Amzeeq (Minocycline) - Topical

What Is Amzeeq?

Amzeeq (minocycline) is a topical (applied to the skin) antibiotic used to treat inflammatory lesions (small or large red bumps) of moderate to severe acne vulgaris (the common form of acne) in adults and adolescents nine and older.

Amzeeq is classified as a tetracycline antibiotic, a medication used to treat bacterial infections.

Specifically, tetracycline antibiotics are effective against bacterial infections of the skin, lymph nodes, urinary tract, genitals, respiratory tract, and other body parts. They can also be used to treat sexually transmitted diseases (STDs).

Amzeeq treats acne vulgaris by killing the bacteria that infect pores and decreasing a specific natural oily substance that causes acne.

No therapeutically equivalent generic version of Amzeeq is currently available in the United States (U.S.).

However, other brand-name medications contain the same active ingredient (minocycline) as Amzeeq to treat acne, such as Zilxi.

Amzeeq is available via prescription and is administered as a topical foam.

Drug Facts

Generic Name: Minocycline

Brand Name(s): Amzeeq, Zilxi

Drug Availability: Prescription

Therapeutic Classification: Antiacne antibacterial

Available Generically: No

Controlled Substance: N/A

Administration Route: Topical

Active Ingredient: Minocycline

Dosage Form(s): Foam

What Is Amzeeq Used For?

The U.S. Food and Drug Administration (FDA) has approved Amzeeq to treat inflammatory lesions of moderate to severe acne vulgaris in adults and adolescents nine and older.

In acne vulgaris, hair follicles become blocked by dead skin cells, bacteria, and oil (sebum). This results in skin blemishes, including pimples, blackheads, whiteheads, and cysts.

Inflammatory acne occurs when the blocked follicle wall ruptures, spilling excess sebum and bacteria into the surrounding skin. The spilling of sebum and bacteria triggers an immune response from white blood cells that respond by causing redness and irritation visible on the surface of the skin. 

Antibiotics applied topically are a mainstay of inflammatory acne treatment. They can be used in combination with other topical medications from other families. 

How to Use Amzeeq

Follow your healthcare provider’s instructions for using Amzeeq.

Shake well, dispense a cherry-sized amount of foam onto fingertips, then apply to the affected area(s) following cleansing.

If acne is present on other parts of the body (e.g., neck, back, shoulders, chest), you can apply additional amounts of topical foam to these areas.

Apply Amzeeq around the same time each day, at least one hour before bedtime. Do not bathe, shower, or swim for at least one hour after application.

This medication is for the skin only. Do not allow any Amzeeq to touch your eyes or mouth. If spillage occurs, rinse thoroughly with water. Finally, wash your hands after applying the product to the affected areas.

Storage

Store away from light at room temperature (between 68 F and 77 F). For short periods, you may store it between cool and mildly hot temperatures (59 F to 86 F). Keep this medicine in a dry place, and do not store it in your bathroom.

Keep all medications out of reach of children and pets.

Discard all expired or unused drugs. Ask your pharmacist about the best ways to get rid of your medicine. There may be local drug take-back programs in your area.

How Long Does Amzeeq Take to Work?

Amzeeq improves inflammatory acne within 12 weeks of starting this medication.

If you don’t see an improvement in your skin condition after 12 weeks of consistent use, follow up with your healthcare provider to see if you should continue this medication.

What Are the Side Effects of Amzeeq?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Common side effects of Amzeeq include but are not limited to:

Severe Side Effects

Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Serious side effects can include hyperpigmentation (when patches of skin turn gray due to inflammatory and post-inflammatory changes associated with acne).

Long-Term Side Effects

Permanent tooth discoloration or staining can occur when tetracyclines, including minocycline, are taken orally during tooth development (specifically the second and third trimesters of pregnancy and through childhood until age eight).

It is unknown if minocycline applied topically causes this side effect. Nonetheless, Amzeeq should not be used in children under nine.

Report Side Effects

Amzeeq may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication. If you experience a serious side effect, you or your healthcare provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Amzeeq Should I Use?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For topical dosage form (foam):
    • For inflammatory lesions caused by rosacea:
      • Adults—Apply to the affected area of the skin once a day, at least 1 hour before bedtime.
      • Children—Use and dose must be determined by your doctor.
    • For moderate to severe acne:
      • Adults and children 9 years of age and older—Apply to the affected area of the skin once a day, at least 1 hour before bedtime.
      • Children younger than 9 years of age—Use and dose must be determined by your doctor.

Modifications

Some people may require treatment or dosage changes at the discretion of their healthcare provider.

Special caution should be noted regarding the following:

  • No studies have been done in humans to determine if Amzeeq is safe in pregnancy.
  • Once-daily application of topical minocycline is minimally absorbed, resulting in low levels of the drug in the maternal bloodstream, so it is not expected to result in significant fetal exposure to the drug.
  • Minocycline taken orally is expelled in human breast milk. The manufacturer’s prescribing information recommends against breastfeeding while using Amzeeq due to the lack of data on topical minocycline in lactating persons. However, experts believe that topical minocycline used by a lactating person poses no risk to breastfed infants and consider it compatible with breastfeeding.
  • The safety and effectiveness of Amzeeq in adolescents nine and older have been established in three clinical trials. The safety of Amzeeq in children eight and younger have not been established, and there is a concern for orally ingested tetracycline drugs to cause permanent tooth discoloration and stunted bone growth in children.
  • Clinical trials of Amzeeq did not include sufficient numbers of adults 65 and older to determine whether they respond differently or experience more side effects than younger adults.

Missed Dose

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose. Instead, return to your usual dosing schedule. Do not duplicate the amount or take extra doses.

