>10%: Miscellaneous: Discoloration of teeth (in children)

1% to 10%:

Central nervous system: Lightheadedness, vertigo

Dermatologic: Photosensitivity

Gastrointestinal: Nausea, diarrhea

<1%: Abdominal cramps, acute renal failure, anaphylaxis, angioedema, anorexia, azotemia, diabetes insipidus, eosinophilia, erythema multiforme, esophagitis, exfoliative dermatitis, hemolytic anemia, hepatitis, hepatic failure, neutropenia, paresthesia, pericarditis, pigmentation of nails, pruritus, pseudotumor cerebri (blurred vision, bulging fontanels in infants, headache, increased intracranial pressure), rash, Stevens-Johnson syndrome, superinfection, thrombocytopenia, thyroid dysfunction (extremely rare), tinnitus, urticaria, vomiting

Calcium-, magnesium-, or aluminum-containing antacids, oral contraceptives, iron, zinc, sodium bicarbonate, penicillins, cimetidine: May decrease absorption of tetracyclines

Although no clinical evidence exists, tetracyclines may bind with bismuth or calcium carbonate, an excipient in bismuth subsalicylate, during treatment for H. pylori.

Digoxin: Tetracyclines may rarely increase digoxin serum levels.

Methoxyflurane anesthesia when concurrent with tetracyclines may cause fatal nephrotoxicity.

Oral contraceptives: Anecdotal reports suggesting decreased contraceptive efficacy with tetracyclines have been refuted by more rigorous scientific and clinical data.

Warfarin: Hypoprothrombinemic response may be increased with tetracyclines; monitor INR closely during initiation or discontinuation.

Food: Minocycline serum concentrations are not altered if taken with dairy products.

Herb/Nutraceutical: Avoid dong quai, St John's wort (may also cause photosensitization).

Y-site administration: Compatible: Aztreonam, cisatracurium, cyclophosphamide, docetaxel, etoposide, filgrastim, fludarabine, gemcitabine, granisetron, heparin, hydrocortisone sodium succinate, linezolid, magnesium sulfate, melphalan, perphenazine, potassium chloride, remifentanil, sargramostim, teniposide, vinorelbine, vitamin B complex with C. Incompatible: Allopurinol, amifostine, hydromorphone, meperidine, morphine, piperacillin/tazobactam, propofol, thiotepa

Compatibility in syringe: Incompatible: Doxapram

Compatibility when admixed: Incompatible: Rifampin

Absorption: Well absorbed

Distribution: Majority deposits for extended periods in fat; crosses placenta; enters breast milk

Protein binding: 70% to 75%

Half-life elimination: 15 hours

Excretion: Urine

Children >8 years: Oral, I.V.: Initial: 4 mg/kg followed by 2 mg/kg/dose every 12 hours

Adults:

Infection: Oral, I.V.: 200 mg stat, 100 mg every 12 hours not to exceed 400 mg/24 hours

Acne: Oral: 50 mg 1-3 times/day

Dosage adjustment in renal impairment: Consider decreasing dose or increasing dosing interval with renal impairment.

Oral: May be taken with food or milk. Administer with adequate fluid to decrease the risk of esophageal irritation and ulceration.

I.V.: Infuse slowly, usually over a 4- to 6-hour period.

Capsule, as hydrochloride: 50 mg, 75 mg, 100 mg

Dynacin®: 50 mg, 75 mg, 100 mg

Capsule, pellet-filled, as hydrochloride (Minocin®): 50 mg, 100 mg

Injection, powder for reconstitution, as hydrochloride (Minocin®): 100 mg

Tablet, as hydrochloride (Dynacin®): 50 mg, 75 mg, 100 mg

Smilack JD, Wilson WR, and Cockerill FR 3d, "Tetracyclines, Chloramphenicol, Erythromycin, Clindamycin, and Metronidazole,"Mayo Clin Proc, 1991, 66(12):1270-80.