Cynomycin 50

Description

Cynomycin 50 Capsule (Minocycline)

Overview: Cynomycin 50 Capsule contains Minocycline, an antibiotic that belongs to the tetracycline class. It works by stopping bacteria from producing essential proteins needed for their growth and multiplication. It is effective against a variety of bacteria, including Staphylococcus aureus, Neisseria meningitidis, and certain other bacteria responsible for various infections.

Indications: Cynomycin 50 Capsule is used to treat a range of bacterial infections sensitive to Minocycline, including:

• Acne: For moderate to severe forms of acne.
• Non-gonococcal Urethritis: An inflammation of the urethra not caused by gonorrhea.
• Uncomplicated Gonorrhea: A sexually transmitted infection.
• Syphilis: A sexually transmitted infection.
• Susceptible Infections: Other infections caused by bacteria that Minocycline can effectively treat, such as Mycobacterium marinum infections.
• Asymptomatic Meningococcal Carriers: To eliminate the bacteria that cause meningitis from carriers, usually followed by another antibiotic like rifampicin.

Dosage and Administration

Adults:

• Susceptible Infections (General): 200 mg daily, divided into doses as prescribed by your doctor.
• Acne: 50 mg twice a day (BID) or 100 mg once daily. For individuals over 45 kg, a modified-release preparation may be dosed at 1 mg/kg once daily.
• Asymptomatic Meningococcal Carriers: 100 mg twice daily (BID) for 5 days, followed by a course of rifampicin as directed by your doctor.
• Non-gonococcal Urethritis: 100 mg every 12 hours for at least 7 days.
• Uncomplicated Gonorrhea: An initial dose of 200 mg, followed by 100 mg every 12 hours for a minimum of 4 days. Follow-up cultures should be done within 2-3 days after completing the therapy to ensure the infection is cleared.
• 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: An initial dose of 200 mg, followed by 100 mg every 12 hours for 10-15 days.

Children:

• Specific dosage information for children is not provided in the original text. Please consult a healthcare professional for use in children.

Renal Dose (Kidney Impairment):

• Kidney Impairment: The dose should be reduced, or the time between doses should be increased. The maximum daily dose is 200 mg.

Administration:

• Pellet-filled capsules: These should generally be taken on an empty stomach. Take with a full glass of water, at least 1 hour before or 2 hours after meals.
• General: Minocycline can also be taken with or without food. Taking it with meals might help reduce stomach upset.

Important Considerations

Contraindications:

• Hypersensitivity: Do not use if you have a known allergy to Minocycline or any other tetracycline antibiotics.
• Concurrent use with Methoxyflurane: Do not use at the same time as methoxyflurane (an anesthetic), as this can lead to fatal kidney toxicity.
• Lactation (Breastfeeding): Contraindicated while breastfeeding.

Precautions: Use this medication with caution if you have:

• A history or predisposition to oral candidiasis (thrush).
• Pre-existing Systemic Lupus Erythematosus (SLE), as Minocycline can worsen it.
• Myasthenia Gravis.
• Liver or kidney impairment.
• Pregnancy: Minocycline can cause harm to the developing fetus, including permanent tooth discoloration and bone growth inhibition.
• Patient Counseling: This medication may impair your ability to drive or operate machinery, especially due to potential dizziness or vertigo. Avoid prolonged exposure to sunlight or artificial UV light, as it can cause increased sensitivity and sunburn.
• Monitoring Parameters: Your doctor will monitor your liver function tests (LFTs), blood urea nitrogen (BUN), kidney function, and complete blood count (CBC). If treatment continues for more than 6 months, monitoring for hepatotoxicity (liver damage), pigmentation changes, and signs of SLE should be done every 3 months.
• Lactation: Minocycline enters breast milk. Some manufacturers advise against nursing, while the American Academy of Pediatrics (AAP) considers it compatible with nursing due to calcium chelation of the drug, which may prevent its absorption in the infant. However, the long-term safety of prolonged exposure in infants is unknown.

