What happens if I overdose Minocycline Hydrochloride?
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.
Proper storage of Minocycline Hydrochloride:
Store Minocycline Hydrochloride at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), in a tightly closed, light-resistant container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Minocycline Hydrochloride out of the reach of children and away from pets.
Overdose of Minocycline Hydrochloride in details
The adverse events more commonly seen in overdose are dizziness, nausea, and vomiting.
No specific antidote for Minocycline Hydrochloride is known.
In case of overdosage, discontinue medication, treat symptomatically, and institute supportive measures. Minocycline Hydrochloride is not removed in significant quantities by hemodialysis or peritoneal dialysis.
What should I avoid while taking Minocycline Hydrochloride?
This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.
Avoid exposure to sunlight or tanning beds. Minocycline Hydrochloride can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.
For 2 hours before or after you take Minocycline Hydrochloride, avoid taking antacids, laxatives, multivitamins, or supplements that contain calcium or iron. These other medicines can make it harder for your body to absorb Minocycline Hydrochloride.
Minocycline Hydrochloride warnings
Teratogenic Effects
A. Minocycline Hydrochloride, LIKE OTHER TETRACYCLINE-CLASS DRUGS, CAN CAUSE FETAL HARM WHEN ADMINISTERED TO A PREGNANT WOMAN. IF ANY TETRACYCLINE IS USED DURING PREGNANCY OR IF THE PATIENT BECOMES PREGNANT WHILE TAKING THESE DRUGS, THE PATIENT SHOULD BE APPRISED OF THE POTENTIAL HAZARD TO THE FETUS.
Minocycline Hydrochloride extended-release tablets should not be used during pregnancy or by individuals of either gender who are attempting to conceive a child.
B. THE USE OF DRUGS OF THE TETRACYCLINE CLASS DURING TOOTH DEVELOPMENT (LAST HALF OF PREGNANCY, INFANCY, AND CHILDHOOD UP TO THE AGE OF 8 YEARS) MAY CAUSE PERMANENT DISCOLORATION OF THE TEETH (YELLOW-GRAY-BROWN).
This adverse reaction is more common during long-term use of the drug but has been observed following repeated short-term courses. Enamel hypoplasia has also been reported. TETRACYCLINE DRUGS, THEREFORE, SHOULD NOT BE USED DURING TOOTH DEVELOPMENT.
C. All tetracyclines form a stable calcium complex in any bone-forming tissue. A decrease in fibula growth rate has been observed in premature human infants given oral tetracycline in doses of 25 mg/ kg every 6 hours. This reaction was shown to be reversible when the drug was discontinued.
Results of animal studies indicate that tetracyclines cross the placenta, are found in fetal tissues, and can cause retardation of skeletal development on the developing fetus. Evidence of embryotoxicity has been noted in animals treated early in pregnancy.
Pseudomembranous Colitis
Clostridium difficile associated diarrhea (CDAD) has been reported with nearly all antibacterial agents, including Minocycline Hydrochloride, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile.
C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.
If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.
Hepatotoxicity
Post-marketing cases of serious liver injury, including irreversible drug-induced hepatitis and fulminant hepatic failure (sometimes fatal) have been reported with Minocycline Hydrochloride use in the treatment of acne.
Metabolic Effects
The anti-anabolic action of the tetracyclines may cause an increase in BUN. While this is not a problem in those with normal renal function, in patients with significantly impaired function, higher serum levels of tetracycline-class drugs may lead to azotemia, hyperphosphatemia, and acidosis. If renal impairment exists, even usual oral or parenteral doses may lead to excessive systemic accumulations of the drug and possible liver toxicity. Under such conditions, lower than usual total doses are indicated, and if therapy is prolonged, serum level determinations of the drug may be advisable.
Central Nervous System Effects
Central nervous system side effects including light-headedness, dizziness or vertigo have been reported with Minocycline Hydrochloride therapy. Patients who experience these symptoms should be cautioned about driving vehicles or using hazardous machinery while on Minocycline Hydrochloride therapy. These symptoms may disappear during therapy and usually rapidly disappear when the drug is discontinued.
