Minocycline 100mg Capsules
Overview
What is this medicine?
How to Use This Medicine
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely.
Take your medication as directed, swallowing the tablet whole with a full glass of water.
Continue taking your medication even if your symptoms improve.
Establish a routine by taking your medication at the same time every day.
You can take your medication with or without food. However, if it causes stomach upset, take it with food to help minimize this side effect.
Avoid taking products containing iron or antacids with aluminum, calcium, or magnesium at the same time as your medication. Consult your doctor or pharmacist for guidance on managing these interactions.
Stay hydrated by drinking plenty of non-caffeinated fluids, unless your doctor advises you to limit your fluid intake.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, avoiding the bathroom to prevent moisture exposure.
Protect your medication from heat and light to preserve its effectiveness.
When you no longer need your medication, dispose of it properly.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember.
If the missed dose is close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule.
Do not take two doses at once or take extra doses to make up for a missed dose.
Lifestyle & Tips
- Take with a full glass of water to prevent esophageal irritation.
- Avoid lying down for at least 30 minutes after taking the capsule.
- Although minocycline's absorption is less affected by food/dairy than other tetracyclines, it's still generally advised to avoid taking it with dairy products, antacids, or iron supplements within 2-3 hours to ensure maximum absorption.
- Avoid excessive sun exposure and use sunscreen (SPF 30 or higher) and protective clothing, as minocycline can make your skin more sensitive to sunlight (photosensitivity).
- If you experience severe headache, blurred vision, or dizziness, contact your doctor immediately.
- Do not use in children under 8 years of age due to risk of permanent tooth discoloration.
Available Forms & Alternatives
Available Strengths:
- Minocycline 100mg Capsules
- Minocycline 50mg Capsules
- Minocycline 75mg Capsules
- Minocycline 100mg Capsules
- Minocycline 75mg Capsules
- Minocycline 50mg Capsules
- Minocycline 50mg Tablets
- Minocycline 100mg Tablets
- Minocycline 75mg Tablets
- Minocycline ER 135mg Tablets
- Minocycline ER 90mg Tablets
- Minocycline ER 45mg Tablets
- Minocycline 80mg ER Tablets
- Minocycline 105mg ER Tablets
- Minocycline 65mg ER Tablets
- Minocycline 115mg ER Tablets
- Minocycline 135mg ER Capsules
- Minocycline 55mg ER Tablets
Dosing & Administration
Adult Dosing
Condition-Specific Dosing:
Pediatric Dosing
Dose Adjustments
Renal Impairment:
Hepatic Impairment:
Pharmacology
Mechanism of Action
Pharmacokinetics
Absorption:
Distribution:
Elimination:
Pharmacodynamics
Safety & Warnings
Side Effects
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help right away:
Signs of an allergic reaction: rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, trouble breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
Signs of pancreatitis (pancreas problem): severe stomach pain, severe back pain, or severe upset stomach or vomiting.
Signs of kidney problems: inability to pass urine, changes in urine output, blood in the urine, or significant weight gain.
Signs of lupus: rash on the cheeks or other body parts, easy sunburn, muscle or joint pain, chest pain or shortness of breath, or swelling in the arms or legs.
Fever, chills, or sore throat.
Unexplained bruising or bleeding.
Feeling extremely tired or weak.
Changes in hearing.
Joint pain or swelling.
Muscle pain or weakness.
Ringing in the ears.
Seizures.
Shortness of breath.
Chest pain.
Abnormal heartbeat.
Swelling.
Changes in nail, skin, eye, scar, tooth, or gum color to a darker shade.
Mouth irritation or mouth sores.
Burning, numbness, or tingling sensations that are not normal.
Redness or white patches in the mouth or throat.
Rectal irritation.
Genital irritation.
Vaginal itching or discharge.
Important Warnings
Diarrhea is a common side effect of antibiotics. However, a severe form called C. diff-associated diarrhea (CDAD) can occur, which may lead to a life-threatening bowel problem. If you experience stomach pain, cramps, or loose, watery, or bloody stools, contact your doctor immediately.
Liver problems, including fatal cases, have been reported with this medication. If you notice signs of liver problems, such as dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, vomiting, or yellow skin or eyes, seek medical attention right away.
Raised pressure in the brain has been reported, which may lead to loss of eyesight. If you experience headaches or eyesight problems, such as blurred vision, double vision, or loss of eyesight, contact your doctor immediately.
Cases of thyroid cancer have been reported with long-term use of this medication. If you notice lasting hoarseness, a neck mass, or trouble breathing or swallowing, seek medical attention right away.
Severe skin reactions, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and other serious reactions, can occur. If you experience signs like red, swollen, blistered, or peeling skin; red or irritated eyes; sores in the mouth, throat, nose, eyes, genitals, or skin; fever; chills; body aches; shortness of breath; or swollen glands, seek medical help immediately.
