There are dangerous infections that can complicate the patient’s life for a long time. These include syphilis, gonorrhea and anthrax. Only timely treatment can save a person’s health and even life with these and similar diseases. The antibiotic Minolexin may be the only way to destroy the pathogen.
What is Minolexin
The drug is an antibiotic from the tetracycline group. The therapeutic effect is based on the antibacterial effect through inhibition of pathogen protein synthesis. Minolexin is available in the form of capsules of size No. 2, with the contents in the form of a yellow powder. Capsules with a white cap have a dosage of 100 mg, with a yellow cap - 50 mg. Packed in 10 units per package, placed in cardboard packs of 2 or 3 pieces.
Compound
The active ingredient of the drug is minocycline hydrochloride. The composition of one Minolexin capsule is indicated in the table:
Tablets with a dosage of 50 mg, (mg)
Tablets with a dosage of 100 mg, (mg)
Minocycline hydrochloride (active ingredient)
Composition of the capsule shell (in percent):
Sunset dye
Pharmacological properties
The drug Minolexin belongs to the group of semisynthetic antibiotics from the tetracycline group. It exhibits antibacterial activity against aerobic gram-positive and aerobic gram-negative strains of microorganisms:
- Bacillus anthracis;
- Listeria monocytogenes;
- Staphylococcus aureus;
- Streptococcus pneumoniae;
- Bartonella bacilliformis;
- Brucella species;
- Calymmatobacterium granulomatis;
- Actinomyces species;
- Borrelia recurrentis;
- Chlamydia trachomatis.
Minolexin is used for acne and other diseases because it has a bacteriostatic effect. Nuances:
- The drug reversibly inhibits protein synthesis at the level of ribosomal subunits.
- Its absorption is independent of food intake.
- After administration, the tablets are quickly absorbed, reaching maximum concentration after three hours.
- The active component binds to plasma proteins by 75%, penetrates well into the kidneys, spleen, eye tissue, synovial exudate, pleural and ascitic fluids, maxillary and frontal sinuses, gingival sulcus fluid, cerebrospinal fluid.
Minocycline has been detected in placental tissue and breast milk. It forms insoluble compounds with calcium inside the teeth. Minocycline is recycled in the intestines and liver, up to 60% of the dose is excreted in the feces, and a third by the kidneys. 25% of the dosage remains unchanged. In severe chronic renal failure, only 5% of the drug is excreted. The half-life is 16 hours.
Indications for use
The manufacturer's instructions recommend treatment with Minolexin taking into account laboratory data, including identifying pathogen sensitivity and serotyping, which will reduce the risk of developing resistance. List of indications for prescribing the drug:
- skin infections;
- lymphogranuloma venereum;
- spotted/typhoid fever;
- tularemia;
- actinomycosis;
- acne;
- trachoma (infectious keratoconjunctivitis);
- gonorrhea, chancroid, syphilis;
- typhoid fever;
- plague;
- coxiellosis (Q fever);
- listeriosis;
- brucellosis;
- anthrax;
- paratrachoma (conjunctivitis with inclusions);
- inguinal granuloma;
- psittacosis;
- tick fever;
- cyclic fever;
- infections of the anus and cervical canal in adults;
- non-gonococcal urethritis;
- bartonellosis;
- cholera;
- asymptomatic carriage of Neisseria meningit >
Instructions for use of Minoleksin
The drug is intended for oral administration, the recommended time is after a meal, which reduces the risk of esophageal irritation and ulceration, washed down with water or milk. When taking Minolexin twice a day, the interval between doses is 12 hours. The standard initial dosage is 200 mg, then 100 mg twice a day. The maximum daily volume is 400 mg. Treatment regimens and duration depending on indications:
Twice a day 100 mg
Once a day 50 mg
Acute pelvic inflammation
In some cases, together with cephalosporins
Infection with chlamydia and ureaplasma of the genitourinary system. anogenital area
Uncomplicated gonococcal urethritis in men
Inflammatory type gonorrhea
4-5 days (a single dose of 300 mg is acceptable)
Male uncomplicated gonococcal infections (except anorectal and urethritis)
4 days (initial dosage 200 mg). After 2-3 days after completion of treatment, a microbiological analysis of recovery is required.
Syphilis (primary) with high susceptibility to penicillins
Taking Minolexin can provoke an anti-anabolic effect, which leads to an increase in the level of urea in the blood plasma. Provided the kidneys are functioning normally, this circumstance does not require treatment adjustments. Patients with renal impairment are at risk of developing hyperphosphatemia, azotemia and acidosis, which requires monitoring of creatine and urea levels.
