouble breathing. Other effects not listed above should be reported to the doctor or pharmacist.
== Uses ==
* [[Acne]]
* [[Amoebic dysentery]]
* [[Anthrax]]
* [[Cholera]]
* [[Gonorrhea]] (when [[penicillin]] cannot be given)
* [[Bubonic plague]]
* Respiratory infections such as [[pneumonia]]
* [[Rocky Mountain spotted fever]]
* [[Syphilis]] (when penicillin cannot be given)
* [[Urinary tract infection]]s, rectal infections, and infections of the [[cervix]] caused by certain microbes
==Anti-inflammatory and neuroprotective==
Current research is examining the possible neuroprotective and anti-inflammatory effects of minocycline against progression of a group of [[neurodegenerative disorder]]s including [[multiple sclerosis]] (MS), [[rheumatoid arthritis]] (RA), [[amyotrophic lateral sclerosis]] (ALS), [[Huntington's disease]], and [[Parkinsons disease]],<!--
--><ref>{{cite press release |title= Preliminary Study Shows Creatine and Minocycline May Warrant Further Study In Parkinson’s Disease |publisher= National Institute of Health |date= February 23, 2006 |url=http://www.nih.gov/news/pr/feb2006/ninds-23.htm |format= |language= |accessdate=}} </ref> amongst others neurodegenerative diseases.<!--
--><ref name="Note2">{{cite journal | author=Chen M, Ona VO, Li M, Ferrante RJ, Fink KB, Zhu S, Bian J, Guo L, Farrell LA, Hersch SM, Hobbs W, Vonsattel JP, Cha JH, Friedlander RM | title=Minocycline inhibits caspase-1 and caspase-3 expression and delays mortality in a transgenic mouse model of Huntington disease | journal=Nat Med | year=2000 | pages=797-801 | volume=6 | issue=7 | id=PMID 10888929}}</ref><!--
--><ref>{{cite journal |author=Nirmalananthan N, Greensmith L |title=Amyotrophic lateral sclerosis: recent advances and future therapies |journal=Curr. Opin. Neurol. |volume=18 |issue=6 |pages=712-9 |year=2005 |pmid=16280684 |doi=}}</ref>
The neuroprotective action of minocycline may include its inhibitory effect on 5-[[lipoxygenase]],<!--
--><ref name="Note4">{{cite journal | author=Song Y, Wei EQ, Zhang WP, Zhang L, Liu JR, Chen Z | title=Minocycline protects PC12 cells from ischemic-like injury and inhibits 5-lipoxygenase activation | journal=Neuroreport | year=2004 | pages=2181-4 | volume=15 | issue=14 | id=PMID 15371729}} </ref>
an inflammatory enzyme associated with brain aging, and is being studied for use in [[Alzheimer's disease]] patients.<!--
--><ref name="Note5">{{cite journal | author=Uz T, Pesold C, Longone P, Manev H | title=Aging-associated up-regulation of neuronal 5-lipoxygenase expression: putative role in neuronal vulnerability | journal=FASEB J | year=1998 | pages=439-49 | volume=12 | issue=6 | id=PMID 9535216 |url=http://www.fasebj.org/cgi/content/full/12/6/439}}</ref>
It also has been used as a "last ditch" treatment for [[toxoplasmosis]] in [[AIDS]] patients. Minocycline is neuroprotective in mouse models of amyotrophic lateral sclerosis (ALS) and Huntington's disease and has been recently shown to stabilize the course of Huntington's disease in humans over a 2-year period.
As an anti-inflammatory, minocycline inhibits [[apoptotic|apoptosis]] (cell death) via attenuation of [[TNF-alpha]], downregulating pro-inflammatory [[cytokine]] output. This effect is mediated by a direct action of minocycline on the activated [[T cells]] and on [[microglia]], which results in the decreased ability of T cells to contact microglia which impairs cytokine production in T cell-microglia [[signal transduction]] .<!--
--><ref>{{cite journal |author=Giuliani F, Hader W, Yong VW |title=Minocycline attenuates T cell and microglia activity to impair cytokine production in T cell-microglia interaction |journal=J. Leukoc. Biol. |volume=78 |issue=1 |pages=135-43 |year=2005 |pmid=15817702 |doi=10.1189/jlb.0804477}}</ref>
Minocycline also inhibits microglial activation, through blockade of [[NF-kB|NF-kappa B]] nuclear translocation.
