Q & A - Is minocycline safe for long-term use?

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Arthritis Foundation

Arthritis Today Magazine

Posted 01 Jun 2007

Rheumatoid arthritis questions

Is minocycline safe for long-term use?

Q: I have been taking the antibiotic minocycline as a

disease-modifying drug for the past two months to treat my RA. Is it

safe for long-term use? Will it affect my health or my liver?

A: Minocycline, a drug similar to the antibiotic tetracycline,

generally is considered to be one of the safer disease-modifying

anti-rheumatic drugs (DMARDs). The most common side effects with using

minocycline for three months or so are upset stomach, dizziness,

discolored fingernails and rashes or dark pigmentation of the skin –

especially on sun-exposed areas. It can cause liver damage, but only

in very rare cases. Your doctor should be examining you every few

months and sending you for lab tests to make sure minocycline is

working for your RA and not causing any side effects.

Minocycline is effective in about 60 percent of people with RA who use

it. However, it often is not prescribed because it does not have FDA

labeling approval for this use, and it is a relatively weak DMARD

compared with methotrexate, leflunomide (Arava) or the biologics

(Enbrel, Humira, Kineret, Orencia, Remicade and Rituxan). It isn't the

antibiotic properties, but the effects on the immune system and the

ability to inhibit enzymes that break down cartilage and connective

tissue that make minocycline (and other tetracycline drugs) so

effective.

Don , PharmD, Pharmacist

http://www.arthritis.org/rheumatoid-arthritis-questions.php

Not an MD