View source for Minocycline

{{Short description|Antibiotic medication}}
{{Use dmy dates|date=August 2021}}
{{cs1 config |name-list-style=vanc |display-authors=6}}
{{infobox drug
| Verifiedfields     = changed
| Watchedfields      = changed
| verifiedrevid      = 413871574
| image              = Minocycline.svg
| alt                =
| image2             = Minocycline_(model).png
| alt2               =

<!-- Clinical data -->
| tradename          = Minocin, Amzeeq, others
| Drugs.com          = {{drugs.com|monograph|minocycline-hydrochloride}}
| MedlinePlus        = a682101
| DailyMedID         = Minocycline
| pregnancy_AU       = D
| pregnancy_AU_comment = <ref name="Drugs.com pregnancy">{{Cite web |date=4 December 2018 |title=Minocycline Use During Pregnancy |url=https://www.drugs.com/pregnancy/minocycline.html |access-date=16 May 2020 |website=Drugs.com}}</ref>
| routes_of_administration = [[Oral administration|By mouth]], [[Intravenous therapy|intravenous]], [[Topical medication|topical]]
| class              = [[Antibiotic]]; [[Tetracycline antibiotic]]
| ATC_prefix         = J01
| ATC_suffix         = AA08
| ATC_supplemental   = {{ATC|A01|AB23}}, {{ATC|D10|AF07}}

<!-- Legal status -->
| legal_AU           = S4
| legal_CA           = <!-- / Schedule I, II, III, IV, V, VI, VII, VIII -->
| legal_UK           = <!-- GSL / P / POM / CD / Class A, B, C -->
| legal_US           = Rx-only
| legal_US_comment   = <ref name="Minocin FDA label">{{Cite web |date=28 July 2021 |title=Minocin- minocycline hydrochloride injection |url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e415c323-8219-464b-9e3e-72c5a796cdaa |access-date=19 February 2023 |website=DailyMed}}</ref><ref name="Amzeeq FDA label" />

<!-- Pharmacokinetic data -->
| bioavailability    = 90–100%<ref name="AHFS2019" />
| protein_bound      = 70–75%<ref name="Arzneistoff-Profile">{{Cite book |title=Arzneistoff-Profile |publisher=Govi Pharmazeutischer Verlag |year=2010 |isbn=978-3-7741-9846-3 |veditors=Dinnendahl V, Fricke U |edition=24 |volume=7 |location=Eschborn, Germany |language=de |chapter=Minocyclin}}</ref>
| metabolism         = [[Liver]]<ref name="Arzneistoff-Profile" />
| elimination_half-life = 15.5{{nbsp}}h (11–26{{nbsp}}h)<ref name="Minocin FDA label" /><ref name="AHFS2019" /><ref name="Arzneistoff-Profile" />
| excretion          = Mostly [[fecal]], 10–15% [[renal]]<ref name="Arzneistoff-Profile" />

<!-- Identifiers -->
| CAS_number_Ref     = {{cascite|correct|??}}
| CAS_number         = 10118-90-8
| PubChem            = 54675783
| DrugBank_Ref       = {{drugbankcite|changed|drugbank}}
| DrugBank           = DB01017
| ChemSpiderID_Ref   = {{chemspidercite|correct|chemspider}}
| ChemSpiderID       = 16735907
| UNII_Ref           = {{fdacite|correct|FDA}}
| UNII               = FYY3R43WGO
| KEGG_Ref           = {{keggcite|correct|kegg}}
| KEGG               = D05045
| ChEBI_Ref          = {{ebicite|changed|EBI}}
| ChEBI              = 50694
| ChEMBL_Ref         = {{ebicite|correct|EBI}}
| ChEMBL             = 1434
| synonyms           =

<!-- Chemical data -->
| IUPAC_name         = (2''E'',4''S'',4a''R'',5aS,12a''R'')-2-(Amino-hydroxy-methylidene)-4,7-bis(dimethylamino)-10,11,12a-trihydroxy-4a,5,5a,6- tetrahydro-4''H''-tetracene-1,3,12-trione<ref>{{Cite web |title=Minocycline |url=https://go.drugbank.com/drugs/DB01017 |website=go.drugbank.com}}</ref>
| C                  = 23
| H                  = 27
| N                  = 3
| O                  = 7
| SMILES             = CN(C)c1ccc(c2c1C[C@H]3C[C@H]4[C@@H](C(=C(C(=O)[C@]4(C(=C3C2=O)O)O)C(=O)N)O)N(C)C)O
| StdInChI_Ref       = {{stdinchicite|correct|chemspider}}
| StdInChI           = 1S/C23H27N3O7/c1-25(2)12-5-6-13(27)15-10(12)7-9-8-11-17(26(3)4)19(29)16(22(24)32)21(31)23(11,33)20(30)14(9)18(15)28/h5-6,9,11,17,27,29-30,33H,7-8H2,1-4H3,(H2,24,32)/t9-,11-,17-,23-/m0/s1
| StdInChIKey_Ref    = {{stdinchicite|correct|chemspider}}
| StdInChIKey        = DYKFCLLONBREIL-KVUCHLLUSA-N

<!-- Physical data -->
| solubility         = Low
| sol_units          =
| specific_rotation  = <math>[\alpha]_D^{25}</math> = −166°<ref name="Arzneistoff-Profile" />
}}
<!-- Definition and medical uses -->
'''Minocycline''', sold under the brand name '''Minocin''' among others, is a [[tetracycline antibiotic]] medication used to treat a number of bacterial infections such as some occurring in certain forms of [[pneumonia]].<ref name="Minocin FDA label" /><ref name=AHFS2019/><ref name=BNF76/> It is generally (but not always) less preferred than the tetracycline [[doxycycline]].<ref name=AHFS2019/><ref name=BNF76/> Minocycline is also used for the treatment of [[acne]] and [[rheumatoid arthritis]].<ref name="BNF76">{{Cite book |title=British national formulary : BNF 76 |date=2018 |publisher=Pharmaceutical Press |isbn=9780857113382 |edition=76 |pages=556}}</ref><ref name="Amzeeq FDA label" /> It is taken [[oral administration|by mouth]] or applied to the [[skin]].<ref name="AHFS2019">{{Cite web |title=Minocycline Hydrochloride Monograph for Professionals |url=https://www.drugs.com/monograph/minocycline-hydrochloride.html |access-date=23 March 2019 |website=Drugs.com |publisher=American Society of Health-System Pharmacists}}</ref><ref name="Amzeeq FDA label">{{Cite web |date=25 January 2023 |title=Amzeeq- minocycline aerosol, foam |url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=cc251492-977b-4eb1-a088-a90831324bad |access-date=18 February 2023 |website=DailyMed}}</ref>

<!-- Side effects and mechanisms -->
Common side effects include nausea, diarrhea, dizziness, allergic reactions, and kidney problems.<ref name=AHFS2019/> Serious side effects may include [[anaphylaxis]], a [[lupus]]-like syndrome, and [[photosensitivity|easy sunburning]].<ref name=AHFS2019/> Use in the later part of [[pregnancy]] may harm the baby and safety during [[breastfeeding]] is unclear.<ref name="Preg2019">{{Cite web |title=Minocycline Use During Pregnancy |url=https://www.drugs.com/pregnancy/minocycline.html |access-date=3 March 2019 |website=Drugs.com |language=en}}</ref> It works by decreasing a bacterium's ability to make protein thus stopping its [[bacteriostatic|growth]].<ref name=AHFS2019/>

<!-- History and culture -->
Minocycline was patented in 1961 and came into commercial use in 1971.<ref name="FischerGanellin2006">{{Cite book |url=https://books.google.com/books?id=FjKfqkaKkAAC&pg=PA489 |title=Analogue-based Drug Discovery |vauthors=Fischer J, Ganellin CR |date=2006 |publisher=John Wiley & Sons |isbn=9783527607495 |page=489 |language=en}}</ref> It is available as a [[generic medication]].<ref name=BNF76/><ref>{{Cite web |date=17 October 2022 |title=First Generic Drug Approvals |url=https://www.fda.gov/drugs/drug-and-biologic-approval-and-ind-activity-reports/first-generic-drug-approvals |access-date=28 November 2022 |website=U.S. Food and Drug Administration}}</ref> In 2022, it was the 269th most commonly prescribed medication in the United States, with more than 900,000 prescriptions.<ref>{{Cite web |title=The Top 300 of 2022 |url=https://clincalc.com/DrugStats/Top300Drugs.aspx |url-status=live |archive-url=https://web.archive.org/web/20240830202410/https://clincalc.com/DrugStats/Top300Drugs.aspx |archive-date=30 August 2024 |access-date=30 August 2024 |website=ClinCalc}}</ref><ref>{{Cite web |title=Minocycline Drug Usage Statistics, United States, 2013 - 2022 |url=https://clincalc.com/DrugStats/Drugs/Minocycline |access-date=30 August 2024 |website=ClinCalc}}</ref>

