Minocycline

C. diff Risk

Low

Oral Bioavailability

Excellent

Approximate Cost

Oral: <$1/day
IV: nonform - $326/day

Dosing

Very limited data. Consider doxycycline if appropriate.

  • 4 mg/kg load followed by 2 mg/kg every 12 hours up to 100 mg every 12 hours

  • For serious Acinetobacter infections may consider up to 400 mg/day

  • Dosing is the same for oral and intravenous

  • 100 mg every 12 hours

  • For very serious infections, consider 200 mg loading dose, then 100 mg every 12 hours

  • For serious Acinetobacter infections may consider up to 400 mg/day

  • Dosing is the same for oral and intravenous

  • Intravenous agent is nonformulary and very expensive - reserve for serious infections where other options are not available or cystic fibrosis patients with Stenotrophomonas

General Information

Common Usage

  • Stenotrophomonas maltophila infections

  • Mild Staphylococcal infections (SSTIs) or suppression

  • Acne

  • Multidrug resistant Acinetobacter spp infections

Adverse Effects

  • Vertigo and ataxia

  • GI intolerance (dose related)

  • Worsening azotemia in patient with renal failure

  • Hepatotoxicity

  • Esophageal irritation

  • Photosensitivity

  • Skin and mucosal hyperpigmentation (blue-black, kind of grayish) with long term use

  • Pseudotumor cerebri (rare)

  • Lupus-like syndrome manifested by arthralgia, myalgia

  • Aggravation of myasthenia gravis

Major Interactions

Divalent and trivalent cations - separate administration by 4 hours