Minocycline

Tetracycline·Infectious Diseases - Macrolides & Tetracyclines

Moderate to severe acne vulgaris, susceptible MRSA infections, Nocardia

PBSTETRACYCLINEMinomycin, Akamin50 mg tabletS4+1

Max Dose

200 mg/day

Half-life

15 h

Vestibular Tox

HIGH RISK

Pigmentation

CHRONIC RISK

Rapid Summary

Overview

Highly lipophilic, broad-spectrum bacteriostatic tetracycline. Exceptional tissue penetration. Primarily used for severe, scarring acne and certain MRSA/atypical infections.

Maximum Dose

Max 200 mg/day (Usually 50-100 mg BD).

Clinical Focus

Unique among tetracyclines for causing severe vestibular toxicity (vertigo/dizziness) and irreversible blue-grey skin pigmentation with chronic use.

Bottom Line

Minocycline is a tetracycline used for acne and some resistant infections, but causes vestibular toxicity (dizziness), blue-grey skin discolouration, and drug-induced lupus.

Formulation & Access

Brand Names

Minomycin, Akamin

Oral Routes

Capsules/Tablets (50 mg, 100 mg).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Moderate to severe acne vulgaris, susceptible MRSA infections, Nocardia.

Clinical Place

Often chosen when Doxycycline fails for acne, but limited by its heavier side effect profile.

Quick reference

Class & Role

Tetracycline — Highly lipophilic, broad-spectrum bacteriostatic tetracycline.

Route / Formulation

Capsules/Tablets (50 mg, 100 mg). (Minomycin, Akamin)

Usual Dose & Max

PO 50 mg BD (taken with food/milk to reduce nausea, unlike older tetracyclines). Max 200 mg/day (Usually 50-100 mg BD).

Key Indication Doses

Severe Acne Vulgaris: PO 50 mg BD (taken with food/milk to reduce nausea, unlike older tetracyclines). MRSA Skin Infections: PO 100 mg BD.

Best Uses

Minocycline is a tetracycline used for acne and some resistant infections, but causes vestibular toxicity (dizziness), blue-grey skin discolouration, and drug-induced lupus.

Avoid / Cautions

Children < 8 years (permanent tooth staining), concurrent use with Isotretinoin (massive risk of intracranial hypertension). Pregnancy Category D (impairs fetal bone growth).

Key Risks

Neurological: Vestibular toxicity (severe vertigo, dizziness, ataxia) occurring in up to 20% of women. Benign intracranial hypertension (pseudotumor cerebri). Dermatological: Blue-grey hyperpigmentation of the skin, nails, and scars (can be permanent). Drug-induced lupus erythematosus (DILE). Gastrointestinal: Nausea, pill esophagitis (less than Doxycycline).

Key Interactions

Chelates with Iron, Calcium, and Antacids. Separate by 2 hours. Oral Retinoids (Isotretinoin/Roaccutane). Fatal interaction causing pseudotumor cerebri.

Monitoring

Warn the patient to stop the drug if they experience severe unexplained headaches and blurred vision (signs of increased intracranial pressure). Monitor LFTs and ANA levels if used chronically (Lupus risk).

Clinical Pearl

Minocycline deposits in melanin and collagen. Patients on long-term therapy for acne can suddenly develop a muddy, blue-grey discoloration in their old acne scars or on their shins. It takes years to fade once the drug is stopped.

Access

Minomycin, Akamin50 mg tablet

Brand: Minomycin, Akamin
Formulation: Capsules/Tablets (50 mg, 100 mg)

Minocycline

Tetracycline·Infectious Diseases - Macrolides & Tetracyclines

Moderate to severe acne vulgaris, susceptible MRSA infections, Nocardia

PBSTETRACYCLINEMinomycin, Akamin50 mg tabletS4+1

Max Dose

200 mg/day

Half-life

15 h

Vestibular Tox

HIGH RISK

Pigmentation

CHRONIC RISK

Rapid Summary

Overview

Highly lipophilic, broad-spectrum bacteriostatic tetracycline. Exceptional tissue penetration. Primarily used for severe, scarring acne and certain MRSA/atypical infections.

Maximum Dose

Max 200 mg/day (Usually 50-100 mg BD).

Clinical Focus

Unique among tetracyclines for causing severe vestibular toxicity (vertigo/dizziness) and irreversible blue-grey skin pigmentation with chronic use.

Bottom Line

Minocycline is a tetracycline used for acne and some resistant infections, but causes vestibular toxicity (dizziness), blue-grey skin discolouration, and drug-induced lupus.

Formulation & Access

Brand Names

Minomycin, Akamin

Oral Routes

Capsules/Tablets (50 mg, 100 mg).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Moderate to severe acne vulgaris, susceptible MRSA infections, Nocardia.

Clinical Place

Often chosen when Doxycycline fails for acne, but limited by its heavier side effect profile.

Quick reference

Class & Role

Tetracycline — Highly lipophilic, broad-spectrum bacteriostatic tetracycline.

Route / Formulation

Capsules/Tablets (50 mg, 100 mg). (Minomycin, Akamin)

Usual Dose & Max

PO 50 mg BD (taken with food/milk to reduce nausea, unlike older tetracyclines). Max 200 mg/day (Usually 50-100 mg BD).

Key Indication Doses

Severe Acne Vulgaris: PO 50 mg BD (taken with food/milk to reduce nausea, unlike older tetracyclines). MRSA Skin Infections: PO 100 mg BD.

Best Uses

Minocycline is a tetracycline used for acne and some resistant infections, but causes vestibular toxicity (dizziness), blue-grey skin discolouration, and drug-induced lupus.

Avoid / Cautions

Children < 8 years (permanent tooth staining), concurrent use with Isotretinoin (massive risk of intracranial hypertension). Pregnancy Category D (impairs fetal bone growth).

Key Risks

Key Interactions

Chelates with Iron, Calcium, and Antacids. Separate by 2 hours. Oral Retinoids (Isotretinoin/Roaccutane). Fatal interaction causing pseudotumor cerebri.

Monitoring

Clinical Pearl

Access

Minomycin, Akamin50 mg tablet

Brand: Minomycin, Akamin
Formulation: Capsules/Tablets (50 mg, 100 mg)