==Medical uses==
[[File:Minocycline-150.jpg|thumb|left|100px|Minocycline 100-mg capsules manufactured by Ranbaxy Pharmaceuticals]]

===Acne===
Minocycline and [[doxycycline]] are frequently used for the treatment of [[acne vulgaris]].<ref name="ReynoldsYeungCheng2024" /><ref>{{Cite journal |vauthors=Strauss JS, Krowchuk DP, Leyden JJ, Lucky AW, Shalita AR, Siegfried EC, Thiboutot DM, Van Voorhees AS, Beutner KA, Sieck CK, Bhushan R |date=April 2007 |title=Guidelines of care for acne vulgaris management |journal=Journal of the American Academy of Dermatology |volume=56 |issue=4 |pages=651–663 |doi=10.1016/j.jaad.2006.08.048 |pmid=17276540}}</ref><ref>{{Cite web |title=Minocycline, Doxycycline and Acne Vulgaris |url=http://scienceofacne.com/doxycycline-and-minocycline/ |archive-url=https://web.archive.org/web/20120807133359/http://scienceofacne.com:80/doxycycline-and-minocycline |archive-date=7 August 2012 |access-date=7 August 2012 |publisher=ScienceOfAcne.com}}</ref> Minocycline is specifically [[indicated]] to treat inflammatory lesions of non-nodular moderate to severe acne vulgaris in people nine years of age and older.<ref name="ReynoldsYeungCheng2024">{{Cite journal |vauthors=Reynolds RV, Yeung H, Cheng CE, Cook-Bolden F, Desai SR, Druby KM, Freeman EE, Keri JE, Stein Gold LF, Tan JK, Tollefson MM, Weiss JS, Wu PA, Zaenglein AL, Han JM, Barbieri JS |date=May 2024 |title=Guidelines of care for the management of acne vulgaris |journal=J Am Acad Dermatol |volume=90 |issue=5 |pages=1006.e1–1006.e30 |doi=10.1016/j.jaad.2023.12.017 |pmid=38300170}}</ref><ref name="Amzeeq FDA label" /> Both minocycline and doxycycline have similar levels of effectiveness and common adverse effects for acne, although doxycycline may have a slightly lower risk of adverse side effects.<ref name="ReynoldsYeungCheng2024" /><ref name="pmid21061764">{{Cite journal |vauthors=Kircik LH |date=November 2010 |title=Doxycycline and minocycline for the management of acne: a review of efficacy and safety with emphasis on clinical implications |journal=Journal of Drugs in Dermatology |volume=9 |issue=11 |pages=1407–1411 |pmid=21061764}}</ref> Both [[oral administration|oral]]/[[systemic administration|systemic]] and more recently [[topical medication|topical]] formulations of minocycline are available to treat acne.<ref name="ReynoldsYeungCheng2024" /><ref name="OngeMobley2021">{{Cite journal |vauthors=Onge ES, Mobley WC |date=January 2021 |title=Minocycline Topical Foam: A New Drug for the Treatment of Acne |journal=Ann Pharmacother |volume=55 |issue=1 |pages=105–110 |doi=10.1177/1060028020939926 |pmid=32618475}}</ref>

Historically, oral minocycline has been an effective treatment for acne vulgaris.<ref>{{Cite journal |vauthors=Hubbell CG, Hobbs ER, Rist T, White JW |date=December 1982 |title=Efficacy of minocycline compared with tetracycline in treatment of acne vulgaris |journal=Archives of Dermatology |volume=118 |issue=12 |pages=989–992 |doi=10.1001/archderm.1982.01650240033017 |pmid=6216858}}</ref> However, acne that is caused by antibiotic-resistant bacteria is a growing problem in many countries.<ref>{{Cite journal |vauthors=Eady EA, Gloor M, Leyden JJ |year=2003 |title=Propionibacterium acnes resistance: a worldwide problem |journal=Dermatology |volume=206 |issue=1 |pages=54–56 |doi=10.1159/000067822 |pmid=12566805 |s2cid=6111436}}</ref> In Europe and North America, a number of people with acne no longer respond well to treatment with [[tetracycline]] family antibiotics because their acne symptoms are caused by bacteria (primarily ''[[Cutibacterium acnes]]'') that are resistant to these antibiotics. In order to reduce resistance rates as well as increase the effectiveness of treatment, oral antibiotics should be generally combined with topical acne creams such as benzoyl peroxide or a retinoid ([[tretinoin]], [[adapalene]], etc.).<ref>{{Cite journal |vauthors=Ross JI, Snelling AM, Carnegie E, Coates P, Cunliffe WJ, Bettoli V, Tosti G, Katsambas A, Galvan Peréz Del Pulgar JI, Rollman O, Török L, Eady EA, Cove JH |date=March 2003 |title=Antibiotic-resistant acne: lessons from Europe |journal=The British Journal of Dermatology |volume=148 |issue=3 |pages=467–478 |arxiv=0706.4406 |doi=10.1046/j.1365-2133.2003.05067.x |pmid=12653738 |s2cid=20838517 |hdl=10454/3069}}</ref> There have also been concerns about systemic minocycline having a variety of rare adverse effects in terms of its use to treat acne.<ref name="ReynoldsYeungCheng2024" /><ref name="Dominic2021" />

Oral minocycline is used to treat acne for up to 3 to 4{{nbsp}}months.<ref name="ReynoldsYeungCheng2024" /> Data beyond 3 to 4{{nbsp}}months are limited.<ref name="ReynoldsYeungCheng2024" />

===Other infections===
Minocycline is also used for other skin infections such as [[methicillin-resistant Staphylococcus aureus|methicillin-resistant ''Staphylococcus aureus'']].<ref name="pmid17088156">{{Cite journal |vauthors=Rogers RL, Perkins J |date=September 2006 |title=Skin and soft tissue infections |journal=Primary Care |volume=33 |issue=3 |pages=697–710 |doi=10.1016/j.pop.2006.06.005 |pmid=17088156}}</ref>

Although minocycline's broader spectrum of activity, compared with other members of the group, includes activity against ''[[Neisseria meningitidis]]'',<ref name="pmid15782277">{{Cite journal |vauthors=Fraser A, Gafter-Gvili A, Paul M, Leibovici L |date=March 2005 |title=Prophylactic use of antibiotics for prevention of meningococcal infections: systematic review and meta-analysis of randomised trials |journal=European Journal of Clinical Microbiology & Infectious Diseases |volume=24 |issue=3 |pages=172–181 |doi=10.1007/s10096-005-1297-7 |pmid=15782277 |s2cid=1259483}}</ref> its use for [[prophylaxis]] is no longer recommended because of side effects ([[dizziness]] and [[vertigo]]).

