Minocycline (Amzeeq®)

Minocycline is available as a prescription topical treatment. Minocycline can be prescribed alone or in combination with other topical or oral acne treatments.

• Available form:
  
  
  • Topical treatment: 
    
    
    • Foam 
      Available as prescription
      Generic not available (US)
    • Brand names (US):
      • Amzeeq®

• Available in these doses:
  
  
  • Foam: 4%

• Who is it for? 
  
  
  • Gender:
    • Males and females
  • Severity of acne:
    • Moderate-to-severe
  • Age:
    • Children of 9 years and older, adolescents, and adults 

How to use it:

Minocycline is a topical treatment and is available as a foam. 

Your physician will specify how much of the medication you need to apply and how often. 

Minocycline foam is usually applied once daily a day, one hour before going to bed. Use it at the same time every day. Minocycline foam should be gently massaged into the skin.

Minocycline should only be applied to intact skin. If minocycline gets into a cut or scrape, rinse it off with water. Do not get minocycline in your eyes, nose, or mouth. If it does get into your eyes, wash your eyes with a generous amount of water and seek medical attention if there is any irritation. 

Before applying minocycline, wash acne-prone areas with water and cleanser. Do not scrub the skin. Rinse and pat the skin dry gently with a soft towel. 

Do not wash the acne-affected skin too often because this could dry your skin and make your acne worse. Wash your skin with water and a cleanser no more than 2 or 3 times a day. 

It may take some time before the effects of minocycline are seen on acne. Minocycline needs to be used for 2 to 3 months in order to see its full effect. If there is no improvement after 6 weeks or your acne becomes worse, consult your physician. 

Minocycline helps control your acne but it does not cure it. Continue using minocycline even if your acne clears up after a few days. You may have to use minocycline for months or longer, as prescribed by your physician. If you stop using minocycline too soon, acne may return. It is therefore also important to not miss a dose. 

Use enough minocycline to lightly cover the acne-affected areas. Minocycline should be applied to the whole acne-affected area and not only to the pimples. This is to avoid a break out of new pimples.

• Foam:
  • Do not bathe, shower or swim within one hour after applying the foam on the skin.
  • The minocycline foam is flammable so keep it away from heat, open flames and do not smoke when you are applying the foam and for a short time afterwards.

Be aware of: 

• Before using minocycline, let your physician or pharmacist know if you are allergic to minocycline or any tetracycline-like antibiotic such as sarecycline, doxycycline, omadacycline, tetracycline, demeclocycline, or any of the ingredients in minocycline foam. 
• Before using minocycline, inform your physician about the prescription and non-prescription medications you are using/taking. Your physician may want to monitor closely for side-effects or to adjust doses of your medications. Furthermore, when your physician also prescribes other topical treatments along with minocycline, it is preferable to apply medications at different times to avoid skin irritation. Some medications do not work properly when used at or near the same time.
• Before using minocycline, inform your physician if you ever have suffered from lupus (condition in which the immune system attacks many tissues and organs including the skin, joints, blood, and kidneys), intracranial hypertension (high pressure in the skull that may cause headaches, blurry or double vision, vision loss, and other symptoms), kidney or liver disease.
• Before using minocycline, inform your physician if you ever have ever suffered from asthma.
• If you are using minocycline and are pregnant or are planning to become pregnant, talk to your physician about using minocycline during pregnancy.
• If you are using minocycline and are breastfeeding, talk to your physician about using minocycline during this period.
• Do not drive a car or operate machinery until you know how minocycline affects you because it may make you feel dizzy. 
• Minocycline may make your skin more sensitive to sunlight so avoid unnecessary direct or prolonged exposure to sunlight, especially between 10am and 3pm, and wear protective clothing, sunglasses, and sunscreen (with sun protection factor of at least 15) while using minocycline. Do not use a sunlamp or tanning bed. Inform your physician if your exposure to sunlight causes skin rash, itching, redness or other discoloration of the skin or a severe sunburn. 
• Before using minocycline, be aware that abrasive or medicated soaps and skin products containing alcohol increase the side-effects of minocycline. Inform your physician about the skin care products you intend to use. 
• You can continue your regular diet unless your physician tells you otherwise.
• Inform your physician if the use of minocycline foam dries your skin. This may already happen with normal use.
• You may continue using cosmetics/makeup while using minocycline but it is best to use “water-based” cosmetics only. Cosmetics may make your acne worse so use cosmetics not too often or too heavily. Consult your physician if you have any questions. 
• Do not use minocycline foam for a skin condition that it was not prescribed for, without consulting your physician first. 
• Minocycline foam may stain fabric. 
• Do not share your medication with anyone else. 
• Keep your regular appointments with your physician to track your response to minocycline.

Drug interactions: 

Do not use alcohol-containing or abrasive skin care products, while using minocycline. Inform your physician or pharmacist about all the prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take before starting minocycline. Also inform your physician or pharmacist of the skin products you use including soaps, cleansers, moisturizers, and cosmetics. 

Some drugs interact with minocycline and should not be used together with minocycline. However, your physician may prescribe other drugs together with minocycline which may cause a slight interaction, and in this case precautions are necessary.

Full list of drug interactions (From National Library of Medicine and DailyMed):

• Atracurium
• Metocurine
• Tubocurarine
• Warfarin
• Penicillin

Do not swallow

If minocycline is swallowed, contact an emergency facility or call the American Association of Poison Control Centers at 1 (800) 222-1222 (available 24/7).

If immediate assistance is necessary because the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, call 911.

Information can also be found online at https://www.poisonhelp.org/help

What if I miss a dose?

As soon as you recall that you have missed a dose, apply the missed dose. However, skip the missed dose if it is almost time for your next dose and continue with your prescribed dosing schedule. Do not increase the quantity or frequency of application to make up for the missed dose.

Storage:

Store your medication in the container that the pharmacist provided and keep it out of reach and out of sight of children. Many containers can be opened by children. Keep the container tightly closed. Always lock safety caps and immediately place the medication in a safe location that is up and away from the sight of young children, to prevent poisoning (www.upandaway.org).

Store the medication at room temperature. Keep the medication away from excessive heat and moisture – do not store in the bathroom. Do not freeze minocycline.

Foam: The can of minocycline foam should not be stored at temperatures above 49 degrees Celcius (120 degrees Fahrenheit). Do not poke holes in the can. Minocycline foam is flammable so keep it well away from flames and extreme heat. Do not throw the can into a fire, even when the can is empty.

Disposal:

Do not keep outdated medication and medication that you no longer use. Unneeded medications should be disposed of in a way that pets, children, and other people cannot consume them. Do not flush the medication down the toilet. Contact your pharmacist to learn about the availability of a medicine take-back program in your neighborhood, or get in touch with your local garbage/recycling department to ensure safe disposal. If you do not have access to a take-back program, you can find more information on safe disposal of medication on the FDA website: (https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187.htm)