It is thought that minocycline exerts neuroprotective effects independent of its anti-inflammatory properties.<!--
--><ref name="Maier">{{cite journal |author=Maier K, Merkler D, Gerber J, Taheri N, Kuhnert AV, Williams SK, Neusch C, Bähr M, Diem R |title=Multiple neuroprotective mechanisms of minocycline in autoimmune CNS inflammation |journal=Neurobiol. Dis. |volume=25 |issue=3 |pages=514-25 |year=2007 |pmid=17239606 |doi=10.1016/j.nbd.2006.10.022}}</ref>
A recent study reported the impact of the antibiotic minocycline on clinical and [[magnetic resonance imaging]] (MRI) outcomes and serum immune molecules in MS patients over 24 months of open-label minocycline treatment. Despite a moderately high pretreatment relapse rate in patients in the study prior to treatment, no relapses occurred between months 6 and 24. The only patient with [[gadolinium]]-enhancing lesions on MRI at 12 and 24 months was on half-dose minocycline. Levels of [[interleukin-12]] (IL-12), which at high levels might antagonize the proinflammatory IL-12 receptor, were elevated over 18 months of treatment, as were levels of soluble [[Blood vessel|vascular]] [[cell adhesion molecule|cell adhesion molecule-1]] ([[VCAM-1]]). The activity of [[matrix metalloproteinase|matrix metalloproteinase-9]] was decreased by treatment. Clinical and MRI outcomes in this study were supported by systemic immunological changes and call for further investigation of minocycline in MS.<!--
--><ref>{{cite journal |author=Zabad RK, Metz LM, Todoruk TR, Zhang Y, Mitchell JR, Yeung M, Patry DG, Bell RB, Yong VW |title=The clinical response to minocycline in multiple sclerosis is accompanied by beneficial immune changes: a pilot study |journal=Mult. Scler. |volume=13 |issue=4 |pages=517-26 |year=2007 |pmid=17463074 |doi=10.1177/1352458506070319}}</ref><!--
--><ref>{{cite journal |author=Zemke D, Majid A |title=The potential of minocycline for neuroprotection in human neurologic disease |journal=Clinical neuropharmacology |volume=27 |issue=6 |pages=293-8 |year=2004 |pmid=15613934 |doi=}}</ref><!--
--><ref name="Maier">{{cite journal |author=Maier K, Merkler D, Gerber J, Taheri N, Kuhnert AV, Williams SK, Neusch C, Bähr M, Diem R |title=Multiple neuroprotective mechanisms of minocycline in autoimmune CNS inflammation |journal=Neurobiol. Dis. |volume=25 |issue=3 |pages=514-25 |year=2007 |pmid=17239606 |doi=10.1016/j.nbd.2006.10.022}}</ref><!--
--><ref>{{cite journal |author=Popovic N, Schubart A, Goetz BD, Zhang SC, Linington C, Duncan ID |title=Inhibition of autoimmune encephalomyelitis by a tetracycline |journal=Ann. Neurol. |volume=51 |issue=2 |pages=215-23 |year=2002 |pmid=11835378 |doi=}}</ref>
==Trade names and availability==
Minocycline is no longer covered by patent and is therefore marketed under several trade names:
*'''Minomycin'''
*'''Minocin'''
*'''Arestin'''
*'''Akamin'''
*'''Aknemin'''
*'''Solodyn'''
*'''Dynacin'''
*'''Sebomin'''
StoneBridge Pharma also markets Minocycline as '''Cleeravue-M''' in combination with SteriLid eyelid cleanser in the treatment of [[rosacea]] [[blepharitis]].
==Footnotes==
<div class="references-small"><references/></div>
==External links==
*[http://www.bnf.org/bnf/noframes/search.htm?q=Minocycline&submitImage.x=59&submitImage.y=15 British National Formulary] ''45'' March 2003
*[[New Zealand]] [http://www.medsafe.govt.nz/profs/Datasheet/m/Minotabtab.htm Datasheet] May 2002
*[http://www.drugs.com/minocycline.html Minocycline on drugs.com]
*[http://www.medicinenet.com/minocycline-oral/article.htm Minocycline on medicinenet.com]
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Overview
Minocycline is a tetracycline antiobiotic that is FDA approved for the treatment of is indicated as an adjunct to scaling and root planing procedures for reduction of pocket depth in patients with adult periodontitis. Minocycline may be used as part of a periodontal maintenance program which includes good oral hygiene, and scaling and root planing. Common adverse reactions include the most frequently reported nondental treatment-emergent adverse events in the 3 multicenter US trials were headache, infection, flu syndrome, and pain. Dental conditions include peritonitis, gingivitis, stomatitis, pharyngitis.
Adult Indications and Dosage
FDA-Labeled Indications and Dosage (Adult)
Minocycline is indicated as an adjunct to scaling and root planing procedures for reduction of pocket depth in patients with adult periodontitis. Minocycline may be used as part of a periodontal maintenance program which includes good oral hygiene, and scaling and root planing.
Off-Label Use and Dosage (Adult)
Guideline-Supported Use
There is limited information regarding Off-Label Guideline-Supported Use of Minocycline in adult patients.