It may be used to treat certain strains of methicillin-resistant ''S. aureus'' infection and a disease caused by drug-resistant ''[[Acinetobacter]]'' spp.<ref name="pmid19665876">{{Cite journal |vauthors=Bishburg E, Bishburg K |date=November 2009 |title=Minocycline--an old drug for a new century: emphasis on methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii |journal=International Journal of Antimicrobial Agents |volume=34 |issue=5 |pages=395–401 |doi=10.1016/j.ijantimicag.2009.06.021 |pmid=19665876}}</ref>

A list of uses includes:
* [[Amoebic dysentery]]
* [[Anthrax]]
* [[Bubonic plague]]
* [[Cholera]]
* [[Ehrlichiosis]]
* [[Gonorrhea]] (when [[penicillin]] cannot be given)
* Gougerot-Carteaud syndrome ([[confluent and reticulated papillomatosis]])
* [[Hidradenitis suppurativa]]
* For use as an adjuvant to [[HAART]]<ref>{{Cite journal |vauthors=Copeland KF, Brooks JI |date=April 2010 |title=A novel use for an old drug: the potential for minocycline as anti-HIV adjuvant therapy |journal=The Journal of Infectious Diseases |volume=201 |issue=8 |pages=1115–1117 |doi=10.1086/651278 |pmid=20205572 |doi-access=free}}</ref>
* [[Leprosy]]<ref>{{Cite journal |vauthors=Mungroo MR, Khan NA, Siddiqui R |date=December 2020 |title=Mycobacterium leprae: Pathogenesis, diagnosis, and treatment options |journal=Microbial Pathogenesis |volume=149 |pages=104475 |doi=10.1016/j.micpath.2020.104475 |pmid=32931893 |s2cid=221748544}}</ref>
* [[Periodontal disease]]
* [[Perioral dermatitis]]<ref>U.S. National Library of Medicine (11 December 2009) [https://www.nlm.nih.gov/medlineplus/ency/article/001455.htm 'Perioral dermatitis']. Retrieved 7 August 2010.</ref>
* Respiratory infections such as [[pneumonia]]
* [[Rocky Mountain spotted fever]]
* [[Rosacea]]
* [[Syphilis]] (when penicillin cannot be given)
* [[Urinary tract infection]]s (UTIs), rectal infections, and infections of the [[cervix]] caused by certain microbes

Minocycline has been reported to be effective in the eradication of UTIs and [[prostatitis]].<ref name="JonasCunha1982" /><ref name="PerlettiMarrasWagenlehner2013">{{Cite journal |vauthors=Perletti G, Marras E, Wagenlehner FM, Magri V |date=August 2013 |title=Antimicrobial therapy for chronic bacterial prostatitis |journal=Cochrane Database Syst Rev |volume=2013 |issue=8 |pages=CD009071 |doi=10.1002/14651858.CD009071.pub2 |pmc=11361477 |pmid=23934982}}</ref><ref name="HanusDanziger1984">{{Cite journal |vauthors=Hanus PM, Danziger LH |date=1984 |title=Treatment of chronic bacterial prostatitis |journal=Clin Pharm |volume=3 |issue=1 |pages=49–55 |pmid=6365416}}</ref>

===Other uses===
Both minocycline and doxycycline have shown effectiveness in [[asthma]] due to [[immunosuppressant|immune-suppressing]] effects.<ref name="pmid21501686">{{Cite journal |vauthors=Joks R, Durkin HG |date=December 2011 |title=Non-antibiotic properties of tetracyclines as anti-allergy and asthma drugs |journal=Pharmacological Research |volume=64 |issue=6 |pages=602–609 |doi=10.1016/j.phrs.2011.04.001 |pmid=21501686}}</ref> Minocycline and doxycycline have modest effectiveness in treating [[rheumatoid arthritis]].<ref name="pmid21723947">{{Cite journal |vauthors=Greenwald RA |date=December 2011 |title=The road forward: the scientific basis for tetracycline treatment of arthritic disorders |journal=Pharmacological Research |volume=64 |issue=6 |pages=610–613 |doi=10.1016/j.phrs.2011.06.010 |pmid=21723947}}</ref> However, the 2015 [[American College of Rheumatology]] guideline for the treatment of rheumatoid arthritis does not include minocycline.<ref>{{Cite web |title=Clinical Practice Guidelines: Rheumatoid Arthritis |url=https://www.rheumatology.org/Practice-Quality/Clinical-Support/Clinical-Practice-Guidelines/Rheumatoid-Arthritis |access-date=13 May 2017 |publisher=American College of Rheumatology}}</ref>

Recent research indicate that centrally infused minocycline attenuates brain [[microglial]] activation, [[neuroinflammation]], and [[sympathetic nervous system|sympathetic]] activation during [[pulmonary hypertension]].<ref>{{Cite journal |vauthors=Sharma RK, Oliveira AC, Kim S, Rigatto K, Zubcevic J, Rathinasabapathy A, Kumar A, Lebowitz JJ, Khoshbouei H, Lobaton G, Aquino V, Richards EM, Katovich MJ, Shenoy V, Raizada MK |date=June 2018 |title=Involvement of Neuroinflammation in the Pathogenesis of Monocrotaline-Induced Pulmonary Hypertension |journal=Hypertension |volume=71 |issue=6 |pages=1156–1163 |doi=10.1161/HYPERTENSIONAHA.118.10934 |pmc=5945302 |pmid=29712738}}</ref>

===Available forms===
Minocycline is available in the form of 50 and 100{{nbsp}}mg [[oral administration|oral]] [[capsule (pharmacy)|capsule]]s, among a variety of other formulations.<ref name="Minocin FDA label" /><ref name="Drugs@FDA">{{Cite web |title=Drugs@FDA: FDA-Approved Drugs |url=https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm |access-date=2 December 2024 |website=accessdata.fda.gov}}</ref> The oral form of minocycline is usually taken twice daily, once every 12{{nbsp}}hours, although divided doses four times daily can also be employed.<ref name="Minocin FDA label" /> [[Extended-release]] oral forms are also available.<ref name="Drugs@FDA" /> A [[topical medication|topical]] formulation is available as well.<ref name="ReynoldsYeungCheng2024" /><ref name="OngeMobley2021" /><ref name="Drugs@FDA" />

==Contraindications==
The drug is [[contraindication|contraindicated]] in people with known [[hypersensitivity]] to tetracycline antibiotics, as there is complete cross sensitivity in this group. It is also contraindicated in people with severe [[liver impairment]] and after the 16th week of [[pregnancy]].<ref name="Arzneistoff-Profile" />

==Side effects==
{{See also|List of dental abnormalities associated with cutaneous conditions}}

Minocycline may cause [[abdominal pain|upset stomach]], [[diarrhea]], [[dizziness]], unsteadiness, [[somnolence|drowsiness]], [[mouth sores]], [[migraines]], and [[vomiting]]. It increases [[photophobia|sensitivity to sunlight]], and may affect the [[sleep quality|quality of sleep]] and rarely causes [[sleep disorder]]s.<ref name="pmid6661620">{{Cite journal |vauthors=Nonaka K, Nakazawa Y, Kotorii T |date=December 1983 |title=Effects of antibiotics, minocycline and ampicillin, on human sleep |journal=Brain Research |volume=288 |issue=1–2 |pages=253–259 |doi=10.1016/0006-8993(83)90101-4 |pmid=6661620 |s2cid=22726747}}</ref> It has also been linked to cases of lupus.<ref>{{Cite news |title=MedlinePlus Drug Information: Minocycline Oral |url=https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682101.html}}</ref> Prolonged use of minocycline  can lead to blue-gray staining of skin, fingernails, and  scar tissue. This staining is not permanent, but can take a very long time for the skin color to return to normal; however, a muddy brown skin color in sun-exposed areas is usually permanent.<ref name="pmid19595269">{{Cite journal |vauthors=Geria AN, Tajirian AL, Kihiczak G, Schwartz RA |year=2009 |title=Minocycline-induced skin pigmentation: an update |journal=Acta Dermatovenerologica Croatica |volume=17 |issue=2 |pages=123–126 |pmid=19595269}}</ref> Permanent blue discoloration of gums or teeth discoloration may also occur. Rare but serious side effects include [[fever]], [[jaundice|yellowing of the eyes or skin]], stomach pain, sore throat, vision changes, and mental changes, including [[depersonalization]].<ref name="MedNet">{{Cite web |title=minocycline (Dynacin): Antibiotic Side Effects & Dosage |url=https://www.medicinenet.com/minocycline-oral/article.htm |website=MedicineNet}}</ref><ref name="pmid14746427">{{Cite journal |vauthors=Cohen PR |date=January 2004 |title=Medication-associated depersonalization symptoms: report of transient depersonalization symptoms induced by minocycline |journal=Southern Medical Journal |volume=97 |issue=1 |pages=70–73 |doi=10.1097/01.SMJ.0000083857.98870.98 |pmid=14746427 |s2cid=27125601}}</ref>

