WHO Model Prescribing Information: Drugs Used in Leprosy
(1998; 28 pages) View the PDF document
Table of Contents
View the documentPreface
View the documentIntroduction
View the documentDiagnosis of leprosy
View the documentClassification of leprosy
View the documentTreatment of leprosy
View the documentTreatment of lepra reactions
View the documentTreatment of neuritis
View the documentTreatment of eye complications
View the documentManagement of nerve damage
View the documentTreatment of leprosy during pregnancy and lactation
View the documentTreatment of patient with concomitant active tuberculosis
View the documentTreatment of patients with concomitant HIV infection
Open this folder and view contentsTreatment of leprosy in special situations
Close this folderDrug data sheets
View the documentClofazimine
View the documentDapsone
View the documentMinocycline
View the documentOfloxacin
View the documentPrednisolone
View the documentRifampicin
 

Minocycline

Group: Antimicrobial (tetracycline) agent
Tablet, 50 mg, 100 mg

General information

Minocycline is a semisynthetic tetracycline. It induces bacteriostasis by inhibiting protein synthesis, and is selectively concentrated in susceptible organisms.

Absorption occurs mainly from the stomach and small intestine. Peak plasma concentrations occur within 1-4 hours and decay with a half-life of about 12-30 hours. It is metabolized to a considerable extent in the liver and is eliminated both in the urine and faeces. The drug persists in the body after its administration is stopped possibly due to retention in fatty tissues.

Clinical information

Uses: Single lesion paucibacillary leprosy in combination with rifampicin and ofloxacin. Treatment of multibacillary patients, who can not take rifampicin. Treatment of multibacillary patients, who refuse to take clofazimine.

Dosage:

Treatment of single lesion paucibacillary leprosy in combination with rifampicin and ofloxacin: Adults: single dose of 100 mg.

Treatment of multibacillary patients, who cannot take rifampicin: Treat for 24 months. The treatment regimen is:

Length of Treatment

Drug

Dose

6 months

clofazimine

50 mg daily

 

ofloxacin

400 mg daily

 

minocycline

100 mg daily

     

Followed by an additional

   
     

18 months

clofazimine

50 mg daily

 

plus either

 
 

ofloxacin

400 mg daily

 

or

 
 

minocycline

100 mg daily

Treatment of patients with multibacillary leprosy, who refuse to take clofazimine.

Replace clofazimine in the normal 12 month multidrug therapy with minocycline, 100 mg daily.

An alternative 24 month multidrug therapy regimen (3 drugs), who refuse to take clofazimine is:

- rifampicin, 600 mg once a month for 24 months,
- ofloxacin, 400 mg once a month for 24 months, AND
- minocycline, 100 mg once a month for 24 months

Contraindications: Known hypersensitivity. Severe renal impairment. Pregnancy and early childhood. Do not give with iron salts or with antacids containing calcium, magnesium or aluminum.

Precautions: Monitor liver function prior to administration. In impaired liver function, minocycline may be excreted more slowly than expected. Tetracyclines may cause photosensitivity so patient should avoid exposure to sunlight. Troublesome oesophagitis may be averted if the patient is propped up while swallowing capsules, and washes them down immediately with a glass of water. Capsules and tablets should not be taken with milk or with magnesium or aluminium salts since these impair the absorption of minocycline.

Use in pregnancy

Minocycline is generally contraindicated in pregnancy and during early childhood. Because it is deposited in developing teeth and bones and impairs skeletal calcification, it can result in abnormal osteogenesis and permanent staining of teeth, and occasionally causes hypoplasia of dental enamel.

Adverse effects: Vestibular disturbances, causing dizziness and vertigo occur more commonly than with other tetracyclines. Gastrointestinal irritation is common as is depletion of the normal bowel flora, permitting overgrowth of resistant organisms. Irritative diarrhoea should be differentiated from enteritis due to suprainfection, particularly with coagulase-positive staphylococci, and from pseudomembranous colitis due to Clostridium difficile. Phototoxic reactions occasionally result in porphyria-like skin changes and pigmentation of the nails.

Hypersensitivity reactions are rare. Morbilliform rashes, urticaria, fixed drug eruptions, exfoliative dermatitis, cheilosis, glossitis, pruritus and vaginitis have been reported, as have angioedema, anaphlyaxis and pseudotumour cerebri.

A single dose of minocycline is used in children for treatment of single lesion paucibacillary leprosy. Field trials have shown that a single dose of minocycline is well tolerated in children and field trials have not detected any significant adverse effects due to a single dose of minocycline in children.

Drug Interactions: The action of oral anticoagulants may be potentiated. Severe renal failure has been reported in patients who have received a halogenated anaesthetic agent while taking tetracyclines. Antacids, calcium salts, and ulcer healing drugs (sucralfate) reduce absorption of minocycline. Antiepileptics increase metabolism of minocycline, leading to reduced plasma concentration of minocycline.

to previous section
to next section
 
 
The WHO Essential Medicines and Health Products Information Portal was designed and is maintained by Human Info NGO. Last updated: October 29, 2018