Antimicrobials
Minocycline

Minocycline

Low
Excellent (90 to 100%)

Spectrum of Activity

Dosing

General Information

Typically reserved as an option for MDR Gram-negative infections such as S. maltophilia and A. baumannii.

CBC, renal and liver function tests periodically with prolonged therapy.

  • Vertigo and ataxia
  • GI intolerance (nausea, vomiting)
  • Teeth staining (not recommended for children < 8 years of age unless benefits outweigh risks)
  • Worsening azotemia (in patients with renal failure typically)
  • Hepatotoxicity (dose-related); autoimmune hepatitis
  • Esophageal ulcerations
  • Photosensitivity
  • Skin and mucosal (blue-black) hyperpigmentation with long-term treatment
  • Visual disturbances
  • Aggravation of myasthenia gravis
  • Hemolytic anemia and thrombocytopenia
  • Hypersensitivity, Stevens-Johnson syndrome
  • Pancreatitis
  • Polyvalent cations (aluminum, zinc, magnesium, calcium, iron)/quinapril: decreased absorption of minocycline (separate administration by 4 hr)
  • Digoxin: increased digoxin levels
  • Warfarin: enhanced anticoagulant effect
  • Non-depolarizing neuromuscular blocker (vecuronium, rocuronium): may potentiate neuromuscular blocker
  • Cholestyramine/colestipol: decreased absorption of minocycline (avoid co-administration)
  • Carbamazepine/phenytoin/rifampin: decrease minocycline concentrations
  • Oral contraceptives: may decrease efficacy of oral contraceptives
  • Acitretin: may increase intracranial pressure

Distribution: widely distributed into body tissues and fluids including pleural fluid, bronchial secretions, sputum, ascitic fluid, synovial fluid, aqueous and vitreous humor, and prostatic fluid; poor CNS penetration.