Occasionally, minocycline therapy may result in [[autoimmune disorder]]s such as drug-related [[lupus]] and [[autoimmune hepatitis]], which usually occurs in men who also developed minocycline-induced lupus; however, women are more likely to develop minocycline-induced lupus. Significant or complete recovery occurs in most people who develop minocycline-induced autoimmune problems within a period of a few weeks to a year of cessation of minocycline therapy. Autoimmune problems emerge during chronic therapy, but can sometimes occur after only short courses of a couple of weeks of therapy.<ref name="pmid18200008">{{Cite journal |vauthors=Mongey AB, Hess EV |date=March 2008 |title=Drug insight: autoimmune effects of medications-what's new? |journal=Nature Clinical Practice. Rheumatology |volume=4 |issue=3 |pages=136–144 |doi=10.1038/ncprheum0708 |pmid=18200008 |s2cid=205340777}}</ref><ref name="pmid20642295">{{Cite journal |vauthors=Ochsendorf F |year=2010 |title=Minocycline in acne vulgaris: benefits and risks |journal=American Journal of Clinical Dermatology |volume=11 |issue=5 |pages=327–341 |doi=10.2165/11319280-000000000-00000 |pmid=20642295 |s2cid=24501240}}</ref> [[Drug reaction with eosinophilia and systemic symptoms]] syndrome can occur during the first few weeks of therapy with minocycline.<ref name="pmid20642295" />

Minocycline, but not other tetracyclines, can cause [[vestibular disorder|vestibular disturbance]]s with [[dizziness]], [[ataxia]], [[vertigo]], and [[tinnitus]]. These effects are thought to be related to minocycline's greater penetration into the [[central nervous system]]. Vestibular side effects are much more common in women than in men, occurring in 50 to 70% of women receiving minocycline. As a result of the frequency of this bothersome side effect, minocycline is rarely used in female patients.<ref>{{Cite book |title=Infectious Diseases of the Female Genital Tract |vauthors=Sweet RL, Gibbs RS |publisher=Lippincott Williams & Wilkins |year=2001 |edition=4th |page=635}}</ref> Minocycline's vestibular side effects typically resolve after discontinuation of the drug.<ref name="Bauman 2010 pp.435–436">{{Cite book |title=Ototoxic Drugs Exposed |vauthors=Bauman N |date=2010 |publisher=Integrity First Publications |isbn=978-1-935939-00-9 |edition=3 |pages=435–436 |quote=You can develop symptoms of ototoxicity after only one or two doses. These symptoms normally disappear a day or two after you stop taking this drug.}}</ref><ref name="Drugs.com 2023">{{Cite web |date=27 December 2023 |title=Minocycline Side Effects: Common, Severe, Long Term |url=https://www.drugs.com/sfx/minocycline-side-effects.html |archive-url=https://web.archive.org/web/20240116091026/https://www.drugs.com/sfx/minocycline-side-effects.html |archive-date=16 January 2024 |access-date=16 January 2024 |website=Drugs.com |quote=Headache, dizziness, vertigo, and ataxia have been reported. These side effects were reversible within 3 to 48 hours of stopping therapy and occurred less often with low doses.}}</ref><ref name="pmid4143012">{{Cite journal |vauthors=Williams DN, Laughlin LW, Lee YH |date=September 1974 |title=Minocycline: Possible vestibular side-effects |journal=Lancet |volume=2 |issue=7883 |pages=744–6 |doi=10.1016/s0140-6736(74)90941-6 |pmid=4143012 |quote=17 (89%) of 19 persons taking minocycline for the treatment of bacteriuria or for prophylaxis of meningococcal disease developed nausea, vomiting, weakness, ataxia, vertigo, or dizziness, 24-48 hours after the initiation of therapy. These symptoms usually occurred in combination, were often acute and severe, and disappeared shortly after therapy was discontinued.}}</ref><ref name="pmid1081373">{{Cite journal |vauthors=Jacobson JA, Daniel B |date=October 1975 |title=Vestibular reactions associated with minocycline |journal=Antimicrobial Agents and Chemotherapy |volume=8 |issue=4 |pages=453–6 |doi=10.1128/AAC.8.4.453 |pmc=429369 |pmid=1081373}}</ref>

Symptoms of an [[allergic reaction]] include [[rash]], itching, swelling, severe dizziness, and trouble breathing.<ref name="MedNet" /> Minocycline has also been reported to very rarely cause [[idiopathic intracranial hypertension]] (pseudotumor cerebri),<ref name="pmid15675888">{{Cite journal |vauthors=Friedman DI |year=2005 |title=Medication-induced intracranial hypertension in dermatology |journal=American Journal of Clinical Dermatology |volume=6 |issue=1 |pages=29–37 |doi=10.2165/00128071-200506010-00004 |pmid=15675888 |s2cid=28395784}}</ref> a side effect also more common in female patients, potentially leading to permanent vision damage if not recognized early and treated.<ref>{{Cite journal |vauthors=Mechrgui M, Kanani S |date=August 2022 |title=The Ophthalmic Side Effects of Topiramate: A Review |journal=Cureus |volume=14 |issue=8 |pages=e28513 |doi=10.7759/cureus.28513 |pmc=9420653 |pmid=36059357 |doi-access=free}}</ref>

Contrary to most other tetracycline antibiotics ([[doxycycline]] excluded), minocycline may be used in those with kidney disease, but may aggravate [[systemic lupus erythematosus]].<ref name="Note1">{{Cite journal |vauthors=Gough A, Chapman S, Wagstaff K, Emery P, Elias E |date=January 1996 |title=Minocycline induced autoimmune hepatitis and systemic lupus erythematosus-like syndrome |journal=BMJ |volume=312 |issue=7024 |pages=169–172 |doi=10.1136/bmj.312.7024.169 |pmc=2349841 |pmid=8563540}}</ref> It may also trigger or unmask [[autoimmune hepatitis]].<ref name="pmid16394302">{{Cite journal |vauthors=Krawitt EL |date=January 2006 |title=Autoimmune hepatitis |journal=The New England Journal of Medicine |volume=354 |issue=1 |pages=54–66 |doi=10.1056/NEJMra050408 |pmid=16394302 |s2cid=5361674}}</ref>

Minocycline can cause the rare condition of [[idiopathic intra-cranial hypertension|secondary intracranial hypertension]], which has initial symptoms of headache, visual disturbances, dizziness, vomiting, and confusion.<ref name="Friedman 2005 pp. 29–37">{{Cite journal |vauthors=Friedman DI |year=2005 |title=Medication-induced intracranial hypertension in dermatology |journal=American Journal of Clinical Dermatology |publisher=Springer Science and Business Media LLC |volume=6 |issue=1 |pages=29–37 |doi=10.2165/00128071-200506010-00004 |pmid=15675888 |s2cid=28395784}}</ref> [[Cerebral edema|Brain swelling]] and [[rheumatoid arthritis]] are rare side effects of minocycline in some people.<ref>{{Cite journal |vauthors=Lefebvre N, Forestier E, Farhi D, Mahsa MZ, Remy V, Lesens O, Christmann D, Hansmann Y |date=May 2007 |title=Minocycline-induced hypersensitivity syndrome presenting with meningitis and brain edema: a case report |journal=Journal of Medical Case Reports |volume=1 |pages=22 |doi=10.1186/1752-1947-1-22 |pmc=1884162 |pmid=17511865 |doi-access=free}}</ref>

Minocycline, like most tetracyclines, becomes dangerous past its expiration date.<ref name="ReferenceA">"Principles and methods for the assessment of nephrotoxicity associated with exposure to chemicals". Environmental health criteria: 119. World Health Organization (WHO). {{ISBN|92-4-157119-5}}. ISSN 0250-863X. 1991</ref> While most prescription drugs lose potency after their expiration dates, tetracyclines are known to become toxic over time. Expired tetracyclines can cause serious damage to the kidney due to the formation of a degradation product, anhydro-4-epitetracycline.<ref name="ReferenceA" /> Minocycline's absorption is impaired if taken at the same time of day as calcium or iron supplements. Unlike some of the other tetracycline group antibiotics, it can be taken with calcium-rich foods such as milk, although this does reduce the absorption slightly.<ref>{{Cite book |url=https://archive.org/details/druginteractions0000unse_u2m5 |title=Drug Interactions in Infectious Diseases |vauthors=Piscitelli SC, Rodvold K |publisher=Humana Press |year=2005 |isbn=978-1-58829-455-5 |url-access=registration}}</ref>