Other Side Effects
Not all side effects are severe. However, if you experience any of the following, contact your doctor or seek medical attention if they bother you or do not go away:
Diarrhea.
Upset stomach or vomiting.
Decreased appetite.
Dizziness, drowsiness, tiredness, or weakness.
Reporting Side Effects
If you have questions about side effects or want to report any side effects, contact your doctor or the FDA at 1-800-332-1088. You can also report side effects online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Severe headache, blurred vision, double vision, or vision loss (signs of increased intracranial pressure)
- Severe dizziness or vertigo
- Severe skin rash, blistering, peeling, or swelling (signs of severe skin reactions like SJS, TEN, DRESS)
- Yellowing of the skin or eyes, dark urine, severe stomach pain (signs of liver problems)
- Unusual bleeding or bruising, persistent sore throat, fever, or fatigue (signs of blood disorders)
- Joint pain, swelling, or stiffness (signs of drug-induced lupus-like syndrome)
- Blue-gray skin discoloration (especially with long-term use)
Before Using This Medicine
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced.
If you are currently taking any of the following medications: Acitretin, Isotretinoin, or a Penicillin.
* If you are breast-feeding or plan to breast-feed, as you may need to avoid nursing while taking this medication.
This list is not exhaustive, and it is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. They will help determine if it is safe to take this medication with your existing treatments and health conditions.
Remember, do not start, stop, or change the dose of any medication without first consulting your doctor to ensure your safety.
Precautions & Cautions
Regular blood tests will be necessary, as directed by your doctor. Be sure to discuss any concerns or questions you have with your doctor. Additionally, this medication may interfere with certain laboratory tests, so it is crucial to notify all your healthcare providers and laboratory personnel that you are taking this drug.
Do not exceed the prescribed duration of treatment, as this may increase the risk of a secondary infection. Furthermore, this medication can increase your susceptibility to sunburn. Exercise caution when spending time in the sun, and promptly inform your doctor if you experience unusual sunburn.
Generally, this medication is not recommended for children under 8 years old. However, in some cases, it may be necessary for younger children to take this drug. If this is the case, consult with your doctor to discuss the potential risks and benefits.
In children under 8 years old, this medication may cause permanent tooth discoloration, resulting in a yellow-gray-brown color. If this occurs, the discoloration will not resolve. It is essential to discuss this potential side effect with your doctor. Although less common, tooth discoloration has also been reported in adults, but it typically resolves after the medication is discontinued and a dental cleaning is performed.
When taking this medication, it is crucial to note that birth control pills and other hormone-based contraceptives may be less effective. To prevent pregnancy, consider using an additional form of birth control, such as a condom.
If you are pregnant or become pregnant while taking this medication, it is vital to contact your doctor immediately, as this drug may pose a risk to the unborn baby.
Overdose Information
Overdose Symptoms:
- Nausea
- Vomiting
- Diarrhea
- Dizziness
- Lightheadedness
- Increased intracranial pressure (headache, blurred vision)
What to Do:
Call 1-800-222-1222 (Poison Control Center) immediately. Treatment is primarily supportive. Gastric lavage may be indicated if ingestion is recent. Hemodialysis is not effective in removing minocycline.
Drug Interactions
Contraindicated Interactions
- Isotretinoin and other oral retinoids (increased risk of pseudotumor cerebri)
Major Interactions
- Anticoagulants (e.g., Warfarin - may potentiate anticoagulant effect, monitor INR)
- Penicillins (tetracyclines may interfere with the bactericidal action of penicillins, avoid concomitant use)
- Ergot alkaloids (theoretical risk of ergotism, though less documented for minocycline)
- Methoxyflurane (may result in fatal renal toxicity)
Moderate Interactions
- Antacids containing aluminum, calcium, or magnesium (may decrease minocycline absorption, separate by 2-3 hours)
- Iron preparations (may decrease minocycline absorption, separate by 2-3 hours)
- Bismuth subsalicylate (may decrease minocycline absorption)
- Oral contraceptives (may decrease efficacy of oral contraceptives, advise backup method)
- Typhoid vaccine, live (antibiotics may reduce therapeutic effect of live bacterial vaccines, administer minocycline at least 24 hours after vaccine)
- Cholestyramine, colestipol (may decrease minocycline absorption)
- Barbiturates, Carbamazepine, Phenytoin (may decrease minocycline half-life)
Minor Interactions
- Digoxin (may increase digoxin levels in some patients)
Monitoring
Baseline Monitoring
Rationale: To establish baseline and identify pre-existing hepatic impairment, as minocycline can cause hepatotoxicity.
