Arestin eent

Name: Arestin eent

Interactions for Arestin

No formal drug interaction studies have been performed.1

Stability

Storage

Subgingival

Powder, extended-release

20–25°C (may be exposed to temperatures ranging from 15–30°C).1 Avoid exposure to excessive heat.1

Minocycline dosing information

Usual Adult Dose for Acne:

Immediate-release formulations:
Initial dose: 50 to 100 mg orally twice a day for 3 to 6 weeks or until improvement occurs
Maintenance dose: 50 to 100 mg orally once a day

Extended-release tablets:
45 to 49 kg: 45 mg orally once a day
50 to 59 kg: 55 mg orally once a day
60 to 71 kg: 65 mg orally once a day
72 to 84 kg: 80 mg orally once a day
85 to 96 kg: 90 mg orally once a day
97 to 110 kg: 105 mg orally once a day
111 to 125 kg: 115 mg orally once a day
126 to 136 kg: 135 mg orally once a day

Duration: 12 weeks

Usual Adult Dose for Actinomycosis:

100 mg orally or IV every 12 hours

Duration: Initial parenteral therapy for 2 to 6 weeks, followed by oral therapy for a total duration of 6 to 12 months

Clinical response should be monitored by CT or MRI.

Usual Adult Dose for Bacterial Infection:

Oral: 200 mg initially followed by 100 mg orally every 12 hours; alternatively, 100 to 200 mg initially followed by 50 mg orally 4 times a day has been used

IV: 200 mg initially followed by 100 mg IV every 12 hours (maximum dose: 400 mg/24 hours)

Usual Adult Dose for Meningitis - Meningococcal:

Elimination of Neisseria meningitidis carrier state: 100 mg orally every 12 hours for 5 days

Rifampin, ciprofloxacin, or ceftriaxone are considered first-line agents.

Usual Adult Dose for Skin or Soft Tissue Infection:

Mycobacterium marinum: 100 mg orally or IV every 12 hours for at least 3 months

Vibrio vulnificus: 100 mg IV or orally every 12 hours plus cefotaxime 2 g IV every 8 hours or ceftazidime 1 to 2 g IV every 8 hours

Usual Adult Dose for Skin and Structure Infection:

Mycobacterium marinum: 100 mg orally or IV every 12 hours for at least 3 months

Vibrio vulnificus: 100 mg IV or orally every 12 hours plus cefotaxime 2 g IV every 8 hours or ceftazidime 1 to 2 g IV every 8 hours

Usual Pediatric Dose for Acne:

12 years or older:
Extended-release tablets:
45 to 49 kg: 45 mg orally once a day
50 to 59 kg: 55 mg orally once a day
60 to 71 kg: 65 mg orally once a day
72 to 84 kg: 80 mg orally once a day
85 to 96 kg: 90 mg orally once a day
97 to 110 kg: 105 mg orally once a day
111 to 125 kg: 115 mg orally once a day
126 to 136 kg: 135 mg orally once a day

Duration: 12 weeks

Usual Pediatric Dose for Bacterial Infection:

Above 8 years of age: 4 mg/kg orally or IV initially followed by 2 mg/kg every 12 hours

The usual adult dosage should not be exceeded.

What other drugs will affect minocycline?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • isotretinoin;

  • a penicillin antibiotic - amoxicillin, ampicillin, dicloxacillin, oxacillin, penicillin, ticarcillin, Amoxil, Moxatag, Augmentin, Principen, and others;

  • a blood thinner - warfarin, Coumadin, Jantoven; or

  • ergot medicine - dihydroergotamine, ergotamine, ergonovine, methylergonovine.

This list is not complete. Other drugs may interact with minocycline, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

In Summary

Commonly reported side effects of minocycline include: headache. Other side effects include: vulvovaginal candidiasis, diarrhea, dizziness, dysphagia, epigastric distress, melanoglossia, nausea and vomiting, sore throat, stomatitis, and anorexia. See below for a comprehensive list of adverse effects.

Usual Adult Dose for Skin and Structure Infection

IV: 200 mg IV initially followed by 100 mg IV every 12 hours
Maximum dose: 400 mg/24 hours

Oral:
Infection due to Staphylococcus aureus: 200 mg orally initially followed by 100 mg orally every 12 hours
-Alternative regimen (if more frequent dosing preferred): 100 to 200 mg orally initially followed by 50 mg orally 4 times a day

Infection due to Mycobacterium marinum: 100 mg orally every 12 hours for 6 to 8 weeks

Comments:
-Not the drug of choice for any type of staphylococcal infection
-The optimal dose has not been established to treat M marinum infections; the recommended dose has been successful in limited cases.

