minocycline (Rx)

Brand and Other Names:Dynacin, Minocin, more...Minocin Kit, Minolira, Solodyn, Ximino
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet/capsule

  • 50mg
  • 75mg
  • 100mg

tablet, extended-release

  • 45mg (Solodyn)
  • 55mg (Solodyn)
  • 65mg (Solodyn)
  • 80mg (Solodyn)
  • 90mg (Solodyn)
  • 105mg (Minolira, Solodyn)
  • 135mg (Minolira, Solodyn)

injection, intravenous

  • 100mg/vial

Acne Vulgaris

50-100 mg PO twice daily

Solodyn, Minolira (extended-release tablets): 1 mg/kg PO qDay  

Administer therapy for 12 weeks

Extended-release tablets

  • Solodyn
    • 45-49 kg: 45 mg qDay (1-0.92 mg/kg)
    • 50-59 kg: 55 mg qDay (1.1-0.93 mg/kg)
    • 60-71 kg: 65 mg qDay (1.08-0.92 mg/kg)
    • 72-84 kg: 80 mg qDay (1.11-0.95 mg/kg)
    • 85-96 kg: 90 mg qDay (1.06-0.94 mg/kg)
    • 97-110 kg: 105 mg qDay (1.08-0.95 mg/kg)
    • 111-125 kg: 115 mg qDay (1.04-0.92 mg/kg)
    • 126-136 kg: 135 mg qDay (1.07-0.99 mg/kg)
  • Minolira
    • 45-59 kg: 52.5 mg qDay (half of the 105-mg tab)
    • 60-89 kg: 67.5 mg qDay (half of the 135-mg tab)
    • 90-125 kg: 105 mg qDay
    • 126-136 kg: 135 mg qDay

Purulent Cellulitis (Off-label)

Community acquired MRSA: 200 mg PO initially

Maintenance: 100 mg PO twice daily for 5-10 days

Chlamydial or Ureaplasma Urealyticum

Uncomplicated infection: 100 mg PO q12hr for at least 7 days

Gonococcal Infection

Uncomplicated infection in males (no anorectal infections or presence of urethritis: 200 mg PO initially)

Maintenance: 100 mg PO twice daily for at least 4 days

Uncomplicated gonococcal urethritis in men: 100 mg PO q12hr for 5 days

Meningococcal Carrier State

100 mg PO q12hr for 5 days

Urethral, Endocervical, or Rectal Infections

Caused by C. trachomatis or U. urealyticum (uncomplicated infection): 100 mg PO q12hr for 7 days

Mycobacterium marinum

100 mg PO q12hr for 6-8 weeks

Syphilis

200 mg PO initially, followed by 100 mg q12hr for 10-15 days

Rheumatoid Arthritis (Off-label)

100 mg PO twice daily

Infective Endocarditis

100 mg IV twice daily for at least 5 weeks

Infections, General Dosing

200 mg PO/IV initially, THEN 100 mg PO/IV q12hr; not to exceed 400 mg/day, OR

Alternatively, 200 mg PO initially, THEN 100 mg PO q12hr; OR 100-200 mg initially; THEN 50 mg PO q6hr

Dosage Modifications

Renal impairment: Reduce dose and/or frequency

Dosing Considerations

Susceptible organisms

  • Acinetobacter baumannii, Actinomyces spp, Afipia felis, Bacteroides spp, Bartonella bacilliformis, Borrelia recurrentis, Brucella spp, Burkholderia cepacia, Klebsiella granulomatis, Campylobacter jejuni, Chlamydia spp, Clostridium spp, Coxiella burnetii, Eikenella corrodens, Escherichia coli, Entamoeba spp, Francisella tularensis, Haemophilus ducreyi, Legionella pneumophila, Leptospira interrogans, Listeria monocytogenes, Mycoplasma hominis, Mycoplasma pneumoniae, Neisseria meningitidis, Neisseria gonorrhoeae, Nocardia asteroides, Prevotella melaninogenica, Propionibacterium acnes, Rickettsiae, Shigella spp, MRSA, Streptococcus pneumoniae, Streptococcus pyogenes, Treponema pallidum, Ureaplasma urealyticum, Vibrio cholerae, Yersinia pestis, Yersinia enterocolitica, Yersinia pseudotuberculosis, mycobacteria other than tuberculosis