Benign Intracranial Hypertension
Pseudotumor cerebri (benign intracranial hypertension) in adults and adolescents has been associated with the use of tetracyclines. Minocycline Hydrochloride has been reported to cause or precipitate pseudotumor cerebri, the hallmark of which is papilledema. Clinical manifestations include headache and blurred vision. Bulging fontanels have been associated with the use of tetracyclines in infants. Although signs and symptoms of pseudotumor cerebri resolve after discontinuation of treatment, the possibility for permanent sequelae such as visual loss that may be permanent or severe exists. Patients should be questioned for visual disturbances prior to initiation of treatment with tetracyclines. If visual disturbance occurs during treatment, patients should be checked for papilledema. Concomitant use of isotretinoin and Minocycline Hydrochloride should be avoided because isotretinoin, a systemic retinoid, is also known to cause pseudotumor cerebri.
Autoimmune Syndromes
Tetracyclines have been associated with the development of autoimmune syndromes. The long-term use of Minocycline Hydrochloride in the treatment of acne has been associated with drug-induced lupus -like syndrome, autoimmune hepatitis and vasculitis. Sporadic cases of serum sickness have presented shortly after Minocycline Hydrochloride use. Symptoms may be manifested by fever, rash, arthralgia, and malaise. In symptomatic patients, liver function tests, ANA, CBC, and other appropriate tests should be performed to evaluate the patients. Use of all tetracycline-class drugs should be discontinued immediately.
Photosensitivity
Photosensitivity manifested by an exaggerated sunburn reaction has been observed in some individuals taking tetracyclines. This has been reported rarely with Minocycline Hydrochloride. Patients should minimize or avoid exposure to natural or artificial sunlight (tanning beds or UV A/B treatment) while using Minocycline Hydrochloride. If patients need to be outdoors while using Minocycline Hydrochloride, they should wear loose-fitting clothes that protect skin from sun exposure and discuss other sun protection measures with their physician.
Serious Skin/Hypersensitivity Reaction
Cases of anaphylaxis, serious skin reactions (e.g. Stevens Johnson syndrome), erythema multiforme, and drug rash with eosinophilia and systemic symptoms (DRESS) syndrome have been reported postmarketing with Minocycline Hydrochloride use in patients with acne. DRESS syndrome consists of cutaneous reaction (such as rash or exfoliative dermatitis), eosinophilia, and one or more of the following visceral complications such as: hepatitis, pneumonitis, nephritis, myocarditis, and pericarditis. Fever and lymphadenopathy may be present. In some cases, death has been reported. If this syndrome is recognized, the drug should be discontinued immediately.
Tissue Hyperpigmentation
Tetracycline-class antibiotics are known to cause hyperpigmentation. Tetracycline therapy may induce hyperpigmentation in many organs, including nails, bone, skin, eyes, thyroid, visceral tissue, oral cavity (teeth, mucosa, alveolar bone), sclerae and heart valves. Skin and oral pigmentation has been reported to occur independently of time or amount of drug administration, whereas other tissue pigmentation has been reported to occur upon prolonged administration. Skin pigmentation includes diffuse pigmentation as well as over sites of scars or injury.
Development of Drug-Resistant Bacteria
Bacterial resistance to the tetracyclines may develop in patients using Minocycline Hydrochloride extended-release tablets, therefore, the susceptibility of bacteria associated with infection should be considered in selecting antimicrobial therapy. Because of the potential for drug-resistant bacteria to develop during the use of Minocycline Hydrochloride extended-release tablets, it should be used only as indicated.
Superinfection
As with other antibiotic preparations, use of Minocycline Hydrochloride extended-release tablets may result in overgrowth of nonsusceptible organisms, including fungi. If superinfection occurs, Minocycline Hydrochloride extended-release tablets should be discontinued and appropriate therapy instituted.
Laboratory Monitoring
Periodic laboratory evaluations of organ systems, including hematopoietic, renal and hepatic studies should be performed. Appropriate tests for autoimmune syndromes should be performed as indicated.
What should I discuss with my healthcare provider before taking Minocycline Hydrochloride?
