Treating Acne With Oral Minocycline

Antibiotic can clear up blemishes, inflammation

Minocycline for acne is a commonly prescribed oral antibiotic. It belongs to a group of antibiotics called tetracyclines. The acne treatments doxycycline and tetracycline also belong to this group.

It offers significant benefits, especially for people with inflammatory acne, although it may take up to two months to see the improvements. Minocycline also is used to treat respiratory and urinary tract infections as well as some sexually transmitted infections.

This article discusses minocycline and its uses, dosages, and side effects. It includes possible drug interactions and risks, along with information on when you may need to see a healthcare provider for them.

Tips for treating acne with oral minocycline
Verywell / Brianna Gilmartin.

Minocycline Benefits

Minocycline has been used for decades and is especially effective against inflammatory acne. However, it's rarely used alone—it's nearly always prescribed along with a topical acne medication. The combination usually leads to better results than just minocycline.

Minocycline works to treat acne in two ways. First, it stops the growth of bacteria that cause acne breakouts. Second, it reduces inflammation. If you have red, inflamed pimples, this is good news.

On the other hand, minocycline won't do much for blackheads and other non-inflamed blemishes. Topical retinoids are a better choice for those. Keep in mind that it doesn't treat acne scars, either.

Other Oral Antibiotics for Acne

Minocycline isn't the only oral antibiotic used to treat acne. Other options are:

What to Expect

Minocycline comes in a capsule, or, as the brand Solodyn, an extended-release tablet. If your healthcare provider prescribes the capsule, you'll take it either two or four times a day at regular intervals. Solodyn is a once-per-day treatment.

Minocycline Brand Names

Minocycline is sold as: Minocin, Dynacin, Vectrin, Solodyn (extended-release). It is typically more expensive than doxycycline and tetracycline but may be effective when these other oral antibiotic treatments have failed.

All brand-name versions of minocycline can be taken with or without food, but the generic form needs to be taken either one hour before or two hours after a meal.Regardless of the brand or formulation, you should drink a full glass of water with every dose.

Be sure to follow the instructions from your healthcare provider precisely, and don't take more or less of the drug than is prescribed.

For the first few days you take minocycline capsules (not extended-release tablets), it's important that you begin with a single daily dose—usually recommended at bedtime—and work up to the full prescribed amount. You may experience some side effects, including:

  • Dizziness
  • Headaches

However, for most people, these symptoms are gone by morning. Your healthcare provider and pharmacist should offer you guidance as to when to start taking additional daily doses.

How Quickly It May Work

It can take between six and eight weeks for the medication to have a noticeable effect on your acne, which may require some patience. If you're also using a topical acne treatment, you may start seeing results from that before the minocycline is in full effect.

Because it can take two months to have any impact, expect your healthcare provider to keep you on the minocycline for at least three months to gauge its full effectiveness.

Contraindications

Minocycline shouldn't be used if you’re pregnant or breastfeeding, so let your healthcare provider know if either of these applies to you.

Children under age 8 shouldn't use minocycline because of a risk of permanent tooth discoloration. Some sources recommend waiting until after age 10 or even age 12. Talk to your healthcare provider to find out what's right in your case (or your child's).

Drug Interactions

Minocycline can interact negatively with several classes of drugs. This may impact whether you can take certain drugs, including minocycline, or require a dosage adjustment to be safe. Potentially problematic drug classes include:

  • Low-dose oral contraceptives (birth control pills): Minocycline may lower the effectiveness of these medications, which could lead to breakthrough bleeding or unwanted pregnancy. An additional form of birth control is recommended while you take minocycline.
  • Anticoagulants: The dosage of these blood thinners may need to be lowered while taking minocycline. Examples of anticoagulants are Coumadin (warfarin), Xarelto (rivaroxaban), and Eliquis (apixaban).
  • Penicillin: Minocycline may interfere with how these antibiotics work, so combining them is not advised. Examples of penicillin drugs are amoxicillin, ampicillin, and oxacillin.
  • Methoxyflurane: Combining this inhaled anesthetic with minocycline can lead to fatal kidney toxicity. The brand name is Penthrane.
  • Other tetracyclines: Taking minocycline with other drugs in its class may also lead to severe kidney toxicity.

Absorption of minocycline can be impaired by certain metals or nutrients that are used medicinally. Let your healthcare provider know if you regularly take:

Your healthcare provider should always have a complete list of all drugs—including prescription and over-the-counter—and supplements that you take.