For pediatric patients (over 8 years old) who have been diagnosed with infections sensitive to minocycline, the drug is prescribed in the following dosages: initially at the rate of 4 mg per kilogram of the child’s weight, then twice a day - 2 mg/kg. The initial dosage for children weighing more than 25 kg will be 100 mg, then dosage according to the regimen is 50 mg twice a day.
Overdose
If you take a dose in excess of the instructions for use, an overdose may occur. It is characterized by dizziness, nausea, and vomiting. There is no specific antidote for minocycline. If the dose is exceeded, you must stop taking the drug. provide supportive and symptomatic treatment. Hemodialysis and peritoneal dialysis are ineffective.
Side effects
Like other representatives of the tetracycline group, Minolexin exhibits side effects. They are especially pronounced in the digestive, musculoskeletal, genitourinary and respiratory systems. According to the instructions, these include:
- vomiting, nausea, diarrhea, pseudomembranous colitis, pancreatitis, interstitial nephritis, cholestasis, increased activity of liver enzymes;
- stomatitis, dyspepsia, glossitis, enterocolitis, inflammation in the oral cavity, pancreatitis, hyperbilirubinemia, autoimmune hepatitis, liver failure;
- itching, erythema, alopecia, nail pigmentation, necrolysis, vasculitis, rash, dermatitis;
- shortness of breath, pneumonia, bronchospasm, exacerbation of asthma;
- arthritis, arthralgia, joint immobility, myalgia;
- dizziness, convulsions, fever, tinnitus, numbness of extremities, vertigo, inhibition of reactions, increased intracranial pressure, headache;
- discoloration of tooth enamel, staining of sweat, darkening of the tongue, gums, palate, skin;
- vulvovaginal candidiasis, balanitis;
- allergies, urticaria, anaphylactoid purpura, pericarditis, pulmonary infiltration due to eosinophilia, exacerbation of systemic lupus erythematosus;
- eosinopenia, agranulocytosis, pancytopenia, anemia, neutrocytopenia, thrombocytopenia, leukopenia;
- malignant neoplasms of the thyroid gland (rare).
Contraindications
Minolexin is prescribed with caution in cases of liver and kidney dysfunction, and in combination with hepatotoxic drugs. According to the instructions, its contraindications are:
- hypersensitivity to components;
- porphyria;
- severe liver and kidney failure;
- leukopenia;
- systemic lupus erythematosus;
- pregnancy, lactation;
- children under 8 years of age;
- lactose intolerance, glucose-galactose malabsorption, lactase deficiency;
- combination with isotretinoin.
Minolexin and alcohol
Doctors do not recommend combining Minolexin with alcohol. This is due to the fact that the antibiotic increases the load on the liver, like ethyl alcohol, which can result in unpredictable side reactions. Additionally, ethanol reduces the effectiveness of the antibiotic, which results in the need to adjust the dose of the drug.
Use during pregnancy and lactation
According to the instructions for use, the use of Minocycline during pregnancy is justified only if the expected benefit to the mother is higher than the potential risk to the development of the fetus inside her womb. Otherwise, Minolexin is prohibited. If antibiotic treatment is necessary during breastfeeding, lactation is suspended. The medicine can pass into breast milk and the baby’s body and cause irreversible damage to the bone system.
Use in childhood
The antibiotic Minolexin is contraindicated for use in children under eight years of age. This prohibition in the instructions for use is due to the fact that the active component of the composition binds to calcium ions of teeth and bones, which grow in a child under 8 years of age. Early use of the drug inhibits the development of dental bone tissue; in the future, such children may develop problems with chewing.
Drug interactions
The use of Minolexin with other medications may not always have positive consequences. More often these combinations are contraindicated. Consider the recommendations from the instructions:
- The drug reduces the prothromblin activity of blood plasma, which necessitates a reduction in doses of anticoagulants when receiving anticoagulant therapy.
- Combination with bacteriostatic drugs should be avoided.
- The absorption of the drug is impaired when combined with antacids containing aluminum, calcium, magnesium, or iron-containing preparations. This reduces the effectiveness of antibiotic therapy.
- It is prohibited to combine Minolexin with Isotretinoin due to excessive benign increase in intracranial pressure.
- The medication may cause end-stage renal toxicity when combined with Methoxyflurane and interferes with the effectiveness of oral contraceptives (additional contraception is required).
- The combination of the product with ergot alkaloids leads to the risk of developing ergotism.