Sarcoidosis (Orphan)

Orphan indication sponsor

  • Autoimmunity Research Foundation; Autoimmunity Research, Inc; Thousand Oaks, CA 91360

Dosage Forms & Strengths

tablet/capsule

  • 50mg
  • 75mg
  • 100mg

tablet, extended-release

  • 45mg (Solodyn)
  • 55mg (Solodyn)
  • 65mg (Solodyn)
  • 80mg (Solodyn)
  • 90mg (Solodyn)
  • 105mg (Minolira, Solodyn)
  • 135mg (Minolira, Solodyn)

injection, intravenous

  • 100mg/vial

Acne Vulgaris

<12 years: Safety and efficacy not established

Immediate-release products: 4 mg/kg PO initially (not to exceed 200 mg), THEN 2 mg/kg/day PO q12hr; not to exceed 400 mg/day  

Solodyn, Minolira (extended-release tablets): 1 mg/kg PO qDay

Administer therapy for 12 weeks

Extended-release tablets

  • Solodyn
    • 45-49 kg: 45 mg qDay (1-0.92 mg/kg)
    • 50-59 kg: 55 mg qDay (1.1-0.93 mg/kg)
    • 60-71 kg: 65 mg qDay (1.08-0.92 mg/kg)
    • 72-84 kg: 80 mg qDay (1.11-0.95 mg/kg)
    • 85-96 kg: 90 mg qDay (1.06-0.94 mg/kg)
    • 97-110 kg: 105 mg qDay (1.08-0.95 mg/kg)
    • 111-125 kg: 115 mg qDay (1.04-0.92 mg/kg)
    • 126-136 kg: 135 mg qDay (1.07-0.99 mg/kg)
  • Minolira
    • 45-59 kg: 52.5 mg qDay (half of the 105-mg tab)
    • 60-89 kg: 67.5 mg qDay (half of the 135-mg tab)
    • 90-125 kg: 105 mg qDay
    • 126-136 kg: 135 mg qDay

C. trachomatis or U. urealyticum

100 mg PO q12hr for 7 days

Infections, General Dosing

≤8 years: Not recommended, unless unable to take other, alternate antibiotics

>8 years: 4 mg/kg PO/IV initially; not to exceed 200 mg; THEN 2 mg/kg PO/IV q12hr; not to exceed adult dose; not to exceed 100 mg PO/IV q12hr for 5-10 days  

Dosing Considerations

Susceptible organisms

  • Acinetobacter baumannii, Actinomyces spp, Afipia felis, Bacteroides spp, Bartonella bacilliformis, Borrelia recurrentis, Brucella spp, Burkholderia cepacia, Klebsiella granulomatis, Campylobacter jejuni, Chlamydia spp, Clostridium spp, Coxiella burnetii, Eikenella corrodens, Escherichia coli, Entamoeba spp, Francisella tularensis, Haemophilus ducreyi, Legionella pneumophila, Leptospira interrogans, Listeria monocytogenes, Mycoplasma hominis, Mycoplasma pneumoniae, Neisseria meningitidis, Neisseria gonorrhoeae, Nocardia asteroides, Prevotella melaninogenica, Propionibacterium acnes, Rickettsiae, Shigella spp, MRSA, Streptococcus pneumoniae, Streptococcus pyogenes, Treponema pallidum, Ureaplasma urealyticum, Vibrio cholerae, Yersinia pestis, Yersinia enterocolitica, Yersinia pseudotuberculosis, mycobacteria other than tuberculosis
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Interactions

Interaction Checker

and minocycline

No Results

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    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

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             activity indicator 

            Contraindicated (2)

            • acitretin

              minocycline, acitretin. Other (see comment). Contraindicated. Comment: Both acitretin and tetracyclines can cause increased intracranial pressure.

            • tretinoin

              minocycline, tretinoin. Either increases toxicity of the other by Other (see comment). Contraindicated. Comment: Both tretinoin and tetracyclines can cause increased intracranial pressure.

            Serious - Use Alternative (57)

            • aluminum hydroxide

              aluminum hydroxide decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.