Minocycline Dosage

Minocycline has a common starting dosage of 50 to 100 milligrams (mg), one or two times a day. You'll slowly taper off minocycline treatment once acne is under control. At this point, acne can often be kept in check by topical treatments alone. Sometimes, though, oral antibiotics have to be taken long-term to keep acne from returning.

Tips for Using Minocycline

  • Try to take your medication at about the same time every day. It works better when there's a constant amount in your bloodstream.
  • Take the entire course, even if your skin starts looking better.
  • Don't lie down immediately after taking minocycline, as it can irritate the esophagus and lead to pain.
  • Give it time. It won't happen instantly, but gradually you'll notice less redness and fewer breakouts.

Side Effects

Side effects can happen. However, for most people, they aren't too uncomfortable. Just make sure to check in with your healthcare provider if you notice any problems. Some of the more common side effects are:

  • Nausea and vomiting
  • Diarrhea
  • Dizziness

Bluish discoloration of the gums, mouth, skin, nails, tears, and urine can also happen with minocycline use. It generally occurs only with long-term use and it is reversible.

Tooth discoloration (again, of bluish nature) is also possible. While it's extremely unusual, the discoloration can be permanent.

Less common side effects include:

  • Itching of the vagina or rectum
  • Tinnitus (ringing of the ears)
  • Hair loss
  • Dry mouth
  • Swollen tongue
  • Sore throat
  • Inflammation in the tip of the penis
  • Muscle pain
  • Mood changes
  • Numbness, tingling, or prickling sensations

If any of those side effects are persistent or become severe, let your healthcare provider know. They may take you off the medication, depending on the nature and severity of the side effects.

Drug-Induced Lupus

Very rarely, taking minocycline long-term can cause drug-induced lupus. Again, this is very rare and it usually goes away within weeks after stopping treatment.

When to See a Healthcare Provider

Minocycline can cause some serious side effects, but they're less common. Call your healthcare provider or get medical attention immediately if you have:

  • Blurry, double, or loss of vision
  • Rash, hives, or blistering/peeling skin
  • Swelling of the face, throat, tongue, lips, and eyes
  • Problems breathing or swallowing
  • Yellowing eyes or skin with nausea, vomiting, or confusion
  • Bloody urine
  • Watery or bloody stools with stomach cramps or fever (up to two months after stopping treatment)
  • Joint pain or inflammation
  • Swollen lymph nodes
  • Unusual bleeding or bruising
  • Seizures
  • Chest pain or irregular heartbeat

If any of these occur, your healthcare provider will likely take you off of minocycline.

Frequently Asked Questions

  • Does minocycline hurt your liver?

    There's some evidence of liver toxicity when taking minocycline, so it should be used with caution in people with impaired liver function. Hepatitis and liver failure have been reported in people taking the drug.

  • Does minocycline make you gain weight?

    Minocycline is associated with a loss of appetite. That can actually cause weight loss. Animal studies suggest it may help people treated for other conditions to control their weight. It may be possible to offset weight gain caused by taking antipsychotic drugs or weight loss due to cancer chemotherapy, but more research is needed.

8 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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  2. American Osteopathic College of Dermatology. Minocycline.

  3. National Institutes of Health, U.S. National Library of Medicine, MedlinePlus. Minocycline.

  4. National Institutes of Health, U.S. National Library of Medicine: DailyMed. Label: Minocycline hydrochloride tablet, extended release.

  5. U.S. Food and Drug Administration. Full prescribing information: Solodyn (minocycline HCI) Extended Release Tablets for oral use.

  6. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Drug-induced lupus erythematosus.

  7. Perez-Gomez A, Carretero M, Weber N, Peterka V, To A, Titova V, et al. A phenotypic Caenorhabditis elegans screen identifies a selective suppressor of antipsychotic-induced hyperphagia. Nat Commun. 2018 Dec 10;9(1):5272. doi:10.1038/s41467-018-07684-y.

  8. Garrido-Mesa N, Zarzuelo A, Gálvez J. Minocycline: far beyond an antibiotic. Br J Pharmacol. 2013 May;169(2):337-52. doi:10.1111/bph.12139.

By Angela Palmer
Angela Palmer is a licensed esthetician specializing in acne treatment.