While taking Minolexin and after 2-3 weeks of stopping treatment, diarrhea or pseudomembranous colitis may develop. For treatment, it is necessary to use ion exchange resins (colestipol, cholestyramine), use Bacitracin, Vancomycin or Metronidazole. Drugs that inhibit intestinal motility are prohibited. The antibiotic increases sensitivity to the sun, slows concentration and reaction speed.
Analogs
The drug can be replaced with drugs from the group of tetracycline antibiotics that are similar in properties and effect. These include:
- Bassado – capsules based on doxycycline;
- Vibramycin - antibacterial capsules containing doxycycline;
- Vidoccin is a lyophilisate for a solution for intravenous administration based on doxycycline;
- Doxal - bacteriostatic capsules containing doxycycline;
- Doxybene – capsules based on doxycycline;
- Tetracycline - tablets with the same component;
- Tigacil – lyophilisate for the preparation of infusion solution based on tigecycline;
- Xedocin - doxycycline-based tablets;
- Monoclin - tablets containing doxycycline.
Minolexin tablets are sold by prescription and stored at temperatures up to 25 degrees for two years. They are purchased via the Internet or pharmacy chains at the following prices (in Moscow):
Release form of the drug, packaging volume (manufacturer Avva-Rus, Russia)
Indications for use
Minolexin is used to treat the following diseases, subject to the sensitivity of pathogenic microorganisms:
— Spotted fever, typhoid fever, typhoid fever, Q fever (coxiellosis), vesicular rickettsiosis and tick fever
— Respiratory tract infections
— Conjunctivitis with inclusions (paratrachoma)
— Non-gonococcal urethritis, infections of the cervical canal and anus in adults
— Yaws (tropical granuloma, non-venereal syphilis)
In the case of acute intestinal amebiasis, the use of Minolexin as an addition to amoebicidal drugs is allowed.
For severe acne, the drug can be used as an additional therapy.
Oral administration of minocycline is indicated for asymptomatic carriage of Neisseria meningitidis for the eradication of meningococci from the nasopharynx.
To prevent the emergence of resistance, the use of minocycline is recommended in accordance with the results of laboratory tests, including serotyping and determination of pathogen sensitivity. For the same reason, the use of Minolexin for prophylactic purposes is not recommended in case of a high risk of meningococcal meningitis.
Oral minocycline is not recommended for the treatment of meningococcal infections.
Clinical experience shows the effectiveness of minocycline in the treatment of Mycobacterium marinum infections, however, these data are currently not confirmed by the results of controlled clinical trials.
Possible analogues (substitutes)
Active substance, group
Dosage form
We often ask ourselves: “Is it possible to open a capsule with a medicine?” The reasons may be different - reluctance or inability to swallow the capsule, the need to reduce the dosage, mix it with baby food, etc. Read more.
Contraindications
— Hypersensitivity to minocycline, tetracyclines and other components of the drug
— Severe liver and kidney failure
— Children under 8 years of age (period of dental development)
— Simultaneous use with isotretinoin
— Lactase deficiency, lactose intolerance, glucose-galactose malabsorption.
Minolexin is used with caution in patients with impaired liver and kidney function, as well as when used simultaneously with hepatotoxic drugs.
How to use: dosage and course of treatment
Minolexin is taken orally after meals. It is recommended to take a sufficient amount of liquid (milk) to reduce the risk of irritation and ulceration in the esophagus.
The initial dose of Minolexin is 200 mg (2 capsules of 100 mg or 4 capsules of 50 mg), then take 100 mg (1 capsule of 100 mg or 2 capsules of 50 mg) every 12 hours (twice a day).
The maximum daily dose should not exceed 400 mg.
Infections of the genitourinary system and anogenital area caused by chlamydia and ureaplasma: 100 mg (1 capsule of 100 mg or 2 capsules of 50 mg) every 12 hours for 7-10 days.
Inflammatory diseases of the pelvic organs in women in the acute stage: 100 mg (1 capsule of 100 mg or 2 capsules of 50 mg) every 12 hours, sometimes in combination with cephalosporins.
Primary syphilis in patients with hypersensitivity to penicillins: 100 mg (1 capsule of 100 mg or 2 capsules of 50 mg) twice a day for 10 - 15 days.
Gonorrhea: 100 mg (1 capsule of 100 mg or 2 capsules of 50 mg) twice a day for 4-5 days, or 300 mg once.
Uncomplicated gonococcal infections (excluding urethritis and anorectal infections) in men: initial dose - 200 mg (2 capsules of 100 mg or 4 capsules of 50 mg), maintenance dose - 100 mg (1 capsule of 100 mg or 2 capsules of 50 mg) after every 12 hours for at least 4 days, followed by a microbiological assessment of recovery 2-3 days after stopping the drug.