Drug Interactions: Minocycline can interact with other medications:

• Antacids containing Calcium and other multi-valent cations (e.g., Aluminum, Bismuth, Iron, Magnesium, Zinc): These can impair the absorption of Minocycline. Take Minocycline at least 2 hours before or after these products.
• Oral Contraceptives: May decrease the effectiveness of birth control pills. You should use an additional method of contraception.
• Penicillins: May interfere with the bactericidal (bacteria-killing) action of penicillin antibiotics.
• Anticoagulants (Blood Thinners): May enhance the effect of blood thinners, increasing the risk of bleeding.
• Diuretics (Water Pills): May increase the risk of kidney toxicity.
• Retinoids (e.g., Isotretinoin): Increased risk of pseudotumor cerebri (a condition mimicking a brain tumor with increased pressure around the brain). Concurrent use is highly discouraged/contraindicated.
• Ergot Alkaloids: Increased risk of ergotism (a condition caused by ergot poisoning).
• Potentially Fatal Interaction:
  • Methoxyflurane: Concurrent use can lead to fatal renal toxicity.

Adverse Effects (Side Effects):

• Common/Serious:
  • Blood: Hemolytic anemia, thrombocytopenia (low platelets), neutropenia (low white blood cells).
  • Endocrine: Brownish-black microscopic discoloration of thyroid tissue, rarely thyroid cancer.
  • Nervous System: Hyperesthesia (increased sensitivity), paresthesia (tingling/numbness), headache, dizziness, vertigo, ataxia (lack of coordination), bulging fontanelles in infants, benign intracranial hypertension (pseudotumor cerebri) in adults.
  • Eyes/Ears: Discoloration of conjunctiva (eye lining) and lacrimal secretions (tears), impaired hearing, tinnitus (ringing in ears).
  • Cardiovascular/Pulmonary: Pericarditis (inflammation around the heart), pulmonary infiltration, pulmonary eosinophilia (a lung condition).
  • Gastrointestinal: Anorexia (loss of appetite), nausea, vomiting, diarrhea, dyspepsia (indigestion), dysphagia (difficulty swallowing), esophagitis, esophageal ulceration.
  • Liver: Increases in LFT values, hepatitis, acute hepatic failure (rare but severe liver damage), jaundice (yellowing of skin/eyes), hyperbilirubinemia.
  • Skin: Erythema multiforme, exfoliative dermatitis, photosensitivity (increased sensitivity to sun), alopecia (hair loss), hyperpigmentation (skin darkening), rash.
  • Kidney: Acute renal failure (rare).
  • Other: Discoloration of teeth, buccal mucosa (inside of cheek), and tongue.
• Potentially Fatal:
  • Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome: A severe, widespread drug reaction affecting multiple organs.
  • Stevens-Johnson Syndrome (SJS): A severe, life-threatening skin reaction.
  • Clostridium difficile-associated disease (CDAD): A severe form of diarrhea.
  • Hypersensitivity syndrome: Characterized by eosinophilia, fever, and rash.
  • Lupus-like and serum sickness-like syndromes: Both involve symptoms like joint pain, fever, and joint stiffness or swelling.

Mechanism of Action: Minocycline exerts its antibacterial effect by inhibiting bacterial protein synthesis. It does this by binding to the 30S ribosomal subunit (and possibly the 50S subunit) of susceptible bacteria, thereby blocking the processes necessary for protein production. It is active against a wide range of bacteria, including Streptococcus aureus, Neisseria meningitidis, various enterobacteria, Acinetobacter, Bacteroides, Haemophilus, Nocardia species, and some mycobacteria.

Note: Cynomycin 50 50mg Capsule is manufactured by Medreich, and its generic name is Minocycline. Cynomycin 50 is available in Nepal. This information, provided by Farmaco Nepal drug index, is for general reference and is not intended for diagnosis, medical advice, or treatment. It should not be considered a substitute for the professional judgment of a healthcare provider in Mechinagar, Koshi Province, Nepal, or any other location. Always consult a qualified medical professional for specific health concerns or before starting any new medication.