Available as:
Indications
Cinomycin Capsule is used for:
Acne, Nongonococcal urethritis, Uncomplicated gonorrhoea, Syphilis, Susceptible infections
Adult Dose
Oral
Susceptible infections
Adult: 200 mg daily in divided doses.
Acne
Adult: 50 mg bid or 100 mg once daily. ?45 kg: 1 mg/kg once daily as modified-release preparation.
Asymptomatic meningococcal carriers
Adult: 100 mg bid for 5 days, followed by a course of rifampicin.
Nongonococcal urethritis
Adult: 100 mg 12 hrly for at least 7 days.
Uncomplicated gonorrhoea
Adult: Initially, 200 mg, followed by 100 mg 12 hrly for a min of 4 days, follow-up cultures should be done w/in 2-3 days after completion of therapy.
Uncomplicated urethral gonorrhoea in men
Adult: 100 mg 12 hrly for 5 days.
Mycobacterium marinum infections
Adult: 100 mg 12 hrly for 6-8 wk.
Syphilis
Adult: 200 mg initially, followed by 100 mg 12 hrly for 10-15 days.
Child Dose
Renal Dose
Renal impairment: Reduce dose or increase dosing interval. Max: 200 mg/day.
Administration
Pellet-filled cap: Should be taken on an empty stomach. Take w/ a full glass of water on an empty stomach at least 1 hr before or 2 hr after meals.
May be taken with or without food. May be taken w/ meals to reduce GI discomfort.
Contra Indications
Hypersensitivity to minocycline and other tetracyclines. Concurrent use w/ methoxyflurane. Lactation.
Precautions
Patient w/ history of predisposition to oral candidiasis, pre-existing SLE and myasthenia gravis. Hepatic and renal impairment. Pregnancy. Patient Counselling May impair ability to drive or operate machinery. Avoid prolonged exposure to sunlight. Monitoring Parameters Monitor LFT, BUN, renal function, CBC. If treatment continues for longer than 6 mth, monitor every 3 mth for hepatotoxicity, pigmentation and SLE.
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-Lactation
Interactions
Impaired absorption by concomitant admin w/ Ca-containing antacids and other divalent or trivalent cations (e.g. Al, bismuth, Fe, Mg, Zn). May decrease effectiveness of oral contraceptives. May interfere w/ the bactericidal action of penicillins. May potentiate the effect of anticoagulants. Increased risk of nephrotoxicity w/ diuretics. Increased risk of pseudotumour cerebri w/ retinoids (e.g. isotretinoin). Increased risk of ergotism w/ ergot alkaloids.
Potentially Fatal: Concurrent use w/ methoxyflurane may result to fatal renal toxicity.
Adverse Effects
Side effects of Minocycline :
Haemolytic anaemia, thrombocytopenia, neutropenia, brownish-black microscopic discolouration of thyroid tissue, thyroid cancer, hyperaesthesia, paraesthesia, headache, dizziness, vertigo, ataxia, bulging fontanelles in infants and benign intracranial HTN in adults, discolouration of the conjunctiva and lacrimal secretions, impaired hearing, tinnitus, pericarditis, pulmonary infiltration, pulmonary eosinophilia, anorexia, nausea, vomiting, diarrhoea, dyspepsia, dysphagia, oesophagitis, oesophageal ulceration, increases in LFT values, hepatitis, acute hepatic failure, jaundice, hyperbilirubinaemia, erythema multiforme, exfoliative dermatitis, photosensitivity, alopecia, hyperpigmentation, rash, acute renal failure, discolouration of teeth, buccal mucosa and tongue.
Potentially Fatal: Drug Rash w/ Eosinophilia and Systemic Symptoms (DRESS), Stevens-Johnson syndrome, Clostridium difficile-associated disease, hypersensitivity syndrome (comprising eosinophilia, fever, rash), lupus-like and serum sickness-like syndrome (both comprising arthralgia, fever, joint stiffness or swelling).
Mechanism of Action
Minocycline inhibits protein synthesis by binding to 30S and possibly 50S ribosomal subunits of susceptible bacteria. It is active against Streptococcus aureus, Neisseria meningitidis, various enterobacteria, Acinetobacter, Bacteroides, Haemophilus and Nocardia spp., and some mycobacteria.
Note
Cinomycin 50mg Capsule manufactured by Wyeth. Its generic name is Minocycline. Cinomycin is availble in Nepal.
Farmaco Nepal drug index information on Cinomycin Capsule is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.