Uncomplicated gonococcal urethritis in men: 100 mg (1 capsule of 100 mg or 2 capsules of 50 mg) every 12 hours for 5 days.
Acne: 50 mg (1 capsule of 50 mg) per day, for a long course of 6-12 weeks.
While taking the drug, due to the anti-anabolic effect inherent in drugs of the tetracycline group, an increase in the level of urea in the blood plasma may be observed. In patients with normal renal function, this does not require discontinuation of the drug. In patients with severe renal impairment, azotemia, hyperphosphatemia and acidosis may develop. In this situation, it is necessary to control the level of urea and creatinine in the blood plasma, and the maximum daily dose of minocycline should not exceed 200 mg.
The pharmacokinetics of minocycline in patients with renal failure (creatinine clearance less than 80 ml/min) has not yet been studied sufficiently to conclude that dose adjustment is necessary.
In case of liver dysfunction, use the drug with caution.
Children over 8 years of age for infections caused by pathogens sensitive to minocycline: initial dose of 2 mg/kg every 12 hours.
pharmachologic effect
Minolexin (minocycline) is a semisynthetic antibiotic from the tetracycline group. It has a bacteriostatic effect on cells of sensitive strains of microorganisms due to reversible inhibition of protein synthesis at the level of 30S ribosomal subunits. Has a wide spectrum of antibacterial activity.
Some of the microorganisms listed below have shown resistance to minocycline, so laboratory sensitivity testing is recommended before use. Antibiotics of the tetracycline group are not recommended for the treatment of streptococcal and staphylococcal infections unless sensitivity of microorganisms to minocycline is shown.
Minocycline susceptibility testing is strongly recommended for the following organisms:
— Fusobacterium nucleatum subspecies fusiforme
— Treponema pallidum subspecies pallidum
— Treponema pallidum subspecies pertenue
Side effects
The spectrum of adverse events associated with minocycline does not differ from other tetracyclines.
From the digestive system: anorexia, nausea, vomiting, diarrhea, dyspepsia, stomatitis, glossitis, dysphagia, hypoplasia of tooth enamel, enterocolitis, pseudomembranous colitis, pancreatitis, inflammatory lesions (including fungal) in the oral cavity and anogenital area, hyperbilirubinemia, cholestasis , increased levels of 'liver' enzymes, liver failure, including terminal, hepatitis, including autoimmune.
From the genitourinary system: vulvovaginal candidiasis, interstitial nephritis, dose-dependent increase in urea content in the blood plasma.
From the skin: baldness, erythema nodosum, nail pigmentation, itching, toxic epidermal necrosis, vasculitis, maculopapular and erythematous rash, Stevens-Johnson syndrome, exfoliative dermatitis, balanitis.
From the respiratory tract: shortness of breath, bronchospasm, exacerbation of asthma, pneumonia.
From the musculoskeletal system: arthralgia, arthritis, limited mobility and swelling of the joints, discoloration of bone tissue, muscle pain (myalgia).
Allergic reactions: urticaria, angioedema, polyarthralgia, anaphylactic reactions (including shock), anaphylactoid purpura (Henoch-Schönlein purpura), pericarditis, exacerbations of systemic lupus, pulmonary infiltration accompanied by eosinophilia.
From the hematopoietic organs: agranulocytosis, hemolytic anemia, thrombocytopenia, leukopenia, neutrocytopenia, pancytopenia, eosinopenia, eosinophilia.
From the central nervous system: convulsions, dizziness, numbness (including extremities), lethargy, vertigo, increased intracranial pressure in adults, headaches.
From the senses: tinnitus and hearing impairment.
From the side of metabolism: Thyroid gland: a single case of malignant neoplasm, discoloration (according to the results of pathomorphological studies), dysfunction.
Other: Change in color of the oral cavity (tongue, gums, palate), change in color of tooth enamel, fever, coloration of secretions (for example, sweat).
In case of an overdose of Minolexin, dizziness, nausea and vomiting are most often observed. A selective antidote for minocycline is currently unknown. In case of overdose, it is necessary to stop taking the drug, provide symptomatic treatment and supportive care. Hemo- and peritoneal dialysis remove minocycline in small quantities.
Special instructions
With long-term use of minocycline, the cellular composition of peripheral blood should be regularly monitored, liver function tests should be performed, and the concentration of nitrogen and urea in the serum should be determined.
When using contraceptives with estrogens during therapy with Minolexin, additional contraceptives or combinations thereof should be used.
A false increase in the level of catecholamines in urine is possible when they are determined by the fluorescent method. When examining a biopsy of the thyroid gland in patients who have been receiving tetracyclines for a long time, one should take into account the possibility of dark brown staining of the tissue in micropreparations.
While taking the drug and 2-3 weeks after stopping treatment, diarrhea caused by Clostridium dificile (pseudomembranous colitis) may develop. In mild cases, it is sufficient to discontinue treatment and use ion exchange resins (cholestyramine, colestipol); in severe cases, replacement of loss of fluid, electrolytes and protein, and the appointment of vancomycin, bacitracin or metronidazole are indicated. Do not use medications that inhibit intestinal motility.
To avoid the development of resistance, minocycline should be used only in accordance with the results of a sensitivity study of pathogenic microorganisms. If susceptibility testing of microorganisms is not possible, the epidemiology and susceptibility profile of microorganisms in a particular region should be taken into account.
In the case of sexually transmitted diseases, if concomitant syphilis is suspected, before starting treatment it is necessary to conduct dark-field microscopy studies. Serological diagnostics of blood serum is recommended to be carried out at least once every four months.
Periodic laboratory diagnostics of body functions, including hematopoietic and renal functions, as well as the condition of the liver, are necessary.
Algorithms for action in the event of certain side effects:
If superinfection develops, minocycline should be discontinued and adequate therapy should be prescribed. If intracranial pressure increases, minocycline should be discontinued.
Diarrhea is a common disorder associated with antibiotic use. If diarrhea occurs during treatment with minocycline, you should immediately consult a doctor.
Antibiotics of the tetracycline group cause increased sensitivity to direct sunlight and ultraviolet radiation. If erythema occurs, you should stop taking the antibiotic.
Impact on the ability to drive vehicles and operate machinery: care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions, due to the fact that minocycline has a side effect such as dizziness .
Interaction
Tetracycline group drugs reduce the prothrombin activity of blood plasma, which may necessitate a reduction in doses of anticoagulants in patients on anticoagulant therapy.
Due to the fact that bacteriostatic drugs affect the bactericidal effect of penicillins, simultaneous administration of drugs from the penicillin and tetracycline groups should be avoided.
The absorption of tetracyclines is impaired when taken simultaneously with antacids containing aluminum, calcium, magnesium or iron-containing drugs, which may lead to a decrease in the effectiveness of antibiotic therapy.
Cases of terminal renal toxicity have been reported while taking methoxyflurane and tetracycline drugs.
Simultaneous use of tetracycline antibiotics and oral contraceptives may lead to a decrease in the effectiveness of contraception.
Avoid taking isotretinoin immediately before, simultaneously or immediately after taking Minolexin, since both drugs can cause a benign increase in intracranial pressure.
Concomitant use of drugs from the tetracycline group with ergot alkaloids and their derivatives increases the risk of developing ergotism.
Questions, answers, reviews about the drug Minolexin
The information provided is intended for medical and pharmaceutical professionals. The most accurate information about the drug is contained in the instructions supplied with the packaging by the manufacturer. No information posted on this or any other page of our website can serve as a substitute for personal contact with a specialist.
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Clinical and pharmacological group
Active substance
Release form, composition and packaging
Hard gelatin capsules, No. 2, with a yellow body and cap; The contents of the capsules are yellow powder.
| 1 caps. | |
| minocycline hydrochloride | 50 mg |
Excipients: microcrystalline cellulose - 73.5 mg, low molecular weight povidone - 8.75 mg, potato starch - 7 mg, magnesium stearate - 1.75 mg, lactose monohydrate - up to 175 mg.
Composition of hard gelatin capsule: water - 13% -16%, quinoline yellow dye - 0.5833% -0.75%, sunset yellow dye (E110) - 0.0025% -0.0059%, titanium dioxide - 0.9740% -2.0%, gelatin - up to 100 %.
10 pieces. — contour cell packaging (2) — cardboard packs.
10 pieces. — cellular contour packages (3) — cardboard packs.
Hard gelatin capsules, No. 2, with a white body and cap; The contents of the capsules are yellow powder.
| 1 caps. | |
| minocycline hydrochloride | 100 mg |
Excipients: microcrystalline cellulose - 147 mg, low molecular weight povidone - 17.5 mg, potato starch - 14 mg, magnesium stearate - 3.5 mg, lactose monohydrate - up to 350 mg.
Composition of hard gelatin capsule: water - 13% -16%, titanium dioxide - 2.0% -2.1118%, gelatin - up to 100%.
10 pieces. — contour cell packaging (2) — cardboard packs.
10 pieces. — cellular contour packages (3) — cardboard packs.
pharmachologic effect
Semi-synthetic antibiotic from the tetracycline group. It has a bacteriostatic effect on cells of sensitive strains of microorganisms due to reversible inhibition of protein synthesis at the level of 30S ribosomal subunits. Has a wide spectrum of antibacterial activity.
- aerobic gram-positive - some of the following microorganisms have shown resistance to minocycline, so before use it is recommended to conduct laboratory sensitivity testing - Bacillus anthracis, Listeria monocytogenes, Staphylococcus aureus, Streptococcus pneumoniae. Antibiotics of the tetracycline group are not recommended for the treatment of streptococcal and staphylococcal infections unless sensitivity of microorganisms to minocycline is shown;
— aerobic gram-negative — Bartonella bacilliformis, Brucella species, Calymmatobacterium granulomatis, Campylobacter fetus, Francisella tularensis, Haemophilus ducrey, Vibrio cholerae, Yersinia pestis.
Minocycline sensitivity testing is strongly recommended for the following microorganisms: Acinetobacter species, Enterobacter aerogenes, Escherichia coli, Haemophilus influenzae, Klebsiella species, Neisseria gonorrhoeae, Neisseria meningitidis, Shigella species.
Additionally: Actinomyces species, Borrelia recurrentis, Chlamydia psittaci, Chlamydia trachomatis, Clostridium species, Entamoeba species, Fusobacterium nucleatum subspecies fusiforme, Mycobacterium marinum, Mycoplasma pneumoniae, Propionibacterium acnes, Rickettsiae, Treponema pallidum subspecies pallidum, Treponema pallidum subspecies pertenue, Ureaplasma urealyticum.
Pharmacokinetics
Food intake does not have a significant effect on the extent of absorption of minocycline. Minocycline has a high degree of lipid solubility and low Ca 2+ binding affinity. It is quickly absorbed from the digestive tract in proportion to the dose taken. The maximum concentration of minocycline in blood plasma (Cmax) after oral administration at a dose of 200 mg is 3.5 mg/l and is reached (Tmax) after 2-4 hours.
Binding to blood proteins is 75%; the effect of various diseases on this parameter has not been studied. Vd is 0.7 l/kg. Minocycline penetrates well into organs and tissues: 30-45 minutes after oral administration it is found in therapeutic concentrations in the kidneys, spleen, eye tissues, pleural and ascitic fluids, synovial exudate, exudate of the maxillary and frontal sinuses, and in the fluid of the gingival grooves. Penetrates well into the cerebrospinal fluid (20-25% of the level determined in plasma). Penetrates the placental barrier and is excreted in breast milk.
With repeated administrations, the drug may accumulate. Accumulates in the reticuloendothelial system and bone tissue. In bones and teeth it forms insoluble complexes with Ca 2+.
Subject to enterohepatic recirculation, 30-60% of the dose taken is excreted with intestinal contents; 30% is excreted by the kidneys in 72 hours (of which 20-30% is unchanged), in severe chronic renal failure - only 1-5%. The half-life (T1/2) of minocycline is approximately 16 hours.
Indications
Minocycline hydrochloride is used to treat the following diseases, subject to the sensitivity of pathogenic microorganisms:
- spotted fever, typhoid fever, typhoid fever, Q fever (coxiellosis), vesicular rickettsiosis and tick-borne fever;
- respiratory tract infections;
- trachoma (infectious keratoconjunctivitis);
— conjunctivitis with inclusions (paratrachoma);
- non-gonococcal urethritis, infections of the cervical canal and anus in adults;
- yaws (tropical granuloma, non-venereal syphilis);
In the case of acute intestinal amebiasis, the use of minocycline as an addition to amoebicidal drugs is allowed.
For severe acne, minocycline may be used as adjunctive therapy.
The use of minocycline is indicated for asymptomatic carriage of Neisseria meningitidis for the eradication of meningococci from the nasopharynx.
To prevent the emergence of resistance, the use of minocycline is recommended in accordance with the results of laboratory tests, including serotyping and determination of pathogen sensitivity. For the same reason, the use of minocycline for prophylactic purposes is not recommended in cases of high risk of meningococcal meningitis.
Clinical experience shows the effectiveness of minocycline in the treatment of Mycobacterium marinum infections, but at present these data are not confirmed by the results of controlled clinical trials.