            • aminolevulinic acid oral

              aminolevulinic acid oral, minocycline. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.

            • aminolevulinic acid topical

              minocycline increases toxicity of aminolevulinic acid topical by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration of photosensitizing drugs may enhance the phototoxic reaction to photodynamic therapy with aminolevulinic acid.

            • amoxicillin

              minocycline decreases effects of amoxicillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Tetracyclines may interfere with the bactericidal action of penicillins. Monitor for decreased therapeutic effects of penicillins if concomitantly used with a tetracycline.

            • ampicillin

              minocycline decreases effects of ampicillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Tetracyclines may interfere with the bactericidal action of penicillins. Monitor for decreased therapeutic effects of penicillins if concomitantly used with a tetracycline.

            • atracurium

              minocycline increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

            • BCG vaccine live

              minocycline decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

            • bismuth subsalicylate

              bismuth subsalicylate decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • calcium acetate

              calcium acetate, minocycline. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.

            • calcium carbonate

              calcium carbonate, minocycline. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.

            • calcium chloride

              calcium chloride, minocycline. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.

            • calcium citrate

              calcium citrate, minocycline. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.

            • calcium gluconate

              calcium gluconate, minocycline. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.

            • carbonyl iron

              carbonyl iron decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • cholera vaccine

              minocycline, cholera vaccine. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid coadministration of cholera vaccine with systemic antibiotics since these agents may be active against the vaccine strain. Do not administer cholera vaccine to patients who have received oral or parenteral antibiotics within 14 days prior to vaccination.

            • cisatracurium

              minocycline increases effects of cisatracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

            • dicloxacillin

              minocycline decreases effects of dicloxacillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug.

            • ferric maltol

              ferric maltol decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • ferrous fumarate

              ferrous fumarate decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • ferrous gluconate

              ferrous gluconate decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • ferrous sulfate

              ferrous sulfate decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • iron dextran complex

              iron dextran complex decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • iron sucrose

              iron sucrose decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • isotretinoin

              isotretinoin, minocycline. Mechanism: unknown. Contraindicated. Risk of pseudotumor cerebri.

            • magnesium chloride

              magnesium chloride decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • magnesium citrate

              magnesium citrate decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • magnesium hydroxide

              magnesium hydroxide decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • magnesium oxide

              magnesium oxide decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • magnesium sulfate

              magnesium sulfate decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • methoxyflurane

              minocycline, methoxyflurane. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of nephrotoxicity.

            • methyl aminolevulinate

              minocycline, methyl aminolevulinate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.

            • nafcillin

              minocycline decreases effects of nafcillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. bacteriostatic antibiotics may interfere with the bactericidal actions of penicillins.

            • onabotulinumtoxinA

              minocycline increases effects of onabotulinumtoxinA by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

            • oxacillin

              minocycline decreases effects of oxacillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. bacteriostatic agents may inhibit the effects of bactericidal agents.

            • pancuronium

              minocycline increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

            • penicillin G aqueous

              minocycline decreases effects of penicillin G aqueous by pharmacodynamic antagonism. Avoid or Use Alternate Drug.

            • penicillin VK

              minocycline decreases effects of penicillin VK by pharmacodynamic antagonism. Avoid or Use Alternate Drug.

            • pexidartinib

              minocycline and pexidartinib both increase Other (see comment). Avoid or Use Alternate Drug. Pexidartinib can cause hepatotoxicity. Avoid coadministration of pexidartinib with other products know to cause hepatoxicity.

            • pivmecillinam

              minocycline decreases effects of pivmecillinam by pharmacodynamic antagonism. Avoid or Use Alternate Drug.

            • polysaccharide iron

              polysaccharide iron decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • pretomanid

              minocycline, pretomanid. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Pretomanid regimen associated with hepatotoxicity. Avoid alcohol and hepatotoxic agents, including herbal supplements and drugs other than bedaquiline and linezolid.

            • rapacuronium

              minocycline increases effects of rapacuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

            • rocuronium

              minocycline increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

            • rose hips

              rose hips decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • sodium bicarbonate

              sodium bicarbonate decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.