Uses: For the treatment of skin and skin structure infections due to S aureus when bacteriologic testing shows suitable susceptibility to this drug; for the treatment of infections due to M marinum

Infectious Diseases Society of America (IDSA) Recommendations: 100 mg orally twice a day

Comments:
-Recommended for skin and soft tissue infections due to methicillin-susceptible and methicillin-resistant S aureus
-After an initial dose of 200 mg, recommended for purulent cellulitis (cellulitis associated with purulent drainage/exudate without a drainable abscess) due to methicillin-resistant S aureus
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Chancroid

200 mg orally initially followed by 100 mg orally every 12 hours
-Alternative regimen (if more frequent dosing preferred): 100 to 200 mg orally initially followed by 50 mg orally 4 times a day

Use: For the treatment of chancroid due to H ducreyi

Usual Pediatric Dose for Acne

12 years or older:
Extended-release formulations:
45 to 49 kg: 45 mg orally once a day
50 to 59 kg: 55 mg orally once a day
60 to 71 kg: 65 mg orally once a day
72 to 84 kg: 80 mg orally once a day
85 to 96 kg: 90 mg orally once a day
97 to 110 kg: 105 mg orally once a day
111 to 125 kg: 115 mg orally once a day
126 to 136 kg: 135 mg orally once a day

Duration of therapy: 12 weeks

Comments:
-Recommended dose is about 1 mg/kg once a day.
-This drug did not show any effect on non-inflammatory acne lesions.
-Safety not established beyond 12 weeks.

Use: To treat only inflammatory lesions of non-nodular moderate to severe acne vulgaris

AAD Recommendations:
Immediate-release formulations:
-Children older than 8 years: 4 mg/kg orally initially followed by 2 mg/kg orally every 12 hours

Comments:
-Recommended as adjunctive treatment of moderate to severe inflammatory acne
-This drug should not be used as monotherapy.
-Use should be limited to the shortest duration possible; reevaluation recommended at 3 to 4 months to minimize resistant bacteria developing.
-Current guidelines should be consulted for additional information.

Renal Dose Adjustments

Immediate-release formulations:
-CrCl less than 80 mL/min: Dose adjustments may be required; however, no specific guidelines have been suggested.
Maximum dose: 200 mg/24 hours

Extended-release formulations:
-Renal dysfunction: Dose reductions and/or extended dosing intervals are recommended; however, no specific guidelines have been suggested.

Minocycline Breastfeeding Warnings

Tetracyclines have been considered contraindicated during breastfeeding due to possible staining of infants' dental enamel or bone deposition of tetracyclines; however, a close review of available literature suggests harmful effects are unlikely with short-term use of this drug during lactation as milk levels are low and infant absorption is inhibited by the calcium in breast milk. According to some experts, this drug should be avoided; the nursing infant's teeth may be stained with prolonged maternal therapy. After a single 200 mg oral dose in 2 patients (time postpartum not provided), a peak milk level of 0.8 mg/L was reached 6 hours after dosing. Milk levels averaged between 0.5 and 0.8 mg/L during the 12 hours after dosing; a total of 18 mcg was excreted during this time. After using this drug (100 mg twice a day) for almost 4 years, a woman developed galactorrhea after taking perphenazine, amitriptyline, and diphenhydramine; the breast secretion was black. In another woman (who produced occasional small amounts of breast milk during the 18 months after weaning), expressed milk had become black 3 to 4 weeks after starting 150 mg/day orally; iron levels in her milk were more than 100 times higher than iron levels found in normal milk and her mammogram was normal. In both cases, macrophages containing a black, iron-containing pigment were found in the milk; the pigment is thought to be an iron chelate of this drug or 1 of its metabolites.

LactMed: Short-term use is considered acceptable; as a precaution (theoretical), prolonged or repeat courses should be avoided throughout breastfeeding. -According to some authorities, use is contraindicated; according to other authorities, a decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother. Excreted into human milk: Yes Comments: -The effects in the nursing infant are unknown; the infant should be monitored for rash and possible effects on the gastrointestinal flora (e.g., diarrhea or candidiasis [thrush, diaper rash]). -According to some authorities, permanent tooth discoloration may occur in developing infants; enamel hypoplasia has been reported. -Black discoloration of breast milk has been reported with this drug. -Tetracycline, a related drug, is considered compatible with breastfeeding by the American Academy of Pediatrics.

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