Side effects

Side-effects include:

• nausea and vomiting
• diarrhoea
• erythema and even severe exfoliative rashes
• blue-black hyperpigmentation affecting the skin, mucus membranes, nails, adult teeth, and internal organs
• headache and visual disturbances may be indicative of benign intracranial hypertension
• dizziness and vertigo - in females more commonly than males

There is evidence that minocycline can cause drug-induced systemic lupus erythematosus and chronic active hepatitis (1). Minocycline has also been imlicated in the development of drug-induced eosinophilic pneumonitis (1).

Notes (2):

• minocycline's known and most common side effects, including nausea, vertigo and mild dizziness, occur mainly early after its administration and disappear shortly following therapy discontinuation
  • for treatments continued for more than 6 months, it is recommended to monitor every 3 months for hepatotoxicity, pigmentation and systemic lupus erythematosus
    • treatment should be discontinued if these develop or if pre-existing systemic lupus erythematosus worsens
  • the higher risk of lupus-erythematosus-like syndrome and irreversible pigmentation associated with minocycline in comparison with other tetracyclines has limited its extensive use in human infections, being currently indicated just for the treatment of acne vulgaris

Reference:

• BMJ editorial. Minocycline for acne. BMJ 1996;312: 138.
• Garrido-Mesa N et al.Minocycline: far beyond an antibiotic. Br J Pharmacol. 2013 May;169(2):337-52.