Minocycline, like other tetracyclines, is associated with esophageal irritation and ulceration if insufficient fluids are taken with the drug before sleep.<ref>Drugs.com [https://www.drugs.com/disease-interactions/minocycline.html#Esophageal_Irritation 'Minocycline Disease Interactions']. Retrieved 12 February 2017.</ref>

A 2007 study suggested that minocycline harms [[amyotrophic lateral sclerosis]] (ALS) patients. Patients on minocycline declined more rapidly than those on placebo. The mechanism of this side effect is unknown, although a hypothesis is that the drug exacerbated an autoimmune component of the primary disease. The effect does not seem to be dose-dependent because the patients on high doses did not do worse than those on the low doses.<ref>{{Cite journal |vauthors=Couzin J |date=November 2007 |title=Clinical research. ALS trial raises questions about promising drug |journal=Science |volume=318 |issue=5854 |pages=1227 |doi=10.1126/science.318.5854.1227a |pmid=18033854 |s2cid=72187805}}</ref>

Other possible rare side effects of minocycline include [[hyperpigmentation]] and [[hypersensitivity reaction]]s, among others.<ref name="ReynoldsYeungCheng2024" /><ref name="Dominic2021">{{Cite journal |vauthors=Dominic MR |date=2021 |title=Adverse Reactions Induced by Minocycline: A Review of Literature |journal=Curr Drug Saf |volume=16 |issue=3 |pages=309–321 |doi=10.2174/1574886316666210120090446 |pmid=33494681}}</ref> It has been associated with more rare and serious adverse effects than other tetracyclines.<ref name="MartinsMartoJohnson2021">{{Cite journal |vauthors=Martins AM, Marto JM, Johnson JL, Graber EM |date=June 2021 |title=A Review of Systemic Minocycline Side Effects and Topical Minocycline as a Safer Alternative for Treating Acne and Rosacea |journal=Antibiotics (Basel) |volume=10 |issue=7 |page=757 |doi=10.3390/antibiotics10070757 |pmc=8300648 |pmid=34206485 |doi-access=free}}</ref> Some of the rare adverse effects of minocycline may result in death.<ref name="MartinsMartoJohnson2021" /> This has spurred interest in topical instead of systemic minocycline for treatment of acne.<ref name="MartinsMartoJohnson2021" /><ref name="ReynoldsYeungCheng2024" />

Minocycine has shown [[thyroid]] toxicity in animals, including in rodents, mini pigs, dogs, and monkeys.<ref name="Minocin FDA label" />

The use of minocycline to treat acne has been associated with skin and gut [[dysbiosis]] (see [[antibiotic misuse]]).<ref>{{Cite journal |vauthors=Thompson KG, Rainer BM, Antonescu C, Florea L, Mongodin EF, Kang S, Chien AL |date=February 2020 |title=Minocycline and Its Impact on Microbial Dysbiosis in the Skin and Gastrointestinal Tract of Acne Patients |journal=Annals of Dermatology |volume=32 |issue=1 |pages=21–30 |doi=10.5021/ad.2020.32.1.21 |pmc=7992645 |pmid=33911705 |doi-access=free}}</ref>

==Overdose==
Symptoms of minocycline [[overdose]] may include [[dizziness]], [[nausea]], and [[vomiting]].<ref name="Minocin FDA label" /> There is no specific [[antidote]] for overdose of minocycline and treatment should be symptom-based and supportive.<ref name="Minocin FDA label" /> The drug is not removed by [[hemodialysis]] or [[peritoneal dialysis]].<ref name="Minocin FDA label" />

==Interactions==
The combination of minocycline with dairy, antacids, calcium and magnesium supplements, iron products, laxatives containing magnesium, or [[bile acid sequestrant]]s may decrease minocycline's effectiveness by forming [[chelate]]s. Combining it with [[isotretinoin]], [[acitretin]] or other [[retinoid]]s can increase the risk for intracranial hypertension. Minocycline significantly reduces concentrations of the anti-HIV drug [[atazanavir]] in the body.<ref name="Arzneistoff-Profile" /><ref name="mediQ">{{Cite web |title=Minocycline |url=https://www.mediq.ch/ |access-date=6 August 2020 |publisher=mediQ}}</ref>

==Pharmacology==
===Pharmacodynamics===

====Antibiotic activity====
{{Main|Tetracycline antibiotics#Mechanism of action}}

Minocycline mediates its [[antibiotic]] activity by binding to the [[Prokaryotic small ribosomal subunit|30S ribosomal subunit]] of [[bacteria]] and thereby [[protein synthesis inhibitor|inhibiting protein synthesis]].<ref name="AsadiAbdiKouhsari2020">{{Cite journal |vauthors=Asadi A, Abdi M, Kouhsari E, Panahi P, Sholeh M, Sadeghifard N, Amiriani T, Ahmadi A, Maleki A, Gholami M |date=September 2020 |title=Minocycline, focus on mechanisms of resistance, antibacterial activity, and clinical effectiveness: Back to the future |journal=J Glob Antimicrob Resist |volume=22 |pages=161–174 |doi=10.1016/j.jgar.2020.01.022 |pmid=32061815 |doi-access=free}}</ref><ref name="Garrido-MesaZarzueloGálvez2013">{{Cite journal |vauthors=Garrido-Mesa N, Zarzuelo A, Gálvez J |date=January 2013 |title=What is behind the non-antibiotic properties of minocycline? |journal=Pharmacol Res |volume=67 |issue=1 |pages=18–30 |doi=10.1016/j.phrs.2012.10.006 |pmid=23085382}}</ref> It is primarily [[bacteriostatic]].<ref name="Minocin FDA label" /> The drug is a broad-spectrum antibiotic and shows activity against a wide range of both [[Gram-positive bacteria|Gram-positive]] and [[Gram-negative bacteria]].<ref name="AsadiAbdiKouhsari2020" /><ref name="Garrido-MesaZarzueloGálvez2013" /><ref name="JonasCunha1982" />

====Other activities====
Minocycline shows a number of [[off-target activity|off-target activities]] in addition to its antibiotic activity.<ref name="SinghKhannaKalra2021">{{Cite journal |vauthors=Singh S, Khanna D, Kalra S |date=2021 |title=Minocycline and Doxycycline: More Than Antibiotics |journal=Curr Mol Pharmacol |volume=14 |issue=6 |pages=1046–1065 |doi=10.2174/1874467214666210210122628 |pmid=33568043}}</ref><ref name="BahramiMorrisPourgholami2012" /><ref name="Garrido-MesaZarzueloGálvez2013" /> These include [[enzyme inhibitor|inhibition]] of [[matrix metalloproteinase]]s (MMPs), [[anti-inflammatory]] effects, [[apoptosis|antiapoptotic]] effects, [[antioxidant]] effects, and [[neuroprotective]] effects.<ref name="SinghKhannaKalra2021" /><ref name="BahramiMorrisPourgholami2012" /><ref name="Garrido-MesaZarzueloGálvez2013" />

Some other reported activities of minocycline include:
* [[PARP1]] [[PARP inhibitor|inhibition]] [[Ligand binding|''K''<sub>i</sub>]] = 13.8{{nbsp}}nM<ref name="pmid16769901">{{Cite journal |vauthors=Alano CC, Kauppinen TM, Valls AV, Swanson RA |date=June 2006 |title=Minocycline inhibits poly(ADP-ribose) polymerase-1 at nanomolar concentrations |journal=Proceedings of the National Academy of Sciences of the United States of America |volume=103 |issue=25 |pages=9685–9690 |bibcode=2006PNAS..103.9685A |doi=10.1073/pnas.0600554103 |pmc=1480467 |pmid=16769901 |doi-access=free}}</ref>
* [[Neuroprotection]] [[IC50|IC<sub>50</sub>]] = 10{{nbsp}}nM<ref name="pmid11306611">{{Cite journal |vauthors=Tikka T, Fiebich BL, Goldsteins G, Keinanen R, Koistinaho J |date=April 2001 |title=Minocycline, a tetracycline derivative, is neuroprotective against excitotoxicity by inhibiting activation and proliferation of microglia |journal=The Journal of Neuroscience |volume=21 |issue=8 |pages=2580–2588 |doi=10.1523/JNEUROSCI.21-08-02580.2001 |pmc=6762519 |pmid=11306611}}</ref>
* [[Microglia]] full inhibition = 20{{nbsp}}nM<ref name="pmid11306611" />
* Suppression of the [[Laboratory mouse|mouse]]'s [[locomotor activity]] = 0.5{{nbsp}}mg/kg<ref name="minomycin-if">{{Cite web |title=minomycin-if |url=http://www.info.pmda.go.jp/go/interview/2/671450_6152005F1052_2_1F.pdf |url-status=dead |archive-url=https://web.archive.org/web/20170908112018/http://www.info.pmda.go.jp/go/interview/2/671450_6152005F1052_2_1F.pdf |archive-date=8 September 2017 |access-date=8 September 2017}}</ref>
* Indirect inhibition of inducible [[nitric oxide synthase]]<ref>{{Cite journal |vauthors=Amin AR, Attur MG, Thakker GD, Patel PD, Vyas PR, Patel RN, Patel IR, Abramson SB |date=November 1996 |title=A novel mechanism of action of tetracyclines: effects on nitric oxide synthases |journal=Proceedings of the National Academy of Sciences of the United States of America |volume=93 |issue=24 |pages=14014–14019 |bibcode=1996PNAS...9314014A |doi=10.1073/pnas.93.24.14014 |pmc=19486 |pmid=8943052 |doi-access=free}}</ref>