            • sodium citrate/citric acid

              sodium citrate/citric acid decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.

            • sodium sulfate/?magnesium sulfate/potassium chloride

              sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Administer tetracyclines at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

            • sodium sulfate/potassium sulfate/magnesium sulfate

              sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Administer tetracyclines at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

            • strontium ranelate

              strontium ranelate decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Contraindicated. Suspend strontium ranelate during antibiotic therapy.

            • succinylcholine

              minocycline increases effects of succinylcholine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

            • temocillin

              minocycline decreases effects of temocillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug.

            • ticarcillin

              minocycline decreases effects of ticarcillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug.

            • tretinoin

              minocycline, tretinoin. Either increases levels of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

            • tretinoin topical

              minocycline, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

            • tripotassium dicitratobismuthate

              tripotassium dicitratobismuthate decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • typhoid vaccine live

              minocycline decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

            • vecuronium

              minocycline increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

            Monitor Closely (34)

            • bazedoxifene/conjugated estrogens

              minocycline will decrease the level or effect of bazedoxifene/conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • cefdinir

              minocycline decreases effects of cefdinir by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

            • cefditoren

              minocycline decreases effects of cefditoren by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

            • cefoxitin

              minocycline decreases effects of cefoxitin by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

            • cefpodoxime

              minocycline decreases effects of cefpodoxime by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

            • ceftriaxone

              minocycline decreases effects of ceftriaxone by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

            • cefuroxime

              minocycline decreases effects of cefuroxime by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

            • cholestyramine

              cholestyramine decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • conjugated estrogens

              minocycline will decrease the level or effect of conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • dichlorphenamide

              dichlorphenamide, minocycline. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis.

            • didanosine

              didanosine will decrease the level or effect of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Applies to didanosine chewable tablets and powder for oral solution; administer 2 hr before or several hours after didanosine oral solution or chewable tablet administration

            • digoxin

              minocycline will increase the level or effect of digoxin by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.

            • dihydroergotamine

              minocycline, dihydroergotamine. Either increases toxicity of the other by Mechanism: unknown. Use Caution/Monitor. coadministration of ergot alkaloids and tetracyclines increases risk of ergotism.

            • ergoloid mesylates

              minocycline, ergoloid mesylates. Either increases toxicity of the other by Mechanism: unknown. Use Caution/Monitor. coadministration of ergot alkaloids and tetracyclines increases risk of ergotism.

            • ergotamine

              minocycline, ergotamine. Either increases toxicity of the other by Mechanism: unknown. Use Caution/Monitor. coadministration of ergot alkaloids and tetracyclines increases risk of ergotism.

            • estradiol

              minocycline will decrease the level or effect of estradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • estrogens conjugated synthetic

              minocycline will decrease the level or effect of estrogens conjugated synthetic by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • estropipate

              minocycline will decrease the level or effect of estropipate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • ethinylestradiol

              minocycline will decrease the level or effect of ethinylestradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • lanthanum carbonate

              lanthanum carbonate decreases levels of minocycline by cation binding in GI tract. Use Caution/Monitor. Administer oral tetracycline antibiotics at least 2 hr before or after lanthanum. Interaction applies only to oral tetracyclines.

            • levonorgestrel oral/ethinylestradiol/ferrous bisglycinate

              minocycline will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. Antibiotics may decrease hormonal contraceptive efficacy.

            • magnesium supplement

              magnesium supplement will decrease the level or effect of minocycline by Other (see comment). Modify Therapy/Monitor Closely. Formation of an insoluble complex reduces absorption of the drug through intestinal tract; administer magnesium 2hr before the tetracycline or 4hr after the tetracycline.

            • mestranol

              minocycline will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • methotrexate

              minocycline increases levels of methotrexate by decreasing elimination. Use Caution/Monitor. If tetracyclines cannot be avoided in patients receiving high-dose methotrexate, closely monitor methotrexate plasma concentrations and patients for signs and symptoms of toxicity.

            • methoxsalen

              methoxsalen, minocycline. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive photosensitizing effects.

            • methylergonovine

              minocycline, methylergonovine. Either increases toxicity of the other by Mechanism: unknown. Use Caution/Monitor. coadministration of ergot alkaloids and tetracyclines increases risk of ergotism.

