Minocycline

From Wikipedia, the free encyclopedia

This article may require cleanup to meet Wikipedia's quality standards.
Please discuss this issue on the talk page or replace this tag with a more specific message.
This article has been tagged since October 2006.


Minocycline
Systematic (IUPAC) name
2-(amino-hydroxy-methylidene)-4,7- bis(dimethylamino)-10,11,12a-trihydroxy-4a,5,5a, 6-tetrahydro-4H-tetracene-1,3,12-trione (synonym 7-Dimethylamino-6-demethyl- 6-deoxytetracycline)
Identifiers
CAS number	10118-90-8
ATC code	J01AA08
PubChem	24960
DrugBank	APRD00547
Chemical data
Formula	C₂₃H₂₇N₃O₇
Mol. mass	457.477
Pharmacokinetic data
Bioavailability	100% (oral)
Metabolism	liver
Half life	11-22 hours
Excretion	mostly fecal, rest renal
Therapeutic considerations
Pregnancy cat.	? (Aust)
Legal status	Schedule 4 (Aust)
Routes	oral

Minocycline hydrochloride, also known as minocycline, is a member of the broad spectrum tetracycline antibiotics, and has a broader spectrum than the other members. It is a bacteriostatic antibiotic. As a result of its long half-life it generally has serum levels 2-4 times that of most other tetracyclines (150 mg giving 16 times the activity levels compared to 250 mg of tetracycline at 24-48 hours).

It is marketed under several trade names, including Minomycin, Minocin, Arestin, Akamin, Aknemin, Solodyn and Dynacin. StoneBridge Pharma also markets Minocycline as Cleeravue-M in combination with SteriLid eyelid cleanser in the treatment of rosacea blepharitis.

1 Indications
2 Cautions and side effects
3 Possible additional indications
4 References
5 Additional References
6 External links

[edit] Indications

It is primarily used to treat acne and rosacea as the once daily 100mg dosage is far easier for patients than the four times a day required with Tetracycline or Oxytetracycline.

Although minocycline's broader spectrum of activity, compared to other members of the group, includes activity against Neisseria meningitidis, its use as a prophylaxis is no longer recommended because of side effects (dizziness and vertigo).

It may be used to treat certain strains of MRSA infection and disease caused by drug resistant Acinetobacter.

For other uses of Minocycline see Tetracycline antibiotics and Oxytetracycline as the uses are much the same between Tetracyclines with only minor exceptions.

[edit] Cautions and side effects

In addition to those common to the Tetracycline antibiotics group, minocycline may be used in renal impairment, but may aggravate systemic lupus erythematosus.^[1]

Also, more so than other tetracyclines, minocycline can cause the rare condition of secondary intracranial hypertension which has initial symptoms of headache, visual disturbances, and confusion.

Minocycline, like all Tetracyclines, becomes dangerous past its expiration date. 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 kidneys.

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 (by ~5%).^{[citation needed]}

[edit] Possible additional indications

Current research is examining the possible neuroprotective and anti-inflammatory effects of minocycline against progression of a group of neurodegenerative disorders including Multiple Sclerosis (MS), Rheumatoid Arthritis (RA), Amyotrophic Lateral Sclerosis (ALS), Huntington's Disease, and Parkinsons disease^[1], amongst others nuerodegenerative diseases. ^[2]^[3]^[2]

The neuroprotective action of minocycline may include its inhibitory effect on 5-lipoxygenase, ^[5] an inflammatory enzyme associated with brain aging and is being studied for use in Alzheimers patients.^[5] It also has been used as a "last ditch" treatment for toxoplasmosis in AIDS patients.

As an anti-inflammatory, minocycline inhibits apoptosis (cell death) via attenuation of TNF-alpha, downregulating pro-inflammatory cytokine output. This effect is mediated by a direct action of minocycline on the activated T cells and on microglia, which results in the decreased ability of T cells to contact microglia.^[3]

It is thought that minocycline exerts neuroprotective effects independent of its anti-inflammatory properties.^[4]

[edit] References

^ [1] National Institute of Health Press Release. February 23, 2006
^ [2]Nirmalananthan N, Greensmith L."Amyotrophic lateral sclerosis: recent advances and future therapies". Curr Opin Neurol. 2005 Dec;18(6):712-9.
^ [3]"Giuliani F, Hader W, Yong VW. "Minocycline attenuates T cell and microglia activity to impair cytokine production in T cell-microglia interaction". J Leukoc Biol. 2005 Jul;78(1):135-43.
^ [4]Maier K, Merkler D, Gerber J, Taheri N, Kuhnert AV, Williams SK, Neusch C, Bahr M, Diem R. "Multiple neuroprotective mechanisms of minocycline in autoimmune CNS inflammation". Neurobiol Dis. 2007 Mar;25(3):514-25

[edit] Additional References

^a Gough A, Chapman S, Wagstaff K, Emery P, Elias E (1996). "Minocycline induced autoimmune hepatitis and systemic lupus erythematosus-like syndrome". BMJ 312 (7024): 169-72. PMID 8563540 Free text.
^a 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 (2000). "Minocycline inhibits caspase-1 and caspase-3 expression and delays mortality in a transgenic mouse model of Huntington disease". Nat Med 6 (7): 797-801. PMID 10888929.
^a Tikka TM, Koistinaho JE (2001). "Minocycline provides neuroprotection against N-methyl-D-aspartate neurotoxicity by inhibiting microglia". J Immunol 166 (12): 7527-33. PMID 11390507 Free text.
^a Song Y, Wei EQ, Zhang WP, Zhang L, Liu JR, Chen Z (2004). "Minocycline protects PC12 cells from ischemic-like injury and inhibits 5-lipoxygenase activation". Neuroreport 15 (14): 2181-4. PMID 15371729.
^a Uz T, Pesold C, Longone P, Manev H (1998). "Aging-associated up-regulation of neuronal 5-lipoxygenase expression: putative role in neuronal vulnerability". FASEB J 12 (6): 439-49. PMID 9535216 Free text.