===Pharmacokinetics===
====Absorption====
Minocycline is quickly and nearly completely absorbed from the upper part of the [[small intestine]]. Taking it together with food, including milk, has no relevant influence on resorption. It reaches highest [[blood plasma]] concentrations after 1 to 2{{nbsp}}hours.{{cn|date=January 2025}}

====Distribution====
The drug has a [[plasma protein binding]] of 70 to 75%. It penetrates into almost all tissues; very high concentrations are found in the [[gallbladder]] and liver. It crosses the [[blood–brain barrier]] better than [[doxycycline]] and other tetracyclines, reaching therapeutically relevant concentrations in the [[cerebrospinal fluid]] and also in inflamed [[meninges]].<ref name="Arzneistoff-Profile" /><ref name="AC">{{Cite book |title=Austria-Codex |publisher=Österreichischer Apothekerverlag |year=2020 |veditors=Haberfeld H |location=Vienna |at=Minostad 50 mg-Kapseln |language=de}}</ref> Minocycline achieves good concentrations in the [[urine|urinary]] [[bladder]], and many other tissues.<ref name="JonasCunha1982" /> It shows excellent penetration into the [[prostate gland]].<ref name="JonasCunha1982" /><ref name="CunhaGarabedian-Ruffalo1990">{{Cite journal |vauthors=Cunha BA, Garabedian-Ruffalo SM |date=December 1990 |title=Tetracyclines in urology: current concepts |journal=Urology |volume=36 |issue=6 |pages=548–556 |doi=10.1016/0090-4295(90)80201-w |pmid=2247929}}</ref> However, while permeation of prostate tissue and semen is good, levels are lower in prosatic fluid.<ref name="JonasCunha1982" />

====Metabolism====
Minocycline is inactivated by [[drug metabolism|metabolism]] in the liver to about 50%. It is primarily metabolized into 9-hydroxyminocycline.<ref name="DrugBank">{{Cite web |date=30 June 1971 |title=Minocycline: Uses, Interactions, Mechanism of Action |url=https://go.drugbank.com/drugs/DB01017 |access-date=2 December 2024 |website=DrugBank Online}}</ref> Two ''N''-[[demethylation|demethylated]] metabolites are also formed.<ref name="DrugBank" />

====Elimination====
The rest is predominantly excreted into the gut (in part via the gallbladder, in part directly from blood vessels) and eliminated via the feces. About 10–15% are eliminated via the kidneys. It is excreted about 5 to 10% unchanged in urine.<ref name="CunhaGarabedian-Ruffalo1990" /> For comparison, other tetracyclines, like doxycycline and tetracycline, are excreted 30 to 70% unchanged in urine.<ref name="CunhaGarabedian-Ruffalo1990" /> The [[biological half-life]] of minocycline is 11 to 26{{nbsp}}hours in healthy people,<ref name="AHFS2019" /> up to 30{{nbsp}}hours in those with [[kidney failure]],<ref name="AHFS2019" /> and significantly longer in those with [[liver disease]].<ref name="Arzneistoff-Profile" /><ref name="AC" />

==Chemistry==
Minocycline is a [[tetracycline antibiotic|tetracycline]] [[chemical derivative|derivative]].<ref name="JonasCunha1982" /><ref name="BahramiMorrisPourgholami2012">{{Cite journal |vauthors=Bahrami F, Morris DL, Pourgholami MH |date=January 2012 |title=Tetracyclines: drugs with huge therapeutic potential |journal=Mini Rev Med Chem |volume=12 |issue=1 |pages=44–52 |doi=10.2174/138955712798868977 |pmid=22070692}}</ref> It is closely [[structural analog|structurally related]] to other tetracyclic antibiotics such as [[tetracycline]], [[doxycycline]], and [[tigecycline]].<ref name="BahramiMorrisPourgholami2012" /><ref name="JonasCunha1982" />

The drug is used in form of minocycline [[hydrochloride]] [[Water of crystallization|dihydrate]],<ref name="AC" /> which is sparingly [[Solubility|soluble]] in water and slightly soluble in [[ethanol]]. Minocycline reacts acidic in aqueous solution.<ref name="Arzneistoff-Profile" />

The [[partition coefficient]] (P) of minocycline has been reported to be 39.4 (i.e., log P of 1.60).<ref name="SaivinHouin1988">{{Cite journal |vauthors=Saivin S, Houin G |date=December 1988 |title=Clinical pharmacokinetics of doxycycline and minocycline |journal=Clin Pharmacokinet |volume=15 |issue=6 |pages=355–366 |doi=10.2165/00003088-198815060-00001 |pmid=3072140}}</ref> However, other sources have stated the experimental log P of minocycline to be 0.05,<ref name="DrugBank" /> 0.5,<ref name="Fuoco2012">{{Cite journal |vauthors=Fuoco D |date=June 2012 |title=Classification Framework and Chemical Biology of Tetracycline-Structure-Based Drugs |journal=Antibiotics (Basel) |volume=1 |issue=1 |pages=1–13 |doi=10.3390/antibiotics1010001 |pmc=4790241 |pmid=27029415 |doi-access=free}}</ref> and 1.1.<ref name="FlorenceAttwood1988">{{Cite book |title=Physicochemical Principles of Pharmacy |vauthors=Florence AT, Attwood D |date=1988 |publisher=Macmillan Education UK |isbn=978-0-333-23405-1 |publication-place=London |pages=131–171 |chapter=Solubility and Partitioning of Drugs |doi=10.1007/978-1-349-16558-2_5}}</ref> In any case, minocycline is consistently described as a highly [[lipophilicity|lipophilic]] [[chemical compound|compound]] with excellent [[drug permeability|tissue penetration]] and [[distribution (pharmacology)|distribution]].<ref name="LeydenDelRosso2011">{{Cite journal |vauthors=Leyden JJ, Del Rosso JQ |date=February 2011 |title=Oral antibiotic therapy for acne vulgaris: pharmacokinetic and pharmacodynamic perspectives |journal=J Clin Aesthet Dermatol |volume=4 |issue=2 |pages=40–47 |pmc=3050614 |pmid=21386956}}</ref><ref name="SaivinHouin1988" /><ref name="JonasCunha1982">{{Cite journal |vauthors=Jonas M, Cunha BA |date=1982 |title=Minocycline |url=https://journals.lww.com/drug-monitoring/abstract/1982/06000/Minocycline.2.aspx |journal=Ther Drug Monit |volume=4 |issue=2 |pages=137–145 |doi=10.1097/00007691-198206000-00002 |pmid=7048646}}</ref> It has been said to be unique among the tetracyclines in that it is the most lipophilic of all of the members of this group.<ref name="JonasCunha1982" /> Minocycline has 10 to 30{{nbsp}}times greater lipophilicity than tetracycline and 5{{nbsp}}times greater lipophilicity than doxycycline.<ref name="JonasCunha1982" /><ref name="LeydenDelRosso2011" /> The improved lipophilicity of minocycline is thought to be advantageous in terms of its clinical antibiotic effectiveness.<ref name="JonasCunha1982" />