            • mipomersen

              mipomersen, minocycline. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.

            • piperacillin

              minocycline decreases effects of piperacillin by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

            • polycarbophil

              polycarbophil decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • porfimer

              minocycline, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

            • sodium picosulfate/magnesium oxide/anhydrous citric acid

              minocycline decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.

              sodium picosulfate/magnesium oxide/anhydrous citric acid decreases levels of minocycline by cation binding in GI tract. Use Caution/Monitor. Take at least 2 hours before and not less than 6 hours after administration of sodium picosulfate, magnesium oxide and anhydrous citric acid to avoid magnesium chelation.

            • tobramycin inhaled

              tobramycin inhaled and minocycline both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity

            • trimagnesium citrate anhydrous

              trimagnesium citrate anhydrous decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Multivalent cation-containing products may reduce bioavailability of tetracyclines; administer tetracycline at least 2 hr before or 6 hr after magnesium; use alternatives if available.

            • zinc

              zinc will decrease the level or effect of minocycline by cation binding in GI tract. Modify Therapy/Monitor Closely. Separate administration of oral tetracycline derivatives and oral zinc salts by at least 2 hr.

            Minor (24)

            • antithrombin alfa

              minocycline increases effects of antithrombin alfa by pharmacodynamic synergism. Minor/Significance Unknown.

            • antithrombin III

              minocycline increases effects of antithrombin III by pharmacodynamic synergism. Minor/Significance Unknown.

            • argatroban

              minocycline increases effects of argatroban by pharmacodynamic synergism. Minor/Significance Unknown.

            • balsalazide

              minocycline will decrease the level or effect of balsalazide by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

            • bemiparin

              minocycline increases effects of bemiparin by pharmacodynamic synergism. Minor/Significance Unknown.

            • biotin

              minocycline will decrease the level or effect of biotin by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

            • bivalirudin

              minocycline increases effects of bivalirudin by pharmacodynamic synergism. Minor/Significance Unknown.

            • colestipol

              colestipol decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

            • dalteparin

              minocycline increases effects of dalteparin by pharmacodynamic synergism. Minor/Significance Unknown.

            • enoxaparin

              minocycline increases effects of enoxaparin by pharmacodynamic synergism. Minor/Significance Unknown.

            • fondaparinux

              minocycline increases effects of fondaparinux by pharmacodynamic synergism. Minor/Significance Unknown.

            • heparin

              minocycline increases effects of heparin by pharmacodynamic synergism. Minor/Significance Unknown.

            • niacin

              minocycline will decrease the level or effect of niacin by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

            • pantothenic acid

              minocycline will decrease the level or effect of pantothenic acid by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

            • phenindione

              minocycline increases effects of phenindione by pharmacodynamic synergism. Minor/Significance Unknown.

            • protamine

              minocycline increases effects of protamine by pharmacodynamic synergism. Minor/Significance Unknown.

            • pyridoxine

              minocycline will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

            • pyridoxine (Antidote)

              minocycline will decrease the level or effect of pyridoxine (Antidote) by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

            • rose hips

              minocycline decreases levels of rose hips by increasing elimination. Minor/Significance Unknown.

            • sucralfate

              sucralfate decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

            • thiamine

              minocycline will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

            • verteporfin

              minocycline, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.

            • vitamin A

              minocycline, vitamin A. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of benign intracranial hypertension.

            • warfarin

              minocycline increases effects of warfarin by pharmacodynamic synergism. Minor/Significance Unknown.

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            Adverse Effects

            Frequency Not Defined

            To report suspected adverse reactions, contact Valeant Pharmaceuticals North America LLC at 1-800-321-4576 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch

            Discoloration of teeth (in children)

            Vestibular symptoms (>30%)

