Minocycline

C. diff Risk

Medium

Oral Bioavailability

Excellent

Approximate Cost

PO (Generic):$
PO (Brand):$$$$
IV (Brand):$$$$

Dosing

Adult

Loading Dose
200 mg IV/PO x1

followed by
100 mg IV/PO BID

Renal

No dose adjustment

Hepatic

No dose adjustment

General Information

Common Usage

  • Respiratory tract infections

  • Tick-born infections

  • Alternative agents for skin and soft tissue infections

Drug Monitoring

Laboratory

  • BMP weekly, LFTs

Clinical

  • Viusal disturbances (rare)

  •  Mucosal hyperpigmentation (blue-purple)

Adverse Effects

  •  Vertigo and ataxia

  •  GI intolerance (dose-related)

  •  Stains and deforms teeth in children < 8 years of age

  •  Skin and mucosal hyperpigmentation

  •  Esophageal ulcerations

  •  Hepatotoxicity (dose-related)

  •  Photosensitivity

Major Interactions

Polyvalent cations: Reduced minocycline absorption

Oral contraceptives: Decreased OC efficacy

Nondepolarizing neuromuscular blockers: May potentiate effects of neuromuscular blocker

Additional Information

Always ask patient's about supplements!

Minocycline chelates cations - sepearate calcium, iron, antacids, or multivitamin administration by at least 2 hours.

Patient's should be counseled to avoid direct sun exposure due to increased risk of photosensitivity

Pharmacology

Antimicrobial class: Tetracycline

Pregnancy category: D (all trimesters)

Average serum half life: 16 hours

Biliary penetration: High

CSF penetration: Low

Lung penetration: High

Urine penetration: Low (<~10% excreted as unchanged drug)