Some medical conditions may interact with Minocycline Hydrochloride. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have asthma, kidney or liver problems, or an autoimmune disorder (eg, lupus)
Some MEDICINES MAY INTERACT with Minocycline Hydrochloride. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Medicines that may harm the liver (eg, acetaminophen, methotrexate, ketoconazole, isoniazid, certain medicines for HIV infection) because the risk of liver side effects may be increased. Ask your doctor if you are unsure if any of your medicines might harm the liver
- Acitretin or isotretinoin because the risk of increased pressure in the brain may be increased
- Aluminum salts (eg, aluminum carbonate) or cimetidine because they may decrease Minocycline Hydrochloride's effectiveness
- Anticoagulants (eg, warfarin) or ergot alkaloids (eg, ergotamine), because the risk of their side effects may be increased by Minocycline Hydrochloride
- Penicillin antibiotics(eg, amoxicillin) because their effectiveness may be decreased by Minocycline Hydrochloride
This may not be a complete list of all interactions that may occur. Ask your health care provider if Minocycline Hydrochloride may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Minocycline Hydrochloride precautions
Teratogenic Effects
A. Minocycline Hydrochloride, LIKE OTHER TETRACYCLINE-CLASS DRUGS, CAN CAUSE FETAL HARM WHEN ADMINISTERED TO A PREGNANT WOMAN. IF ANY TETRACYCLINE IS USED DURING PREGNANCY OR IF THE PATIENT BECOMES PREGNANT WHILE TAKING THESE DRUGS, THE PATIENT SHOULD BE APPRISED OF THE POTENTIAL HAZARD TO THE FETUS.
Minocycline Hydrochloride extended-release tablets should not be used during pregnancy or by individuals of either gender who are attempting to conceive a child.
B. THE USE OF DRUGS OF THE TETRACYCLINE CLASS DURING TOOTH DEVELOPMENT (LAST HALF OF PREGNANCY, INFANCY, AND CHILDHOOD UP TO THE AGE OF 8 YEARS) MAY CAUSE PERMANENT DISCOLORATION OF THE TEETH (YELLOW-GRAY-BROWN).
This adverse reaction is more common during long-term use of the drug but has been observed following repeated short-term courses. Enamel hypoplasia has also been reported. TETRACYCLINE DRUGS, THEREFORE, SHOULD NOT BE USED DURING TOOTH DEVELOPMENT.
C. All tetracyclines form a stable calcium complex in any bone-forming tissue. A decrease in fibula growth rate has been observed in premature human infants given oral tetracycline in doses of 25 mg/ kg every 6 hours. This reaction was shown to be reversible when the drug was discontinued.
Results of animal studies indicate that tetracyclines cross the placenta, are found in fetal tissues, and can cause retardation of skeletal development on the developing fetus. Evidence of embryotoxicity has been noted in animals treated early in pregnancy.
Pseudomembranous Colitis
Clostridium difficile associated diarrhea (CDAD) has been reported with nearly all antibacterial agents, including Minocycline Hydrochloride, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile.
C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.
If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.
Hepatotoxicity
Post-marketing cases of serious liver injury, including irreversible drug-induced hepatitis and fulminant hepatic failure (sometimes fatal) have been reported with Minocycline Hydrochloride use in the treatment of acne.
Metabolic Effects
The anti-anabolic action of the tetracyclines may cause an increase in BUN. While this is not a problem in those with normal renal function, in patients with significantly impaired function, higher serum levels of tetracycline-class drugs may lead to azotemia, hyperphosphatemia, and acidosis. If renal impairment exists, even usual oral or parenteral doses may lead to excessive systemic accumulations of the drug and possible liver toxicity. Under such conditions, lower than usual total doses are indicated, and if therapy is prolonged, serum level determinations of the drug may be advisable.
Central Nervous System Effects
Central nervous system side effects including light-headedness, dizziness or vertigo have been reported with Minocycline Hydrochloride therapy. Patients who experience these symptoms should be cautioned about driving vehicles or using hazardous machinery while on Minocycline Hydrochloride therapy. These symptoms may disappear during therapy and usually rapidly disappear when the drug is discontinued.
