Minocycline vs Doxycycline: What You Need to Know
A pharmacist explains the similarities and differences between these two antibioticsMinocycline and doxycycline are antibiotics commonly prescribed for various medical conditions.They work by blocking bacteria's ability to make protein. This prevents the growth of bacteria. Antibiotics that work this way are called "bacteriostatic."Minocycline and doxycycline are effective against a variety of bacteria. Because of this, they can treat a wide range of bacterial infections, from pneumonia to sexually transmitted infections (STIs).This article discusses the similarities and differences between minocycline and doxycycline and how to know which is right for you.
Milko / Getty Images Close up of woman's hands holding a bottle of medicines at home' title='Close up of woman's hands holding a bottle of medicines at home'>
Milko / Getty Images Close up of woman's hands holding a bottle of medicines at home
Minocycline vs. Doxycycline SimilaritiesMinocycline (brand names include Dynacin, Minocin, and Solodyn) and doxycycline (brand names include Vibramycin, Oracea, and Doryx) have many shared characteristics.They're both in the tetracycline family of antibiotics.You can take both medicines by mouth or injecting them into a vein (IV). Minocycline is also available as topical foams (brand names Amzeeq and Zilxi).They were approved by the U.S. Food and Drug Administration (FDA) around the same time: doxycycline in 1967 and minocycline in 1971.Both medicines have broad-spectrum activity against bacteria, which means that they are effective against the major types of bacteria that cause disease, including:Gram-positive bacteria, such as Streptococcus pneumoniae and Methicillin-resistant Staphylococcus aureus (MRSA)Gram-negative bacteria, such as Escherichia coli and Haemophilus influenzaeAnaerobic bacteria (bacteria that do not require oxygen to grow)They are also effective against other microorganisms that cause infections, including some parasites.Notably, many gram-positive organisms have developed resistance to both minocycline and doxycycline. This means these bacteria have learned how to evade the antibiotics, making the medicines ineffective.Why Take Minocycline or Doxycycline?These antibiotics are taken for specific indications, including bacterial infections and acne.Both doxycycline and minocycline may be taken for conditions including but not limited to the following:Lung infections like community-acquired pneumonia (CAP), alone or with another antibiotic. More data supports the use of doxycycline than minocycline.Skin and soft tissue infections. These medicines are recommended for adults with skin infections associated with pus drainage. They are also effective for cases where methicillin-resistant Staphylococcus aureus (MRSA) is suspected. Doxycycline or minocycline is typically prescribed as a five- to 10-day course for these infections, with a loading dose (higher dose) taken on the first day.STIs like chlamydia, gonorrhea, and syphilis in people who are allergic to penicillin.Acne treatment, minocycline, and doxycycline treat moderate or severe acne, and studies show they're similarly effective. They combat the bacteria that cause acne and also help with inflammation. When taken for acne, these medicines are usually dosed lower than they are for other infections. Doxycycline is usually dosed at 100 milligrams (mg) once or twice a day. Minocycline is typically dosed at 50 to 135 mg daily. For acne, doxycycline or minocycline should be taken with a topical (applied to the skin) product like retinoid or benzoyl peroxide.There are a few differences to keep in mind between the two antibiotics. Some scenarios dictate using one versus the other. Here are a few examples:Minocycline is recommended instead of doxycycline to combat drug-resistant Acinetobacter baumannii. This bacteria causes infections in healthcare settings like hospitals and nursing homes.Minocycline is more likely to treat skin infections caused by MRSA than doxycycline.Minocycline is approved for people who are carriers of the bacteria that causes meningitis, even if they don't have symptoms.Doxycycline is the most frequently used antibiotic for STI prevention after unprotected sex.Doxycycline is recommended to prevent Lyme disease after a tick bite.Your healthcare provider is the best resource to help determine which medicine will treat your infection.Side Effects and SafetyThere are some notable side effects and drug interactions to be aware of if you take minocycline or doxycycline.Side EffectsThe tetracycline class of antibiotics as a whole is associated with the following potential side effects:Reduced bone growth in children.Permanent discoloration of teeth to a yellow, brown, or gray color. Because of this, tetracyclines are generally not recommended during pregnancy or for children younger than 8 years old.Photosensitivity, an extreme sunburn reaction.Clostridioides difficile-associated diarrhea (CDAD), a possible side effect of any antibiotic.Vaginal yeast infections due to an overgrowth of fungi.Rupture of the esophagus.Pseudotumor cerebri (PTC, or idiopathic intracranial hypertension), characterized by headache and vision problems.Though minocycline and doxycycline can cause any of these, there are some nuances to their side effect profiles.Minocycline Side EffectsOverall, minocycline has a higher rate of side effects than other tetracycline antibiotics. Taking an extended-release (ER) product can lower the risk of side effects.Minocycline is the only tetracycline that's able to cross into the brain, so it can cause side effects in the central nervous system (the brain and spinal cord).These side effects include what are known as vestibular effects related to the inner ear. They include problems with balance, like nausea, dizziness, vertigo, or problems concentrating. It's best to not drive or operate