==History==
Minocycline was patented in 1961, was first described in the scientific literature in 1967,<ref name="JonasCunha1982" /> and came into commercial use in 1971.<ref name="FischerGanellin2006" /> A [[topical medication|topical]] [[foam]] for treatment of [[acne]] was approved in 2019.<ref name="Amzeeq FDA label" />

==Society and culture==
===Brand names===
* Minomycin
* Minostad (in Europe, for the treatment of [[acne vulgaris|acne]])
* Akamin
* Minocin
* Minoderm
* Cyclimycin
* Arestin (1-mg doses administered locally into [[periodontal pocket]]s, after [[scaling and root planing]], for treatment of periodontal disease.)<ref>{{Cite web |title=How ARESTIN is supplied and dosed |url=http://www.arestin.com/for-professionals-easy-administer.jsp |url-status=dead |archive-url=https://web.archive.org/web/20100109103746/http://www.arestin.com/for-professionals-easy-administer.jsp |archive-date=9 January 2010 |access-date=1 January 2010 |publisher=[[OraPharma|OraPharma, Inc.]]}}</ref>
* Aknemin
* Solodyn (extended-release, for the treatment of acne)
* Dynacin
* Sebomin
* Mino-Tabs
* Acnamino
* Minopen (in Japan)
* Maracyn 2 (for treatment of bacterial infections in aquarium fish and amphibians)
* Quatrocin (in Syria)
* Minox (in Ireland)
* Minoz (in India and Romania)
* Divaine (in India)
* Vinocyclin 100 (100-mg dose approved for treatment of acne in Vietnam)
* Dentomycin  (2% minocylcine gel for use in periodontal pockets)
* Amzeeq (4% foam, approved for treatment of acne United States)
* Zilxi (1.5% foam, approved for treatment of rosacea in the United States)
* Cleeravue-M

===Generic availability===
It is available as a [[generic medication]].<ref name=BNF76/>

==Research==
===Neuropsychiatric disorders===
Minocycline has been studied for [[treatment-resistant depression]]. According to a 2023 systematic review based on four clinical trials, "There is no significant difference with minocycline compared to placebo for depression not responding to first-line antidepressant therapy."<ref>{{Cite journal |vauthors=Shamim MA, Manna S, Dwivedi P, Swami MK, Sahoo S, Shukla R, Srivastav S, Thaper K, Saravanan A, Anil A, Varthya SB, Singh S, Shamim MA, Satapathy P, Chattu SK, Chattu VK, Padhi BK, Sah R |date=November 2023 |title=Minocycline in depression not responding to first-line therapy: A systematic review and meta-analysis |journal=Medicine |volume=102 |issue=45 |pages=e35937 |doi=10.1097/MD.0000000000035937 |pmc=10637431 |pmid=37960804 |doi-access=free}}</ref>

Early research has found a tentative benefit from minocycline in [[schizophrenia]],<ref>{{Cite journal |vauthors=Dean OM, Data-Franco J, Giorlando F, Berk M |date=May 2012 |title=Minocycline: therapeutic potential in psychiatry |journal=CNS Drugs |volume=26 |issue=5 |pages=391–401 |doi=10.2165/11632000-000000000-00000 |pmid=22486246}}</ref> with several trials underway.<ref>{{Cite journal |vauthors=Arehart-Treichel J |date=17 August 2012 |title=Will Antibiotic Fulfill Its Psychosis-Fighting Promise? |journal=Psychiatric News |volume=47 |issue=16 |pages=10 |doi=10.1176/pn.47.16.psychnews_47_16_10-a}}</ref> A 2014 meta-analysis found minocycline may reduce negative and total symptom scores and was well tolerated.<ref>{{Cite journal |vauthors=Oya K, Kishi T, Iwata N |date=September 2014 |title=Efficacy and tolerability of minocycline augmentation therapy in schizophrenia: a systematic review and meta-analysis of randomized controlled trials |journal=Human Psychopharmacology |volume=29 |issue=5 |pages=483–491 |doi=10.1002/hup.2426 |pmid=25087702 |s2cid=3564390}}</ref>

Some early studies suggest that minocycline may be beneficial as an add-on treatment for moderate-to-severe [[obsessive-compulsive disorder]] (OCD) when used with an [[SSRI]].<ref name="pmid36368186">{{Cite journal |vauthors=van Roessel PJ, Grassi G, Aboujaoude EN, Menchón JM, Van Ameringen M, Rodríguez CI |date=January 2023 |title=Treatment-resistant OCD: Pharmacotherapies in adults |journal=Comprehensive Psychiatry |volume=120 |pages=152352 |doi=10.1016/j.comppsych.2022.152352 |pmid=36368186 |hdl-access=free |hdl=2445/192315}}</ref><ref name="pmid36982324">{{Cite journal |vauthors=Panizzutti B, Skvarc D, Lin S, Croce S, Meehan A, Bortolasci CC, Marx W, Walker AJ, Hasebe K, Kavanagh BE, Morris MJ, Mohebbi M, Turner A, Gray L, Berk L, Walder K, Berk M, Dean OM |date=March 2023 |title=Minocycline as Treatment for Psychiatric and Neurological Conditions: A Systematic Review and Meta-Analysis |journal=International Journal of Molecular Sciences |volume=24 |issue=6 |page=5250 |doi=10.3390/ijms24065250 |pmc=10049047 |pmid=36982324 |doi-access=free}}</ref>

===Stroke and neurodegenerative diseases===
In ongoing research and trial, minocycline demonstrated efficacy and seems a promising [[Neuroprotection|neuroprotective]] agent in acute [[stroke]] patients, especially in AIS subgroup. Further RCTs are needed to evaluate the efficacy and safety of minocycline among ICH patients.<ref>{{Cite journal |vauthors=Malhotra K, Chang JJ, Khunger A, Blacker D, Switzer JA, Goyal N, Hernandez AV, Pasupuleti V, Alexandrov AV, Tsivgoulis G |date=August 2018 |title=Minocycline for acute stroke treatment: a systematic review and meta-analysis of randomized clinical trials |journal=Journal of Neurology |volume=265 |issue=8 |pages=1871–1879 |doi=10.1007/s00415-018-8935-3 |pmid=29948247 |s2cid=49431206 |hdl-access=free |hdl=10757/624615}}</ref>

Research is examining the possible [[Neuroprotection|neuroprotective]] and anti-inflammatory effects of minocycline against the progression of a group of [[neurodegenerative disorder]]s including [[multiple sclerosis]], [[rheumatoid arthritis]], [[Huntington's disease]], and [[Parkinson's disease]].<ref>{{Cite press release |title=Preliminary Study Shows Creatine and Minocycline May Warrant Further Study In Parkinson's Disease |date=23 February 2006 |publisher=National Institute of Health |url=http://www.nih.gov/news/pr/feb2006/ninds-23.htm}}</ref><!-- However, as mentioned above, a 2007 study suggested that minocycline harms ALS patients.[23]--><ref name="Note2">{{Cite journal |vauthors=Chen M, Ona VO, Li M, Ferrante RJ, Fink KB, Zhu S, Bian J, Guo L, Farrell LA, Hersch SM, Hobbs W, Vonsattel JP, Cha JH, Friedlander RM |date=July 2000 |title=Minocycline inhibits caspase-1 and caspase-3 expression and delays mortality in a transgenic mouse model of Huntington disease |journal=Nature Medicine |volume=6 |issue=7 |pages=797–801 |doi=10.1038/77528 |pmid=10888929 |s2cid=22681391}}</ref><ref name="Note3">{{Cite journal |vauthors=Tikka TM, Koistinaho JE |date=June 2001 |title=Minocycline provides neuroprotection against N-methyl-D-aspartate neurotoxicity by inhibiting microglia |journal=Journal of Immunology |volume=166 |issue=12 |pages=7527–7533 |doi=10.4049/jimmunol.166.12.7527 |pmid=11390507 |doi-access=free}}</ref><ref>{{Cite journal |vauthors=Nirmalananthan N, Greensmith L |date=December 2005 |title=Amyotrophic lateral sclerosis: recent advances and future therapies |journal=Current Opinion in Neurology |volume=18 |issue=6 |pages=712–719 |doi=10.1097/01.wco.0000187248.21103.c5 |pmid=16280684 |s2cid=3255995}}</ref> As mentioned above, minocycline harms ALS patients.{{citation needed|date=May 2021}}

