Minocycline

Products

Minocycline is commercially available in the form of film-coated tablets (Minocin). It has been approved in many countries since 1984. Minac capsules are out of commerce. Topical medicines are additionally available in some countries.

Structure and properties

Minocylcine (C23H27N3O7, Mr = 457.5 g/mol) is present in drugs as minocycline hydrochloride, a yellow, crystalline, hygroscopic powder that is sparingly soluble in water. It is a lipophilic and semisynthetic tetracycline.

Effects

Minocycline (ATC J01AA08) has bacteriostatic and anti-inflammatory properties. The effects are due to inhibition of bacterial protein synthesis by reversible blockade of the binding site on the 30S subunit of ribosomes. This limits the growth of propionibacteria.

Indications

For the treatment of acne (acne vulgaris). Minocycline, like doxycycline, is also used to treat rosacea but is not approved for this purpose in many countries. It is also not registered for the treatment of infectious diseases in many countries.

Dosage

According to the package insert. The tablets are usually taken in the morning and evening fasting (1 hour before or two hours after meals) and with plenty of fluid (no milk). The duration of therapy is at least four to six weeks. Do not administer while lying down or before bedtime. In case of intolerance, it is also possible to take it with meals, although this will reduce absorption somewhat. The skin should be protected from UV and solar radiation during treatment.

Contraindications

  • Hypersensitivity, including to other tetracyclines.
  • Pregnancy and lactation
  • Children under 8 years
  • Severe liver dysfunction

Full precautions can be found in the drug label.

Interactions

Some medications may decrease the absorption of minocycline. These include antacids, multivitamins, calcium, magnesium, iron, and colestyramine. They should not be administered concomitantly. Other possible interactions include antibiotics, agents toxic to the liver and kidney, anticoagulants, barbiturates, antiepileptics, contraceptives, and isotretinoin.

Adverse effects

The most common possible adverse effects include: