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Rosacea - Patient's guide
Oral Antibiotics: Tetracycline
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Tetracycline was developed in 1953 and is a broad spectrum antibiotic. There is a family of tetracycline’s that include doxycycline and minocycline, the latter having longer half-lives and enhanced antibacterial activity and improved safety profiles.
Tetracycline is often the first used acne antibiotic, being the least expensive with few side effects and is generally well tolerated.
How Do I Use This Medication?
It is taken on an empty stomach, half an hour before, or 2 hours after a meal. It should not be taken with antacids or milk as it interacts with metallic ions. It should be taken with a large glass of water to avoid it becoming stuck in the esophagus, which might produce ulceration.
Cholystiramune should be avoided. The risk of interacting with the birth control pill is remote. Children and pregnant or breast feeding mother should avoid this drug.
Initially a dose of 1 gram a day can be used either in divided doses of 250 mg or even in a single dose, which is more convenient but increases the side effects especially of nausea or abdominal discomfort. In acne the dose can be decreased after improvement is established.
How Well Does It Work?
It is not unreasonable to expect about a 25% improvement in acne per month. The first sign is less new acne lesions appearing. There is a feeling that this antibiotic does not work as well presently as it did in the past possibly due to antibiotic resistance issues.
How Does It Work?
Tetracycline interferes with bacterial protein synthesis. It is bacterioststic and has broad spectrum action. It blocks the binding to aminoacyl transfer RNA to messenger RNA. It has some immunosuppressive actions and is anti-inflammatory affecting lymphocyte function as well as neutrophil chemotaxis. It inhibits lipase and collagenase.
Will There Be Side Effects?
- Sun sensitivity is common
- Pigmentation of the skin is uncommon, but may occur in the mouth and teeth
- Gastrointestinal irritation is common
- Staining of teeth, enamel hypoplasia and inhibition of skeletal growth is documented
- It should be avoided in children up to the age of 11
- Yeast infections in the mouth, rectal and genital areas are increased
- Pseudotumor cerebri is very uncommon and may be seen after 2 weeks to 10 months of taking this drug
- The symptoms are headache, vomiting, nausea and double vision
- Discontinuing the drug early will reverse the problem
What Other Conditions Are Treated By This Medication?
- Rosacea
- Perioral dermatitis
- Actinomycosis
- Anthrax
- Brucellosis
- Chlamydia
- Granuloma inguinale
- Lymphogranuloma venereum
- Rocky mountain spotted fever
- Syphilis
- Lyme disease
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INTRODUCTION
Minocycline inhibits the growth of Propionibacterium acnes. Anti-inflammatory actions. Drug Class: Antibiotic, Anti-inflammatory-long acting tetracycline... | Read more ... -
CLININCAL EXPERIENCE
Oral antibiotics have had a significant role in the treatment of inflammatory disease such as acne, rosacea, perioral dermatitis and others. Tetracycline has long been the first line antibiotic for acneform eruptions because of its efficacy and affordability although in inconvenience of divides doses on an empty stomach has compromised compliance in some. P. acnes resistance to Tetracycline and Erythromycin has meant looking elsewhere for an alternative antibiotic. Bacterial resistance to Minocycline has been much slower to develop... | Read more ... -
INDICATIONS
Labeled Indications: Dermatologic Dermatologic: Acne vulgaris, Inflammatory acne, Anthrax, Chancroid, Granuloma inguinale, Lymphogranuloma venerum, Skin and soft tissue infections , Syphilis, Yaws... | Read more ... -
PATIENT PROFILE
Any inflammatory acne or rosacea patient who is not likely to respond to topical therapy alone. If scarring present or nodulocystic acne a more aggressive approach may be necessary... | Read more ... -
DOSING
Capsules: Minocycline 50 and 100mg (Minocin* Dynacin*) Suspension: Minocycline 50mg (Minocin* Dynacin*) Parenteral: Minocycline 100mg (Minocin IV*) ... | Read more ... -
EFFICACY
Improvement in inflammatory lesion in acne is about a 20% reduction a month. It may take 1-2 months to see initial benefit. After 6 months there is an approximate 60-70% improvement in inflammatory acne counts. Studies over the last 20 years have shown that tetracycline, erythromycin, doxycycline and minocycline have about the same efficacy in acne... | Read more ... -
COMPLIANCE
All tetracyclines are broad-spectrum bacteriostatic agents. They are well absorbed, although oxytetracycline and tetracycline should not be taken with food. Minocycline as well as Doxycycline are absorbed almost as well on an empty as full stomach... | Read more ... -
SIDE EFFECTS, SAFETY AND RISKS
Discard outdated tetracyclines as degradation products may be toxic. Not recommended in pregnancy and in children under 8 years of age as permanent enamel hyperplasia, discoloration of teeth, and inhibition of fetal skeletal growth may occur... | Read more ... -
COST OF TREATMENT
Cost of treatment of 1 month of standard dose for acne: Minocycline 100 mg daily for 1 month $42. Tetracycline 1gm daily for 1 month ... | Read more ...
View the entire Minocycline (Minocin®, Dynacin®, Vectrin®) presentation.
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Last modified: Tuesday, 17-Aug-2010 12:02:54 MDT