heavy machinery if you experience any of these side effects. These effects are usually reversible; they typically go away when you stop taking minocycline. And they're more likely to occur if you take immediate-release (IR) products.Other common side effects of minocycline affect up to 10% of people and include:HeadacheRashStomach painMuscle painVomitingSerious side effects associated with minocycline are rare. They can include:Autoimmune disorders, in which the body attacks itself. Research shows that people who take minocycline for acne are twice as likely to develop systemic lupus erythematosus (SLE) as those who take other tetracyclines.Liver damage, including hepatitis.Severe allergic reactions (hypersensitivity reactions), including anaphylaxisand drug rash with eosinophilia and systemic symptoms (DRESS), which are life-threatening.Doxycycline Side EffectsOn the other hand, side effects associated with doxycycline are more common but less severe. They often affect the gastrointestinal (GI) tract and include:GI side effects, like nausea, vomiting, and stomach pain.Esophagitis, an inflamed esophagus, which is more common in older people, with higher doses, and long-term use.Inflammatory bowel disease (IBD). People who take doxycycline for acne are 60% more likely to develop IBD.Keep in mind that doxycycline products are available in multiple forms, including doxycycline hyclate and doxycycline monohydrate. Doxycycline hyclate is more likely to cause GI upset or ulcers.Doxycycline can also cause photosensitivity, so be sure to use plenty of sunscreen if you spend time outside.InteractionsTetracycline antibiotics are not likely to cause significant drug interactions. That said, both minocycline and doxycycline can interact with the following medications:Oral contraceptives. Tetracyclines may make birth control pills less effective.Blood thinners. If you take these medications with a tetracycline antibiotic, you may need a lower dose.Penicillin antibiotics. These will be less effective if taken with tetracyclines.Antacids that contain aluminum, calcium, or magnesium. These keep minocycline and doxycycline from getting fully absorbed.Iron supplements. These keep tetracycline antibiotics from getting fully absorbed.Pepto-Bismol (bismuth subsalicylate). This medicine keeps tetracyclines from getting absorbed.There are a few differences to note:Isotretinoin, an acne medication, should not be taken with minocycline.Some seizure medications, such as barbiturates, Tegretol (carbamazepine), and Dilantin (phenytoin), decrease the time doxycycline stays in the body.
Safe and Responsible Use of AntibioticsAntibiotics are invaluable tools for combating certain bacterial infections. But they are ineffective against viruses that cause colds and flu. And sometimes, they're not even needed for bacterial infections: some ear infections and sinus infections will clear up on their own.Using antibiotics when you don't need them can contribute to antibiotic resistance. This means that bacteria learn to outsmart the antibiotics, so they stop working.Antibiotics should be taken at the lowest effective dose and for the shortest duration possible. To prevent resistance, it's best to use antibiotics for less than four months at a time for most people with acne.
How to Choose Between Minocycline and DoxycyclineFactors to consider when selecting between minocycline and doxycycline include:The condition treated. Though either medicine is effective for many infections, there are some differences. For instance, minocycline is preferred for some infections caused by drug-resistant bacteria, and doxycycline is recommended for the prevention of some STIs.Medical history and allergies. People with liver or kidney failure should not take minocycline.Previous treatment response. Limited evidence suggests that people who have experienced severe minocycline side effects like lupus may be able to take doxycycline safely.Potential side effects. Doxycycline is more likely to cause GI side effects and sun sensitivity. IR minocycline products can cause dizziness, vertigo, or concentration problems. Long-term use of minocycline is associated with rare but severe side effects like lupus and hypersensitivity reactions.Cost and insurance coverage. Insurance providers usually have a list of preferred medications in each class and typically don't pay for all the medicines in each drug family. If your prescription doesn't pay for minocycline, it will likely cover doxycycline. And keep in mind that brand-name products are generally more expensive than generics, even with insurance.Patient preference. Both doxycycline and minocycline can be taken by mouth as capsules or tablets. However, doxycycline is also available in liquid form, and minocycline is a topical product to apply to the skin. Doxycycline tablet Targadox is a good choice for most people with dietary restrictions because it is entirely gluten-free, lactose-free, vegan, and non-GMO.Make sure you discuss treatment options with a healthcare provider to decide which medications are right for you.SummaryDoxycycline and minocycline are broad-spectrum tetracycline antibiotics that target many of the same disease-causing bacteria.They're both commonly taken for acne and bacterial infections like respiratory and skin infections.Minocycline is more likely to cause side effects than doxycycline, and these side effects can be more serious.If you're prescribed these or other antibiotics, follow your healthcare provider's instructions carefully. Don't share your medicine with others; complete the entire course, even if you start feeling better before your medicine runs out. This will help ensure the infection is fully treated. To minimize the risk of antibiotic resistance, take antibiotics for the shortest recommended time. Read the original article on Verywell Health.
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