Overdose: What Happens If I Use Too Much Amzeeq?

Excessive topical use of Amzeeq can result in severe redness, peeling, itching or discomfort.

What Happens if I Overdose on Amzeeq?

If you think you or someone else may have overdosed on Amzeeq, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Amzeeq, call 911 immediately

Precautions

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It is very important that your doctor check your or your child's progress at regular visits to see if the medicine is working properly. Blood tests may be needed to check for unwanted effects.

If your or your child's symptoms do not improve within a few days, or if they become worse, check with your doctor.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away.

Minocycline may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you stop taking this medicine. Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.

Tell your doctor right away if you have confusion, diarrhea, loss of appetite, sleepiness, tiredness, unusual bleeding, or yellow eyes or skin. These could be symptoms of a serious liver problem.

This medicine may cause dizziness, lightheadedness, or spinning feeling. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

This medicine may cause intracranial hypertension (increased pressure in the head). This is more likely to occur in women of childbearing age who are overweight. Tell your doctor right away if you have a headache, blurred vision, or other change in vision.

Autoimmune syndromes (including drug-induced lupus-like syndrome, autoimmune hepatitis, vasculitis and serum sickness) may occur while using this medicine. Call your doctor right away if you or your child have a fever, rash, joint pain, or body weakness while using this medicine.

Minocycline may cause your skin to be more sensitive to sunlight than it is normally. Exposure to sunlight, even for short periods of time, may cause skin rash, itching, redness or other discoloration of the skin, or a severe sunburn. When you begin taking this medicine:

  • Stay out of direct sunlight, especially between the hours of 10:00 a.m. and 3:00 p.m., if possible.
  • Wear protective clothing, including a hat. Also, wear sunglasses.
  • Apply a sunblock product that has a sun protection factor (SPF) number of at least 15. Some patients may require a product with a higher SPF number, especially if they have a fair complexion. If you have any questions about this, check with your doctor.
  • Do not use a sun lamp or tanning bed or booth.
  • If you have a severe reaction from the sun, check with your doctor right away.

Serious skin or allergic reactions, which can be life-threatening, may occur during treatment with this medicine. Call your doctor right away if you have blistering or peeling of the skin, chest pain, dark urine, fever, hives, irregular heartbeat, skin rash, sores in the mouth, stomach pain, swelling in the legs, ankles, or feet, swelling of the face, eyes, lips, tongue, or throat, trouble breathing or swallowing, or yellow eyes or skin.

Check with your doctor right away if you have darkening of the skin, scars, teeth, or gums.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before you have medical tests.

Do not use cosmetics or other skin care products on the treated areas.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Use Amzeeq?

Do not use Amzeeq if you are hypersensitive to minocycline or other drugs in the tetracycline family (e.g., Vibramycin [doxycycline]) or any of its components.

What Other Medications Interact With Amzeeq?

Taking some drugs alongside Amzeeq may impact Amzeeq's effectiveness or ability to be tolerated by the individual. The following are some of the medications that may interact with Amzeeq:

  • Anticoagulants (e.g., warfarin): Oral tetracyclines taken with anticoagulants can increase the risk of bleeding and may require a decrease in anticoagulant dose. Topical Amzeeq likely does not interact with oral anticoagulants, though close laboratory monitoring is prudent when starting any new medication with warfarin. 
  • Penicillin: The use of systemic (oral or intravenous) tetracyclines may decrease the effectiveness of penicillin. Topical Amzeeq is not likely to present an issue when used with penicillins.

What Medications Are Similar?

Amzeeq is a topical tetracycline antibiotic used to treat acne vulgaris.

Other topical antibiotics used in acne treatment include:

Some tetracycline antibiotics (e.g., Minocin [minocycline], doxycycline) are taken orally for moderate to severe inflammatory acne that has not responded to topical treatment.

Talk to your healthcare provider about using Amzeeq in combination with another topical acne medication, such as benzoyl peroxide, as the simultaneous use of these medications can work to prevent the development of resistant bacteria and is recommended for all people using a topical antibiotic.

Frequently Asked Questions

  • How does Amzeeq work?

    Amzeeq and other topical antibiotics are thought to improve acne by decreasing inflammation and amounts of bacteria typically occurring on the skin and in pores that can worsen acne.

  • What side effects can I expect while using Amzeeq?

    The most common side effects of Amzeeq reported during clinical trials were redness, itching, peeling, and dry skin.

  • How long will Amzeeq take to work?

    Most people who respond to Amzeeq will notice an improvement in acne by 12 weeks, sometimes sooner. Amzeeq helps to prevent future inflammatory lesions from occurring and helps to improve existing lesions.

How Can I Stay Healthy While Using Amzeeq?

Amzeeq may increase your skin’s sensitivity to the sun.

Use sunscreen and protective clothing if you are in the sun. Avoid tanning beds, as you could get a severe sunburn. If you get a sunburn, stop using Amzeeq until your sunburn is healed. 

Talk to your healthcare provider about using Amzeeq with another topical acne medication. This prevents the development of resistant bacteria and is recommended for all people using a topical antibiotic.

The propellant in Amzeeq is flammable; avoid fire, flame, and smoking during and immediately after use.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  7. Zaenglein AL, Pathy AL, Schlosser BJ, et al. Guidelines of care for the management of acne vulgaris. [published correction appears in J Am Acad Dermatol. 2020;82(6):1576]. J Am Acad Dermatol. 2016;74(5):945-73.e33. doi:10.1016/j.jaad.2015.12.037

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By Carrie Yuan, PharmD
Carrie Yuan PharmD is a clinical pharmacist with expertise in chronic disease medication management for conditions encountered in primary care.