Contraindications
- hypersensitivity to minocycline, tetracyclines and other components of the drug;
- severe liver failure;
- severe renal failure;
- systemic lupus erythematosus;
- simultaneous use with isotretinoin;
- lactation period (breastfeeding);
- children under 8 years of age (period of dental development);
- lactase deficiency, lactose intolerance, glucose-galactose malabsorption.
The drug should be prescribed with caution in cases of impaired liver and kidney function, or in the simultaneous use of hepatotoxic drugs.
Dosage
The drug is taken orally after meals. It is recommended to take the capsules with a sufficient amount of liquid (milk) to reduce the risk of irritation and ulceration in the esophagus.
The initial dose of the drug Minolexin is 200 mg (2 capsules of 100 mg or 4 capsules of 50 mg), then take 100 mg (1 capsule of 100 mg or 2 capsules of 50 mg) every 12 hours (2 times /day). The maximum daily dose should not exceed 400 mg.
Infections of the genitourinary system and anogenital area caused by chlamydia and ureaplasma: 100 mg (1 capsule of 100 mg or 2 capsules of 50 mg) every 12 hours for 7-10 days.
Inflammatory diseases of the pelvic organs in women in the acute stage: 100 mg (1 capsule of 100 mg or 2 capsules of 50 mg) every 12 hours, sometimes in combination with cephalosporins.
Primary syphilis in patients with hypersensitivity to penicillins: 100 mg (1 capsule of 100 mg or 2 capsules of 50 mg) 2 times a day for 10-15 days.
Gonorrhea: 100 mg (1 capsule of 100 mg or 2 capsules of 50 mg) 2 times a day for 4-5 days, or once 300 mg.
Uncomplicated gonococcal infections (excluding urethritis and anorectal infections) in men: initial dose - 200 mg (2 capsules of 100 mg or 4 capsules of 50 mg), maintenance dose - 100 mg (1 capsule of 100 mg or 2 capsules of 50 mg) every 12 hours for at least 4 days, followed by microbiological assessment of recovery 2-3 days after stopping the drug.
Uncomplicated gonococcal urethritis in men: 100 mg (1 capsule of 100 mg or 2 capsules of 50 mg) every 12 hours for 5 days.
Acne: 50 mg (1 capsule of 50 mg) per day, for a long course of 6-12 weeks.
While taking the drug, due to the anti-anabolic effect inherent in drugs of the tetracycline group, an increase in the level of urea in the blood plasma may be observed. In patients with normal renal function, this does not require discontinuation of the drug. In patients with severe renal impairment, azotemia, hyperphosphatemia and acidosis may develop. In this situation, it is necessary to control the level of urea and creatinine in the blood plasma; the maximum daily dose of minocycline should not exceed 200 mg. The pharmacokinetics of minocycline in patients with renal failure (creatinine clearance less than 80 ml/min) has not yet been sufficiently studied to conclude that dose adjustment is necessary.
In case of liver dysfunction, use the drug with caution.
For children over 8 years of age for infections caused by pathogens sensitive to minocycline: initial dose - 4 mg/kg, then 2 mg/kg every 12 hours.
| Initial dose | Maintenance dose | |
| Children weighing more than 25 kg | 100 mg (1 capsule of 100 mg or 2 capsules of 50 mg) | 50 mg (1 capsule of 50 mg) every 12 hours |
Side effects
The spectrum of adverse events associated with minocycline does not differ from other tetracyclines.
From the digestive system: anorexia, nausea, vomiting, diarrhea, dyspepsia, stomatitis, glossitis, dysphagia, hypoplasia of tooth enamel, enterocolitis, pseudomembranous colitis, pancreatitis, inflammatory lesions (including fungal) in the oral cavity and anogenital area, hyperbilirubinemia , cholestasis, increased activity of liver enzymes, liver failure, incl. terminal, hepatitis, including autoimmune.
From the genitourinary system: vulvovaginal candidiasis, interstitial nephritis, dose-dependent increase in urea content in blood plasma, balanitis.
From the skin: alopecia, erythema nodosum, nail pigmentation, itching, toxic epidermal necrosis, vasculitis, maculopapular and erythematous rash, Stevens-Johnson syndrome, exfoliative dermatitis.
From the respiratory system: shortness of breath, bronchospasm, exacerbation of asthma, pneumonia.
From the musculoskeletal system: arthralgia, arthritis, limited mobility and swelling of the joints, discoloration of bone tissue, muscle pain (myalgia).
Allergic reactions: urticaria, angioedema, polyarthralgia, anaphylactic reactions (including shock), anaphylactoid purpura (Henoch-Schönlein purpura), pericarditis, exacerbations of systemic lupus, pulmonary infiltration accompanied by eosinophilia.