Timing: Prior to initiating therapy, especially for long-term use or in patients with pre-existing liver disease.
Rationale: To establish baseline and identify pre-existing renal impairment, though minocycline is less renally cleared than other tetracyclines, caution is still warranted.
Timing: Prior to initiating therapy, especially for long-term use or in patients with pre-existing renal disease.
Rationale: To establish baseline and monitor for potential hematologic abnormalities (e.g., neutropenia, thrombocytopenia, hemolytic anemia) with long-term use.
Timing: Prior to initiating therapy, especially for long-term use.
Routine Monitoring
Frequency: Periodically, especially with long-term therapy (e.g., every 3-6 months) or if symptoms of hepatotoxicity develop.
Target: Within normal limits
Action Threshold: Significant elevation (e.g., >3x ULN) warrants discontinuation and investigation.
Frequency: Periodically, especially with long-term therapy or in patients with pre-existing renal impairment.
Target: Within normal limits
Action Threshold: Significant elevation warrants dose adjustment or discontinuation.
Frequency: Periodically, especially with long-term therapy (e.g., every 3-6 months).
Target: Within normal limits
Action Threshold: Significant abnormalities (e.g., severe neutropenia, thrombocytopenia) warrant discontinuation.
Frequency: Ongoing throughout therapy.
Target: Not applicable
Action Threshold: Development of severe headache, blurred vision, diplopia, or papilledema requires immediate medical attention and discontinuation.
Symptom Monitoring
- Dizziness/vertigo (especially at initiation or with higher doses)
- Photosensitivity (severe sunburn-like reaction)
- Gastrointestinal upset (nausea, vomiting, diarrhea)
- Skin discoloration (blue-gray pigmentation, especially in sun-exposed areas or scars, with long-term use)
- Tooth discoloration (permanent in developing teeth of children under 8)
- Headache, blurred vision, diplopia, papilledema (signs of pseudotumor cerebri/idiopathic intracranial hypertension)
- Rash, fever, lymphadenopathy, eosinophilia (signs of Drug Reaction with Eosinophilia and Systemic Symptoms - DRESS syndrome)
- Joint pain, swelling (drug-induced lupus-like syndrome)
- Sore throat, fever, fatigue (signs of blood dyscrasias)
Special Patient Groups
Pregnancy
Minocycline is contraindicated in pregnancy (Pregnancy Category D). It can cause permanent discoloration of teeth (yellow-gray-brown) and reversible inhibition of bone growth in the fetus.
Trimester-Specific Risks:
Lactation
Minocycline is excreted into breast milk. Due to the potential for serious adverse reactions in the nursing infant, including tooth discoloration and inhibition of bone growth, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Pediatric Use
Minocycline is contraindicated in children under 8 years of age due to the risk of permanent tooth discoloration (yellow-gray-brown) and reversible inhibition of bone growth. Use in children 8 years and older should be carefully considered and only when other antibiotics are not suitable.
Geriatric Use
No specific dose adjustment is generally required based on age alone. However, elderly patients may have age-related decreases in renal or hepatic function, which may necessitate dose adjustments or closer monitoring. Elderly patients may also be more susceptible to adverse effects like dizziness or pseudotumor cerebri.
Clinical Information
Clinical Pearls
- Minocycline is unique among tetracyclines for its higher lipophilicity, leading to better tissue penetration (e.g., CNS, skin) and a longer half-life.
- Unlike other tetracyclines, minocycline's absorption is less affected by food or dairy products, but it's still prudent to separate administration from antacids, iron, and calcium supplements by 2-3 hours.
- A common and often dose-related side effect is dizziness/vertigo, especially at the initiation of therapy or with higher doses. Advise patients about this and caution against driving or operating machinery.
- Minocycline can cause blue-gray skin, nail, and tooth discoloration with long-term use, which can be permanent.
- Patients should be strongly advised about photosensitivity and to use sun protection.
- Be vigilant for signs of pseudotumor cerebri (idiopathic intracranial hypertension), such as severe headache, blurred vision, or papilledema, especially if co-administered with retinoids.
- Minocycline has anti-inflammatory properties in addition to its antibiotic effects, making it particularly useful for acne vulgaris at lower doses.
- Take with a full glass of water and remain upright for at least 30 minutes to prevent esophageal irritation/ulceration.
Alternative Therapies
- Doxycycline (another tetracycline, often used for similar indications)
- Tetracycline (older tetracycline, more food/dairy interactions)
- Erythromycin (macrolide, for acne or certain infections)
- Clindamycin (lincosamide, for acne or anaerobic infections)
- Trimethoprim/sulfamethoxazole (for skin infections, UTIs)
- Oral contraceptives (for hormonal acne)
- Topical retinoids (for acne)
- Benzoyl peroxide (for acne)