Non–Guideline-Supported Use
There is limited information regarding Off-Label Non–Guideline-Supported Use of Minocycline in adult patients.
Pediatric Indications and Dosage
FDA-Labeled Indications and Dosage (Pediatric)
There is limited information regarding Minocycline FDA-Labeled Indications and Dosage (Pediatric) in the drug label.
Off-Label Use and Dosage (Pediatric)
Guideline-Supported Use
There is limited information regarding Off-Label Guideline-Supported Use of Minocycline in pediatric patients.
Non–Guideline-Supported Use
There is limited information regarding Off-Label Non–Guideline-Supported Use of Minocycline in pediatric patients.
Contraindications
It should not be used in any patient who has a known sensitivity to tetracyclines.
Warnings
There is limited information regarding Minocycline Warnings' in the drug label.
Adverse Reactions
Clinical Trials Experience
This medication may cause upset stomach, diarrhea, dizziness, unsteadiness, drowsiness, headache or vomiting. If these symptoms persist or worsen, one should notify their doctor. Minocycline increases sensitivity to sunlight. Prolonged sun exposure should be avoided. Wear protective clothing and use a sunscreen if needed. Very unlikely but should be reported: fever, yellowing of the eyes or skin, stomachpain, sore throat, vision changes and mental changes.
In those cases where this drug must be used for extended periods, blue-gray skin discoloration may occur. In the unlikely event one has an allergic reaction to this drug, immediate medical attention should be sought. Symptoms of an allergic reaction include rash, itching, swelling, severe dizziness, trouble breathing. Other effects not listed above should be reported to the doctor or pharmacist.
Postmarketing Experience
There is limited information regarding Minocycline Postmarketing Experience in the drug label.
Drug Interactions
There is limited information regarding Minocycline Drug Interactions in the drug label.
Use in Specific Populations
Pregnancy
Pregnancy Category (FDA):
There is no FDA guidance on usage of Minocycline in women who are pregnant.
Pregnancy Category (AUS):
There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Minocycline in women who are pregnant.
Labor and Delivery
There is no FDA guidance on use of Minocycline during labor and delivery.
Nursing Mothers
There is no FDA guidance on the use of Minocycline in women who are nursing.
Pediatric Use
There is no FDA guidance on the use of Minocycline in pediatric settings.
Geriatic Use
There is no FDA guidance on the use of Minocycline in geriatric settings.
Gender
There is no FDA guidance on the use of Minocycline with respect to specific gender populations.
Race
There is no FDA guidance on the use of Minocycline with respect to specific racial populations.
Renal Impairment
There is no FDA guidance on the use of Minocycline in patients with renal impairment.
Hepatic Impairment
There is no FDA guidance on the use of Minocycline in patients with hepatic impairment.
Females of Reproductive Potential and Males
There is no FDA guidance on the use of Minocycline in women of reproductive potentials and males.
Immunocompromised Patients
There is no FDA guidance one the use of Minocycline in patients who are immunocompromised.
There is limited information regarding Minocycline Monitoring in the drug label.
IV Compatibility
There is limited information regarding the compatibility of Minocycline and IV administrations.
Overdosage
There is limited information regarding Minocycline overdosage. If you suspect drug poisoning or overdose, please contact the National Poison Help hotline (1-800-222-1222) immediately.
There is limited information regarding Minocycline Mechanism of Action in the drug label.
Structure
There is limited information regarding Minocycline Structure in the drug label.
Pharmacodynamics
There is limited information regarding Minocycline Pharmacodynamics in the drug label.
Pharmacokinetics
There is limited information regarding Minocycline Pharmacokinetics in the drug label.
Nonclinical Toxicology
There is limited information regarding Minocycline Nonclinical Toxicology in the drug label.
Clinical Studies
There is limited information regarding Minocycline Clinical Studies in the drug label.
How Supplied
Minocycline equivalent to 50 mg minocycline are opaque white capsules imprinted "0487" and "DYNACIN® 50 mg" and are supplied as follows:
NDC 99207-487-10 Bottles of 100
NDC 99207-487-11 Bottle of 1000.
Minocycline equivalent to 75 mg minocycline are light gray opaque capsules imprinted "0489" and "DYNACIN® 75 mg" and are supplied as follows:
NDC 99207-489-10 Bottles of 100
NDC 99207-489-11 Bottle of 1000.
Minocycline equivalent to 100 mg minocycline are opaque dark gray and opaque white capsules imprinted "0488" and "DYNACIN® 100 mg" and are supplied as follows:
NDC 99207-488-05 Bottles of 50
NDC 99207-488-11 Bottle of 1000.
Dispense in tight, light-resistant container with child-resistant closure.
Store at 20º–25ºC (68º–77ºF).
Protect from light, moisture and excessive heat.
Storage
There is limited information regarding Minocycline Storage in the drug label.
Images
Drug Images
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