A trial found no difference between minocycline and placebo in people with Alzheimers' disease.<ref name="Howard">{{Cite journal |vauthors=Howard R, Zubko O, Bradley R, Harper E, Pank L, O'Brien J, Fox C, Tabet N, Livingston G, Bentham P, McShane R, Burns A, Ritchie C, Reeves S, Lovestone S, Ballard C, Noble W, Nilforooshan R, Wilcock G, Gray R |date=February 2020 |title=Minocycline at 2 Different Dosages vs Placebo for Patients With Mild Alzheimer Disease: A Randomized Clinical Trial |journal=JAMA Neurology |volume=77 |issue=2 |pages=164–174 |doi=10.1001/jamaneurol.2019.3762 |pmc=6865324 |pmid=31738372 |doi-access=free}}</ref> Minocycline is somewhat neuroprotective in mouse models of Huntington's disease.<ref name="Beal">{{Cite journal |vauthors=Beal MF, Ferrante RJ |date=May 2004 |title=Experimental therapeutics in transgenic mouse models of Huntington's disease |journal=Nature Reviews. Neuroscience |volume=5 |issue=5 |pages=373–384 |doi=10.1038/nrn1386 |pmid=15100720 |s2cid=19496441}}</ref>

===Multiple sclerosis===
A 2007 study reported the impact of the antibiotic minocycline on clinical and [[magnetic resonance imaging]]  (MRI) outcomes and serum immune molecules in 40 MS patients over 24 months of open-label minocycline treatment. Despite a moderately high pretreatment relapse rate in the patient group prior to treatment (1.3/year pre-enrollment; 1.2/year during a three-month baseline period), no relapses occurred between months 6 and 24 on minocycline. Also, despite significant MRI disease-activity pretreatment (19/40 scans had gadolinium-enhancing activity during a three-month run-in), the only patient with [[MRI contrast agent|gadolinium-enhancing]] lesions on MRI at 12 and 24 months was on half-dose minocycline. Levels of [[interleukin-12]] (IL-12), which at high levels might antagonize the proinflammatory IL-12 receptor, were elevated over 18 months of treatment, as were levels of soluble [[Blood vessel|vascular]] [[cell adhesion molecule|cell adhesion molecule-1]] ([[VCAM-1]]). The activity of [[matrix metalloproteinase|matrix metalloproteinase-9]] was decreased by treatment. Clinical and MRI outcomes in this study were supported by systemic immunological changes and call for further investigation of minocycline in MS.<ref>{{Cite journal |vauthors=Zemke D, Majid A |year=2004 |title=The potential of minocycline for neuroprotection in human neurologic disease |journal=Clinical Neuropharmacology |volume=27 |issue=6 |pages=293–298 |doi=10.1097/01.wnf.0000150867.98887.3e |pmid=15613934 |s2cid=30431947}}</ref><ref name="Maier">{{Cite journal |vauthors=Maier K, Merkler D, Gerber J, Taheri N, Kuhnert AV, Williams SK, Neusch C, Bähr M, Diem R |date=March 2007 |title=Multiple neuroprotective mechanisms of minocycline in autoimmune CNS inflammation |journal=Neurobiology of Disease |volume=25 |issue=3 |pages=514–525 |doi=10.1016/j.nbd.2006.10.022 |pmid=17239606 |s2cid=39628457}}</ref><ref>{{Cite journal |vauthors=Popovic N, Schubart A, Goetz BD, Zhang SC, Linington C, Duncan ID |date=February 2002 |title=Inhibition of autoimmune encephalomyelitis by a tetracycline |journal=Annals of Neurology |volume=51 |issue=2 |pages=215–223 |doi=10.1002/ana.10092 |pmid=11835378 |s2cid=21209994}}</ref>

===Hearing protection===
Several preclinical studies (in vitro cell cultures and animal models) suggest that minocycline may have otoprotective benefits. Animal models indicate it could potentially reduce noise-induced and blast-induced hearing loss, possibly by protecting [[hair cell]]s and mitigating inflammation.<ref name="pmid28007648">{{Cite journal |vauthors=Zhang J, Song YL, Tian KY, Qiu JH |date=February 2017 |title=Minocycline attenuates noise-induced hearing loss in rats |journal=Neuroscience Letters |volume=639 |pages=31–35 |doi=10.1016/j.neulet.2016.12.039 |pmid=28007648 |s2cid=38379616}}</ref><ref name="pmid36820161">{{Cite journal |vauthors=Perumal V, Ravula AR, Shao N, Chandra N |date=January 2023 |title=Effect of minocycline and its nano-formulation on central auditory system in blast-induced hearing loss rat model |journal=Journal of Otology |volume=18 |issue=1 |pages=38–48 |doi=10.1016/j.joto.2022.09.002 |pmc=9937842 |pmid=36820161}}</ref> ''In vitro'' and animal studies also show minocycline may help decrease ototoxicity from certain drugs like [[gentamicin]],<ref name="pmid15708492">{{Cite journal |vauthors=Wei X, Zhao L, Liu J, Dodel RC, Farlow MR, Du Y |date=2005 |title=Minocycline prevents gentamicin-induced ototoxicity by inhibiting p38 MAP kinase phosphorylation and caspase 3 activation |journal=[[Neuroscience (journal)|Neuroscience]] |volume=131 |issue=2 |pages=513–21 |doi=10.1016/j.neuroscience.2004.11.014 |pmid=15708492 |s2cid=3125930}}</ref> [[neomycin]],<ref name="pmid25950003">{{Cite journal |vauthors=Robinson AM, Vujanovic I, Richter CP |date=2015 |title=Minocycline protection of neomycin induced hearing loss in gerbils |journal=BioMed Research International |volume=2015 |pages=934158 |doi=10.1155/2015/934158 |pmc=4407513 |pmid=25950003 |doi-access=free}}</ref> and [[cisplatin]].<ref name="pmid21716954">{{Cite journal |vauthors=Lee CK, Shin JI, Cho YS |date=June 2011 |title=Protective Effect of Minocycline Against Cisplatin-induced Ototoxicity |journal=Clinical and Experimental Otorhinolaryngology |volume=4 |issue=2 |pages=77–82 |doi=10.3342/ceo.2011.4.2.77 |pmc=3109331 |pmid=21716954}}</ref><ref name="pmid21493367">{{Cite journal |vauthors=Du B, Zhang Y, Tang Y, Wang P |date=May 2011 |title=Minocycline attenuates ototoxicity and enhances antitumor activity of cisplatin treatment in vitro |journal=Otolaryngology–Head and Neck Surgery |volume=144 |issue=5 |pages=719–25 |doi=10.1177/0194599810395090 |pmid=21493367 |s2cid=25994657}}</ref>

===Other uses===
Minocycline also has been used as a "last-ditch" treatment for [[toxoplasmosis]] in AIDS patients.<ref>{{Cite journal |vauthors=Lacassin F, Schaffo D, Perronne C, Longuet P, Leport C, Vilde JL |date=January 1995 |title=Clarithromycin-minocycline combination as salvage therapy for toxoplasmosis in patients infected with human immunodeficiency virus |journal=Antimicrobial Agents and Chemotherapy |volume=39 |issue=1 |pages=276–277 |doi=10.1128/AAC.39.1.276 |pmc=162527 |pmid=7695324}}</ref>

== References ==
{{Reflist}}

{{Stomatological preparations}}
{{Acne-treating agents}}
{{Protein synthesis inhibitor antibiotics}}
{{Leukotriene signaling modulators}}
{{Glutamate receptor modulators}}
{{Portal bar | Medicine}}
{{Authority control}}

[[Category:Anti-acne preparations]]
[[Category:Anti-inflammatory agents]]
[[Category:Disease-modifying antirheumatic drugs]]
[[Category:Drugs developed by Pfizer]]
[[Category:Drugs developed by Wyeth]]
[[Category:Hepatotoxins]]
[[Category:Neuroprotective agents]]
[[Category:NMDA receptor antagonists]]
[[Category:PARP inhibitors]]
[[Category:Tetracycline antibiotics]]
[[Category:Triketones]]
[[Category:Wikipedia medicine articles ready to translate]]