            Pericarditis

            Myocarditis

            Vasculitis

            Angioedema

            Alopecia

            Erythema nodosum

            Erythematous rash

            Exfoliative dermatitis

            Pruritus

            Toxic epidermal necrolysis

            Urticaria

            Dizziness

            Fever

            Fatigue

            Somnolence

            Angioedema

            Hyperpigmentation of nails

            Pigmentation of skin and mucous membranes

            Thyroid dysfunction

            Thyroid discoloration

            Thyroid cancer

            Vulvovaginitis

            Hemolytic anemia

            Neutropenia

            Thrombocytopenia

            Agrunolocytosis

            Pancytopenia

            Hepatic cholestasis

            Hepatitis

            Hyperbilirubinemia

            Jaundice

            CNS effects

            Clostridium difficile diarrhea

            Postmarketing Reports

            Anaphylaxis

            Angioneurotic edema

            Eosinophilia

            Pneumonitis

            Nephritis

            Myocarditis

            Swelling of the face

            Lymphadenopathy

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            Warnings

            Contraindications

            Documented hypersensitivity

            Cautions

            Caution in significant renal impairment (may lead to azotemia, hyperphosphatemia, and acidosis; monitor BUN)

            Adjust dose if renal impairment occurs

            Anaphylaxis reported; discontinue use and institute supportive therapy

            Prolonged use may result in fungal or bacterial superinfection

            Lupus, hepatitis, and vasculitis autoimmune syndromes reported with use; discontinue if lupus symptoms occur and assess liver function tests; ANA and CBC

            Discontinue therapy if pseudomembranous colitis occurs

            Risk of vestibular reactions

            Caution in hepatic impairment; discontinue if liver injury occurs

            Photosensitivity may occur with prolonged exposure to sunlight or tanning equipment; use skin protection and avoid prolonged exposure to sunlight

            Reduce dose in renal impairment; consider drug serum level determinations in prolonged therapy

            Tetracycline use during tooth development (last half of pregnancy through age 8 years) can cause tooth enamel hypoplasia or permanent teeth discoloration; more common with long-term use and with repeated, short courses; during pregnancy, may retard skeletal development and reduce bone growth

            Fanconi-like syndrome may occur with outdated tetracyclines

            Lightheadedness and vertigo may occur; use caution when performing tasks that require mental alertness or operating heavy machinery

            May increase BUN secondary to antianabolic effects

            Cases of drug rash with eosinophilia and systemic symptoms (DRESS) reported, some fatal; discontinue immediately

            Intracranial hypertension (pseudotumor cerebri) has been associated with use of tetracyclines including minocycline; avoid concomitant use of isotretinoin and minocycline; isotretinoin is also known to cause pseudotumor cerebri; although intracranial hypertension typically resolves after discontinuation of treatment, risk of permanent visual loss exists; seek ophthalmologic evaluation if visual disturbance occurs during treatment; since intracranial pressure can remain elevated for weeks after drug cessation, monitor until patient stabilizes

            A decrease in fibula growth rate observed in premature human infants given oral tetracycline in doses of 25 mg/kg q6hr

            Hyperpigmentation may occur in nails, bone, skin (including scars), eyes, sclerae, thyroid, oral cavity, visceral tissue, and heart valves

            Increased risk of ergotism when coadministered with ergot alkaloids

            Sporadic cases of serum sickness-like reaction have presented shortly after oral minocycline use, manifested by fever, rash, arthralgia, lymphadenopathy and malaise

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            Pregnancy & Lactation

            Pregnancy category: D

            Lactation: Enters breast milk, some manufacturers say do not nurse; however AAP considers nursing compatible due to calcium chelation of drug and prevention of its absorption; long-term safety of prolonged exposure unknown

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Infection: Inhibits protein synthesis and thus bacterial growth by binding to 30S and possibly 50S ribosomal subunits of susceptible bacteria

            Rheumatoid arthritis: Mechanism not fully understood; may play immunomodulatory, anti-inflammatory, or chondroprotective effects; thought to be a potent inhibitor of metalloproteinases, which are active in rheumatoid arthritis joint destruction

            Absorption

            Absorption: 90-100%

            Peak plasma time: 1-4 hr (immediate release); 3.5-4 hr (extended release tablet)

            Peak plasma concentration (200 mg dose): 2-3.5 mcg/mL

            Distribution

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

            Protein bound: 70-75%

            Metabolism

            Liver (partially)

            Elimination

            Half-life, elimination: 15-23 hr (PO/IV)

