Minocycline, sold under the brand name Minocin among others, is a tetracycline antibiotic medication used to treat a number of bacterial infections such as some occurring in certain forms of pneumonia.

[4][3] Common side effects include nausea, diarrhea, dizziness, allergic reactions, and kidney problems.

[13][14][15] Minocycline is specifically indicated to treat inflammatory lesions of non-nodular moderate to severe acne vulgaris in people nine years of age and older.

In order to reduce resistance rates as well as increase the effectiveness of treatment, oral antibiotics should be generally combined with topical acne creams such as benzoyl peroxide or a retinoid (tretinoin, adapalene, etc.).

It may be used to treat certain strains of methicillin-resistant S. aureus infection and a disease caused by drug-resistant Acinetobacter spp.

[13][17][35] The drug is contraindicated in people with known hypersensitivity to tetracycline antibiotics, as there is complete cross sensitivity in this group.

[5] Minocycline may cause upset stomach, diarrhea, dizziness, unsteadiness, drowsiness, mouth sores, migraines, and vomiting.

Significant or complete recovery occurs in most people who develop minocycline-induced autoimmune problems within a period of a few weeks to a year of cessation of minocycline therapy.

[41][42] Drug reaction with eosinophilia and systemic symptoms syndrome can occur during the first few weeks of therapy with minocycline.

[44][45][46][47] Symptoms of an allergic reaction include rash, itching, swelling, severe dizziness, and trouble breathing.

[39] Minocycline has also been reported to very rarely cause idiopathic intracranial hypertension (pseudotumor cerebri),[48] a side effect also more common in female patients, potentially leading to permanent vision damage if not recognized early and treated.

[49] Contrary to most other tetracycline antibiotics (doxycycline excluded), minocycline may be used in those with kidney disease, but may aggravate systemic lupus erythematosus.

[51] Minocycline can cause the rare condition of secondary intracranial hypertension, which has initial symptoms of headache, visual disturbances, dizziness, vomiting, and confusion.

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.

The mechanism of this side effect is unknown, although a hypothesis is that the drug exacerbated an autoimmune component of the primary disease.

[58][13] Minocycine has shown thyroid toxicity in animals, including in rodents, mini pigs, dogs, and monkeys.

[5][60] Minocycline mediates its antibiotic activity by binding to the 30S ribosomal subunit of bacteria and thereby inhibiting protein synthesis.

[2] The drug is a broad-spectrum antibiotic and shows activity against a wide range of both Gram-positive and Gram-negative bacteria.

It crosses the blood–brain barrier better than doxycycline and other tetracyclines, reaching therapeutically relevant concentrations in the cerebrospinal fluid and also in inflamed meninges.

[74] In any case, minocycline is consistently described as a highly lipophilic compound with excellent tissue penetration and distribution.

According to a 2023 systematic review based on four clinical trials, "There is no significant difference with minocycline compared to placebo for depression not responding to first-line antidepressant therapy.

"[77] Early research has found a tentative benefit from minocycline in schizophrenia,[78] with several trials underway.

[80] Some early studies suggest that minocycline may be beneficial as an add-on treatment for moderate-to-severe obsessive-compulsive disorder (OCD) when used with an SSRI.

[81][82] In ongoing research and trial, minocycline demonstrated efficacy and seems a promising neuroprotective agent in acute stroke patients, especially in AIS subgroup.

[citation needed] A trial found no difference between minocycline and placebo in people with Alzheimers' disease.

Animal models indicate it could potentially reduce noise-induced and blast-induced hearing loss, possibly by protecting hair cells and mitigating inflammation.

[93][94] In vitro and animal studies also show minocycline may help decrease ototoxicity from certain drugs like gentamicin,[95] neomycin,[96] and cisplatin.