Benign Intracranial Hypertension
Pseudotumor cerebri (benign intracranial hypertension) in adults and adolescents has been associated with the use of tetracyclines. Minocycline Hydrochloride has been reported to cause or precipitate pseudotumor cerebri, the hallmark of which is papilledema. Clinical manifestations include headache and blurred vision. Bulging fontanels have been associated with the use of tetracyclines in infants. Although signs and symptoms of pseudotumor cerebri resolve after discontinuation of treatment, the possibility for permanent sequelae such as visual loss that may be permanent or severe exists. Patients should be questioned for visual disturbances prior to initiation of treatment with tetracyclines. If visual disturbance occurs during treatment, patients should be checked for papilledema. Concomitant use of isotretinoin and Minocycline Hydrochloride should be avoided because isotretinoin, a systemic retinoid, is also known to cause pseudotumor cerebri.
Autoimmune Syndromes
Tetracyclines have been associated with the development of autoimmune syndromes. The long-term use of Minocycline Hydrochloride in the treatment of acne has been associated with drug-induced lupus -like syndrome, autoimmune hepatitis and vasculitis. Sporadic cases of serum sickness have presented shortly after Minocycline Hydrochloride use. Symptoms may be manifested by fever, rash, arthralgia, and malaise. In symptomatic patients, liver function tests, ANA, CBC, and other appropriate tests should be performed to evaluate the patients. Use of all tetracycline-class drugs should be discontinued immediately.
Photosensitivity
Photosensitivity manifested by an exaggerated sunburn reaction has been observed in some individuals taking tetracyclines. This has been reported rarely with Minocycline Hydrochloride. Patients should minimize or avoid exposure to natural or artificial sunlight (tanning beds or UV A/B treatment) while using Minocycline Hydrochloride. If patients need to be outdoors while using Minocycline Hydrochloride, they should wear loose-fitting clothes that protect skin from sun exposure and discuss other sun protection measures with their physician.
Serious Skin/Hypersensitivity Reaction
Cases of anaphylaxis, serious skin reactions (e.g. Stevens Johnson syndrome), erythema multiforme, and drug rash with eosinophilia and systemic symptoms (DRESS) syndrome have been reported postmarketing with Minocycline Hydrochloride use in patients with acne. DRESS syndrome consists of cutaneous reaction (such as rash or exfoliative dermatitis), eosinophilia, and one or more of the following visceral complications such as: hepatitis, pneumonitis, nephritis, myocarditis, and pericarditis. Fever and lymphadenopathy may be present. In some cases, death has been reported. If this syndrome is recognized, the drug should be discontinued immediately.
Tissue Hyperpigmentation
Tetracycline-class antibiotics are known to cause hyperpigmentation. Tetracycline therapy may induce hyperpigmentation in many organs, including nails, bone, skin, eyes, thyroid, visceral tissue, oral cavity (teeth, mucosa, alveolar bone), sclerae and heart valves. Skin and oral pigmentation has been reported to occur independently of time or amount of drug administration, whereas other tissue pigmentation has been reported to occur upon prolonged administration. Skin pigmentation includes diffuse pigmentation as well as over sites of scars or injury.
Development of Drug-Resistant Bacteria
Bacterial resistance to the tetracyclines may develop in patients using Minocycline Hydrochloride extended-release tablets, therefore, the susceptibility of bacteria associated with infection should be considered in selecting antimicrobial therapy. Because of the potential for drug-resistant bacteria to develop during the use of Minocycline Hydrochloride extended-release tablets, it should be used only as indicated.
Superinfection
As with other antibiotic preparations, use of Minocycline Hydrochloride extended-release tablets may result in overgrowth of nonsusceptible organisms, including fungi. If superinfection occurs, Minocycline Hydrochloride extended-release tablets should be discontinued and appropriate therapy instituted.
Laboratory Monitoring
Periodic laboratory evaluations of organ systems, including hematopoietic, renal and hepatic studies should be performed. Appropriate tests for autoimmune syndromes should be performed as indicated.
What happens if I miss a dose of Minocycline Hydrochloride?
Call your dentist for instructions if you miss an appointment for a repeat treatment with Minocycline Hydrochloride mucous membrane.
References
- DrugBank. "minocycline". http://www.drugbank.ca/drugs/DB01017 (accessed September 17, 2018).
- MeSH. "Anti-Bacterial Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
