Cinomycin

Description

Cinomycin Capsule (Minocycline) is a tetracycline antibiotic used to treat various bacterial infections, including:

• Acne
• Nongonococcal urethritis
• Uncomplicated gonorrhea
• Syphilis
• Other susceptible infections

Dosage Information

Adult Dosing (Oral):

• Susceptible Infections: 200 mg daily in divided doses.
• Acne: 50 mg twice daily or 100 mg once daily. For individuals weighing $\ge 45$ kg, 1 mg/kg once daily as a modified-release preparation.
• Asymptomatic Meningococcal Carriers: 100 mg twice daily for 5 days, followed by a course of rifampicin.
• Nongonococcal Urethritis: 100 mg every 12 hours for at least 7 days.
• Uncomplicated Gonorrhea: Initially, 200 mg, followed by 100 mg every 12 hours for a minimum of 4 days. Follow-up cultures should be performed within 2-3 days after completing therapy.
• Uncomplicated Urethral Gonorrhea in Men: 100 mg every 12 hours for 5 days.
• Mycobacterium marinum Infections: 100 mg every 12 hours for 6-8 weeks.
• Syphilis: Initially, 200 mg, followed by 100 mg every 12 hours for 10-15 days.

Child Dosing: Not specified in the provided text.

Renal Dosing:

• Renal Impairment: The dose should be reduced or the dosing interval increased. The maximum daily dose is 200 mg.

Administration

• Pellet-filled capsules: Should be taken on an empty stomach with a full glass of water, at least 1 hour before or 2 hours after meals.
• Minocycline can generally be taken with or without food. Taking it with meals may help reduce gastrointestinal discomfort.

Important Considerations

• Contraindications:
  • Known hypersensitivity to minocycline or other tetracyclines.
  • Concurrent use with methoxyflurane.
  • Lactation (breastfeeding).
• Precautions:
  • Use with caution in patients with a history of or predisposition to oral candidiasis, pre-existing systemic lupus erythematosus (SLE), and myasthenia gravis.
  • Patients with hepatic and renal impairment require careful monitoring and dose adjustments.
  • Pregnancy: Use during pregnancy requires careful consideration due to potential risks (though not detailed here, tetracyclines are generally avoided).
  • Patient Counseling: May impair the ability to drive or operate machinery. Avoid prolonged exposure to sunlight due to photosensitivity.
  • Monitoring Parameters: Monitor liver function tests (LFTs), blood urea nitrogen (BUN), renal function, and complete blood count (CBC). If treatment continues for longer than 6 months, monitor every 3 months for hepatotoxicity, pigmentation, and signs of SLE.
  • Lactation: Minocycline enters breast milk. Some manufacturers advise against nursing; however, the American Academy of Pediatrics (AAP) considers nursing compatible due to calcium chelation of the drug, which may limit its absorption in infants. The long-term safety of prolonged exposure is unknown.