Class: Tetracycline Antibiotic
Dosage Forms. Tablet: 50 mg, 75 mg, 100 mg; Tablet, Extended Release: 45 mg, 55 mg, 65 mg, 80 mg, 90 mg, 105 mg, 115 mg, 135 mg; Capsule: 50 mg, 75 mg, 100 mg
Common FDA Label Indication, Dosing, and Titration.
1. Acne vulgaris (extended-release tablets): 1 mg/kg/day po daily; continue treatment for 12 wk
2. Allergy to penicillin—bacterial infectious disease: Adults, 100 mg po daily or bid; Children >8 y, under 45 kg, 2.2-4.4 mg/kg/d po in 1-2 divided doses
1. Leprosy: 100 mg po daily
MOA. Tetracyclines are broad-spectrum bacteriostatic compounds that inhibit protein synthesis at the 30S ribosomal subunit. Activity includes Gram-positive, Gram-negative, aerobic, and anaerobic bacteria, as well as spirochetes, mycoplasmas, rickettsiae, chlamydiae, and some protozoa. Many bacteria have developed plasmid-mediated resistance. Most Enterobacteriaceae and Pseudomonas aeruginosa are resistant.
Drug Characteristics: Minocycline
Medication Safety Issues: Minocycline
Drug Interactions: Minocycline
Adverse Reactions: Minocycline
Efficacy Monitoring Parameters. Resolution of signs and symptoms of infection, or decreased acne.
Toxicity Monitoring Parameters. Seek medical attention if extreme headache, bloody diarrhea, tooth darkening, or yellowing of the eyes occurs. LFTs, SCr in patients receiving long-term treatment.
Key Patient Counseling Points. May take with food that does not contain calcium (dairy). Complete full course of therapy. Symptoms should improve within 2-3 d if treating infection; if they worsen, seek follow-up with healthcare practitioner. Acne should improve within 1-2 wk. Wear sunscreen.
Clinical Pearls. Dosing is not interchangeable with extended-release and immediate-release products. Dizziness occurs more frequently in women than men. Less hepatotoxicity than is usually seen with doxycycline. May resume normal activities after 24 h of antibiotics and afebrile. Not for use in children under the age of 8 y due to bone and tooth toxicity.