Minocycline

These indications are based on manufacturer information for both originator and generic products. For product specific registered indications, please refer to product specific manufacturer information

Registered South African indications: 

• Upper and lower respiratory tract infections: Sinusitis, pharyngitis, Mycoplasma pneumonia, psittacosis and chronic bronchitis
• Genito-urinary tract infections: Non-specific urethritis (only if the strain is sensitive), lymphogranuloma venereum, chancroid and granuloma inguinale, gonococcal salpingitis, epididymitis, acute epididymo-orchitus, endocervical infections, syphilis and gonorrhoea (in cases of penicillin allergy)
• Soft tissue: Acne
• Ophthalmic: Trachoma and inclusion conjunctivitis
• Intestinal: Cholera, Whipple's disease and tropical sprue
• Miscellaneous: Rickettsial infections, brucellosis, tularaemia, actinomycosis, Lyme disease, yaws, relapsing fever, leptospirosis during the early ineffective phase

Contraindications

• Hypersensitivity to the active ingredients or to any of its excipients
• Hypersensitivity to tetracyclines
• Pregnancy
• Breastfeeding
• Severe renal impairment
• Children < 12 years

Cautions

• Hepatic impairment
• Galactose intolerance
• Lapp lactase deficiency
• Glucose-galactose malabsorption

Forms avail. in SA and covered in this monograph: cap, tab

Infections caused by Gram positive bacilli (including L. monocytogenes, B. anthracis); Gram negative organisms (excluding E. coli, Shigella and P. aeruginosa); Anaerobic organisms including C. tetani and Bacteroides spp.; Others including M. pneumoniae and C. trachomatis

General dosing range

• Oral (cap, tab): 50-100mg, 12hourly

Specific doses based on individual indications

Please note that the dosages below should be used in combination with regional guidelines, taking into account local antibiotic sensitivities

Acne

• Oral (cap, tab): Initial: 50-100mg, 12hrly; Maintenance: 50mg, 12hrly; Min treatment duration: 6 weeks

Not established for use in children younger than 12 years

Pregnancy

• Contraindicated

Breastfeeding

• Contraindicated 

Renal Impairment

• Severe: Contraindicated  

Hepatic Impairment

• Caution; no dose adjustment recommended

Elderly

• No dose adjustment recommended

Central Nervous System Disorders

• Dizziness
• Headache 
• Hypoaesthesia 
• Paraesthesia
• Intracranial hypertension
• Vertigo
• Bulging fontanelle
• Seizures
• Sedation

Cardiovascular Disorders

• Myocarditis 
• Pericarditis

Respiratory Disorders

• Cough
• Dyspnoea
• Bronchospasm 
• Exacerbation of asthma 
• Pulmonary eosinophilia
• Pneumonitis

Gastrointestinal Disorders

• Diarrhoea 
• Nausea and vomiting 
• Stomatitis 
• Discolouration of teeth
• Dyspepsia
• Dysphagia 
• Enamel hypoplasia
• Enterocolitis
• Oesophagitis
• Oesophageal ulceration 
• Glossitis
• Pancreatitis 
• Pseudomembranous colitis

Hepatobiliary Disorders

• Increased hepatic enzymes
• Hepatitis
• Autoimmune hepatoxicity
• Hepatic cholestatis
• Hepatic failure
• Hyperbilirubinaemia
• Jaundice
• Autoimmune hepatitis

Genitourinary Disorders

• Increased serum urea 
• Acute renal failure
• Interstitial nephritis
• Balanitis

Endocrine and Metabolic Disorders

• Abnormal thyroid function
• Brown-black discolouration of the thyroid
• Anorexia

Musculoskeletal Disorders

• Arthralgia 
• Lupus-like syndrome 
• Myalgia
• Arthritis 
• Bone discolouration 
• Cases of or exacerbation of systemic lupus erythematosus 
• Joint stiffness 
• Joint swelling

Skin and Subcutaneous Tissue Disorders

• Alopecia
• Erythema multiforme 
• Erythema nodosum
• Fixed drug eruption 
• Hyperpigmentation of skin 
• Photosensitivity 
• Pruritis
• Rash 
• Urticaria 
• Vasculitis
• Angioedema 
• Exfoliative dermatitis 
• Hyperpigmentation of nails 
• Stevens-Johnson Syndrome 
• Toxic epidermal necrolysis
• Drug rash with eosinophilia and systemic symptoms

Immune, Blood and Lymphatic System Disorders

• Candidiasis 
• Vulvovaginitis
• Eosinophilia
• Leucopenia
• Neutropenia 
• Thrombocytopenia
• Haemolytic anaemia 
• Pancytopenia
• Agranulocytosis
• Anaphylaxis/anaphylactoid reaction
• Hypersensitivity 
• Pulmonary infiltrates 
• Anaphylactoid purpura 
• Polyarteritis nodosa

Sensory Disorders

• Impaired hearing
• Tinnitus

• Angiotensin-converting enzyme inhibitors
• Antacids
• Penicillins
• Anticoagulants
• Diuretics
• Ergotamine
• Ergometrine
• Oral contraceptives
• Retinoids
• Ulcer healing agents

• Hepatic function
• Renal function

Specific cases may require

• Serum magnesium
• Anti-nuclear antibody
• Full blood count
• Ophthalmic exam

Minocycline hydrochloride has a spectrum of activity and mode of action similar to that of tetracycline hydrochloride, but it is more active against many species. In addition, it is reported to be effective in vitro, against some tetracycline resistant staphylococci, streptococci and certain strains of tetracycline-resistant E. coli and H. influenzae.

Spectrum of activity: Gram positive bacilli (including L. monocytogenes, B. anthracis); Gram negative organisms (excluding E. coli, Shigella and P. aeruginosa); Anaerobic organisms including C. tetani and Bacteroides spp.; Others including M. pneumoniae and C. trachomatis

Tablet 50mg

• Minotabs (Sandoz)

Capsule 50mg

• Cyclimycin (Pharmacare)

Capsule 100mg

• Cyclimycin (Pharmacare)