From the hematopoietic system: agranulocytosis, hemolytic anemia, thrombocytopenia, leukopenia, neutrocytopenia, pancytopenia, eosinopenia, eosinophilia.
From the central nervous system: convulsions, dizziness, numbness (including limbs), lethargy, vertigo, increased intracranial pressure in adults, headaches.
From the senses: tinnitus and hearing impairment.
From the metabolic side: a single case of malignant neoplasm of the thyroid gland, discoloration (according to the results of pathomorphological studies), dysfunction of the thyroid gland.
Other: discoloration of the oral cavity (tongue, gums, palate), discoloration of tooth enamel, fever, discoloration of secretions (for example, sweat).
Overdose
Symptoms: dizziness, nausea and vomiting are most common.
Treatment: A selective antidote for minocycline is currently unknown. In case of overdose, it is necessary to stop taking the drug, provide symptomatic treatment and supportive care. Hemo- and peritoneal dialysis remove minocycline in small quantities.
Drug interactions
Tetracycline group drugs reduce the prothrombin activity of blood plasma, which may necessitate a reduction in doses of anticoagulants in patients receiving anticoagulant therapy.
Due to the fact that bacteriostatic drugs affect the bactericidal effect of penicillins, simultaneous administration of drugs from the penicillin and tetracycline groups should be avoided.
The absorption of tetracyclines is impaired when taken simultaneously with antacids containing aluminum, calcium, magnesium or iron-containing drugs, which may lead to a decrease in the effectiveness of antibiotic therapy.
Cases of terminal renal toxicity have been reported while taking methoxyfruran and tetracycline drugs.
The simultaneous use of tetracycline antibiotics and oral contraceptives may lead to a decrease in the effectiveness of contraception.
Avoid taking isotretinoin immediately before, at the same time, or immediately after taking minocycline, as both drugs can cause a benign increase in intracranial pressure.
Concomitant use of tetracycline group drugs with ergot alkaloids and their derivatives increases the risk of developing ergotism.
special instructions
With long-term use of minocycline, the cellular composition of peripheral blood should be regularly monitored, liver function tests should be performed, and the concentration of nitrogen and urea in the serum should be determined.
When using contraceptives with estrogens, additional contraceptives or a combination of contraceptives should be used during minocycline therapy.
A false increase in the level of catecholamines in urine is possible when they are determined by the fluorescent method.
When examining a biopsy of the thyroid gland in patients who have been receiving tetracyclines for a long time, one should take into account the possibility of dark brown staining of the tissue in micropreparations.
While taking the drug and 2-3 weeks after stopping treatment, diarrhea caused by Clostridium dificile (pseudomembranous colitis) may develop. In mild cases, it is sufficient to discontinue treatment and use ion exchange resins (colestyramine, colestipol); in severe cases, replacement of loss of fluid, electrolytes and protein, and the appointment of vancomycin, bacitracin or metronidazole are indicated. Do not use medications that inhibit intestinal motility.
To avoid the development of resistance, minocycline should be used only in accordance with the results of a sensitivity study of pathogenic microorganisms. If susceptibility testing of microorganisms is not possible, the epidemiology and susceptibility profile of microorganisms in a particular region should be taken into account.
In the case of sexually transmitted diseases, if concomitant syphilis is suspected, before starting treatment it is necessary to conduct dark-field microscopy studies. Serological diagnostics of blood serum is recommended to be carried out at least once every 4 months.
Periodic laboratory diagnostics of body functions is necessary, incl. hematopoietic and renal functions, as well as liver condition.
Algorithms for action in the event of certain side effects:
- in case of superinfection, minocycline should be stopped and adequate therapy prescribed;
- if intracranial pressure increases, minocycline should be discontinued;
Diarrhea is a common disorder associated with antibiotic use. If diarrhea occurs during treatment with minocycline, you should immediately consult a doctor;
- Tetracycline antibiotics cause increased sensitivity to direct sunlight and ultraviolet radiation. If erythema occurs, the antibiotic should be discontinued.
Impact on the ability to drive vehicles and operate machinery
Caution must be exercised when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions, due to the fact that minocycline has a side effect such as dizziness.
Pregnancy and lactation
During pregnancy, minocycline is recommended to be prescribed only in cases where the expected benefit from its use for the mother outweighs the potential risk to the fetus.
During treatment with minocycline, breastfeeding is suspended.
Use in childhood
For impaired renal function
The drug should be prescribed with caution in case of impaired renal function.
The use of the drug is contraindicated in severe renal failure.
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