            Excretion: Feces and urine

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            Administration

            Incompatibilities

            IV solutions: Calcium containing solutions (precipitant may form, particularly with alkaline solutions)

            Y-site: Adrenocorticotropic hormone (ACTH), aminophylline, amobarbital sodium, amphotericin B, bicarbonate infusion mixtures, calcium gluconate or chloride, carbenicillin, cephalothin sodium, cefazolin sodium, chloramphenicol succinate, colistin sulfate, heparin sodium, hydrocortisone sodium succinate, iodine sodium, methicillin sodium, novobiocin, penicillin, pentobarbital, phenytoin sodium, polymyxin, prochlorperazine, sodium ascorbate, sulfadiazine, sulfisoxazole, thiopental sodium, vitamin K (sodium bisulfate or sodium salt), whole blood

            Compatibilities

            IV solutions: 0.9% NaCl, dextrose solutions, dextrose and NaCl solutions, Ringer Injection, or Lactated Ringer

            IV Preparation

            Reconstitute cryodessicated powder with 5 mL sterile water for injection

            Immediately dilute further with 500-1000 mL of 0.9% NaCl, dextrose solutions, dextrose and NaCl solutions, Ringer Injection, or Lactated Ringer

            Reformulated Minocin IV

            • Allows for dilution with lower fluid volume
            • After vial reconstitution, dilute further with 100-1000 mL of 0.9% NaCl, dextrose solutions, dextrose and NaCl solutions, or 250-1000 mL of Ringer or Lactated Ringer injections

            IV Administration

            Avoid rapid IV infusion

            Infuse over one hour

            Not to exceed 400mg in 24 hours

            Oral Administration

            May take with or without food

            Ingestion of food along with may help reduce the risk of esophageal irritation and ulceration

            Extended-release tablets (ie, Solodyn) or capsules: Swallow whole without chewing, crushing, or splitting

            Extended-release tablet (Minolira): These tablets are scored and intended to split to give precise dose

            Storage

            Unreconstituted vial: Store at controlled room temperature 20-25 degrees C (68-77 degrees F)

            Final dilutions: Store at controlled room temperature or refrigerated for up to 24 hr

            May be stored at room temperature for up to 4 hours

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            Amzeeq topical
            -
            4 % foam
            minocycline oral
            -
            100 mg capsule
            minocycline oral
            -
            65 mg tablet
            minocycline oral
            -
            100 mg capsule
            minocycline oral
            -
            100 mg capsule
            minocycline oral
            -
            100 mg capsule
            minocycline oral
            -
            75 mg capsule
            minocycline oral
            -
            50 mg capsule
            minocycline oral
            -
            55 mg tablet
            minocycline oral
            -
            45 mg tablet
            minocycline oral
            -
            90 mg tablet
            minocycline oral
            -
            135 mg tablet
            minocycline oral
            -
            50 mg tablet
            minocycline oral
            -
            50 mg capsule
            minocycline oral
            -
            75 mg capsule
            minocycline oral
            -
            100 mg capsule
            minocycline oral
            -
            100 mg tablet
            minocycline oral
            -
            50 mg capsule
            minocycline oral
            -
            50 mg tablet
            minocycline oral
            -
            100 mg capsule
            minocycline oral
            -
            80 mg tablet
            minocycline oral
            -
            105 mg tablet
            minocycline oral
            -
            55 mg tablet
            minocycline oral
            -
            100 mg capsule
            minocycline oral
            -
            80 mg tablet
            minocycline oral
            -
            100 mg tablet
            minocycline oral
            -
            75 mg tablet
            minocycline oral
            -
            50 mg capsule
            minocycline oral
            -
            100 mg capsule
            minocycline oral
            -
            75 mg tablet
            minocycline oral
            -
            100 mg tablet
            minocycline oral
            -
            115 mg tablet
            minocycline oral
            -
            105 mg tablet
            minocycline oral
            -
            115 mg tablet
            minocycline oral
            -
            75 mg tablet
            minocycline oral
            -
            50 mg tablet
            minocycline oral
            -
            75 mg capsule
            minocycline oral
            -
            80 mg tablet
            minocycline oral
            -
            105 mg tablet
            minocycline oral
            -
            135 mg tablet
            minocycline oral
            -
            90 mg tablet
            minocycline oral
            -
            65 mg tablet
            minocycline oral
            -
            50 mg capsule
            minocycline oral
            -
            75 mg capsule
            minocycline oral
            -
            55 mg tablet
            minocycline oral
            -
            75 mg capsule
            Minolira ER oral
            -
            135 mg tablet
            Minolira ER oral
            -
            105 mg tablet
            CoreMino oral
            -
            90 mg tablet
            CoreMino oral
            -
            45 mg tablet
            CoreMino oral
            -
            135 mg tablet
            Minocin intravenous
            -
            100 mg vial
            Minocin intravenous
            -
            100 mg vial
            Minocin intravenous
            -
            100 mg vial
            Solodyn oral
            -
            80 mg tablet
            Solodyn oral
            -
            115 mg tablet
            Solodyn oral
            -
            65 mg tablet
            Solodyn oral
            -
            105 mg tablet
            Solodyn oral
            -
            55 mg tablet

