Minocycline, sold under the brand name Minocin among others, is a tetracycline antibiotic medication used to treat a number of bacterial infections such as some occurring in certain forms of pneumonia. It is generally (but not always) less preferred than the tetracycline doxycycline. Minocycline is also used for the treatment of acne and rheumatoid arthritis. It is taken by mouth or applied to the skin. Common side effects include nausea, diarrhea, dizziness, allergic reactions, and kidney problems. Serious side effects may include anaphylaxis, a lupus-like syndrome, and easy sunburning. Use in the later part of pregnancy may harm the baby and safety during breastfeeding is unclear. It works by decreasing a bacterium's ability to make protein thus stopping its growth. Minocycline was patented in 1961 and came into commercial use in 1971. It is available as a generic medication. In 2022, it was the 269th most commonly prescribed medication in the United States, with more than 900,000 prescriptions.
Medical uses
Acne Minocycline and doxycycline are frequently used for the treatment of acne vulgaris. Minocycline is specifically indicated to treat inflammatory lesions of non-nodular moderate to severe acne vulgaris in people nine years of age and older. Both minocycline and doxycycline have similar levels of effectiveness and common adverse effects for acne, although doxycycline may have a slightly lower risk of adverse side effects. Both oral/systemic and more recently topical formulations of minocycline are available to treat acne. Historically, oral minocycline has been an effective treatment for acne vulgaris. However, acne that is caused by antibiotic-resistant bacteria is a growing problem in many countries. In Europe and North America, a number of people with acne no longer respond well to treatment with tetracycline family antibiotics because their acne symptoms are caused by bacteria (primarily Cutibacterium acnes) that are resistant to these antibiotics. In order to reduce resistance rates as well as increase the effectiveness of treatment, oral antibiotics should be generally combined with topical acne creams such as benzoyl peroxide or a retinoid (tretinoin, adapalene, etc.). There have also been concerns about systemic minocycline having a variety of rare adverse effects in terms of its use to treat acne. Oral minocycline is used to treat acne for up to 3 to 4 months. Data beyond 3 to 4 months are limited.
Other infections Minocycline is also used for other skin infections such as methicillin-resistant Staphylococcus aureus. Although minocycline's broader spectrum of activity, compared with other members of the group, includes activity against Neisseria meningitidis, its use for prophylaxis is no longer recommended because of side effects (dizziness and vertigo). It may be used to treat certain strains of methicillin-resistant S. aureus infection and a disease caused by drug-resistant Acinetobacter spp. A list of uses includes:
Amoebic dysentery Anthrax Bubonic plague Cholera Ehrlichiosis Gonorrhea (when penicillin cannot be given) Gougerot-Carteaud syndrome (confluent and reticulated papillomatosis) Hidradenitis suppurativa For use as an adjuvant to HAART Leprosy Periodontal disease Perioral dermatitis Respiratory infections such as pneumonia Rocky Mountain spotted fever Rosacea Shigellosis Syphilis (when penicillin cannot be given) Urinary tract infections (UTIs), rectal infections, and infections of the cervix caused by certain microbes Minocycline has been reported to be effective in the eradication of UTIs and prostatitis. A 2013 Cochrane review identified and included two comparative clinical trials of minocycline for chronic bacterial prostatitis. For this condition, minocycline has been found to be equivalent or superior to doxycycline, equivalent to trimethoprim/sulfamethoxazole, and superior to the first-generation cephalosporin cephalexin. It was also equivalent to the fluoroquinolone ofloxacin in the treatment of chronic bacterial prostatitis caused by Ureaplasma urealyticum. Treatment durations of minocycline for chronic bacterial prostatitis have ranged from 2 to 4 weeks.
Available forms Minocycline is available in the form of 50 and 100 mg oral capsules, among a variety of other formulations. The oral form of minocycline is usually taken twice daily, once every 12 hours, although divided doses four times daily can also be employed. Extended-release oral forms are also available. A topical formulation is available as well.
Contraindications The drug is contraindicated in people with known hypersensitivity to tetracycline antibiotics, as there is complete cross sensitivity in this group. It is also contraindicated in people with severe liver impairment and after the 16th week of pregnancy.
Side effects
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