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

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            Patient Education
            minocycline intravenous

            MINOCYCLINE - INJECTION

            (MIN-oh-SYE-kleen)

            COMMON BRAND NAME(S): Minocin

            USES: Minocycline is used to treat a wide variety of infections. This medication belongs to a class of drugs known as tetracycline antibiotics. It works by stopping the growth of bacteria.This antibiotic treats only bacterial infections. It will not work for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.

            HOW TO USE: This medication is given by slow injection into a vein as directed by your doctor, usually every 12 hours over 60 minutes. The dosage is based on your medical condition and response to treatment. In children, the dosage is also based on weight.If you are using this medication at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.For the best effect, use this antibiotic at evenly spaced times. To help you remember, use this medication at the same times every day.Continue to use this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.Tell your doctor if your condition lasts or gets worse.

            SIDE EFFECTS: Pain, redness, and tenderness at the injection site may occur. Nausea, vomiting, diarrhea, lightheadedness, dizziness, or a feeling of spinning may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: hearing changes (such as ringing in the ears, decreased hearing), joint stiffness/pain/swelling, signs of kidney problems (such as change in the amount of urine, pink urine), signs of liver problems (such as loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark urine), yellow-gray-brown tooth discoloration, blue-gray skin/lips/tongue/gums.Minocycline may rarely cause a serious increase in pressure inside the skull (intracranial hypertension-IH). The risk of this side effect is greater for women of childbearing age who are overweight or who have had IH in the past. If IH develops, it usually goes away after minocycline is stopped; however, there is a chance of permanent vision loss or blindness. Get medical help right away if you have: severe/lasting headache, vision changes (such as blurred/double vision, decreased vision, sudden blindness), nausea/vomiting that doesn't stop.This medication may rarely cause a severe intestinal condition due to a bacteria called C. difficile. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn't stop, abdominal or stomach pain/cramping, blood/mucus in your stool.If you have these symptoms, do not use anti-diarrhea or opioid products because they may make symptoms worse.Use of this medication for prolonged or repeated periods may result in oral thrush or a new yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever that doesn't go away, new or worsening lymph node swelling, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: See also Side Effects section.Before using minocycline, tell your doctor or pharmacist if you are allergic to it; or to other tetracyclines (such as doxycycline); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems, liver problems.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.Minocycline may cause live bacterial vaccines (such as typhoid vaccine) to not work as well. Do not have any immunizations/vaccinations while using this medication unless your doctor tells you to.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Children younger than 8 years may be more sensitive to the side effects of minocycline, especially tooth discoloration. Tooth discoloration has also occurred in older children and in young adults. Discuss the risks and benefits of this medication with the doctor.Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using minocycline. Minocycline may harm an unborn baby. If you become pregnant, talk to your doctor right away about the risks and benefits of this medication.This medication passes into breast milk. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: retinoid medications taken by mouth (such as acitretin, isotretinoin).This medication may interfere with certain lab tests (such as urine catecholamine levels), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

            NOTES: Lab and/or medical tests (such as complete blood count, kidney/liver function) may be done while you are using this medication. Keep all medical and lab appointments.

            MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.

            STORAGE: Consult the product instructions or your pharmacist for storage details. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

            Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
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            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.