minocycline

Pulmonary infiltrates, night sweats, fever and eosinophilia have developed in several patients receiving minocycline. These effects were also thought to be due to hypersensitivity to minocycline. Case reports have described a severe central nervous system-pulmonary hypersensitivity syndrome requiring high-dose corticosteroid therapy. Signs and symptoms have included dry cough, fever, ataxia, muscle weakness, numbness, visual abnormalities, abnormal brain MRI, seizures, pulmonary infiltrates, elevated serum IgE and erythrocyte sedimentation rate, and eosinophilia. Eosinophilic pneumonia with relapsing acute respiratory failure requiring mechanical ventilation and corticosteroids has been reported in a 54-year-old woman. Initial symptoms included dry cough, low-grade fever, fatigue, and dyspnea. Eosinophilia, elevated leukocytes, and C-reactive protein were noted. Fourteen days after being discharged and resuming minocycline, the patient developed rapidly progressive respiratory failure again requiring mechanical ventilation. Late-onset drug fever (associated with fever, sore throat, abdominal pain, weakness, loose bloody stools, fatigue, 40-pound weight loss, ESR 99 mm/hr, CRP 5.0 mg/dL, and mild increases in liver enzymes) has been reported in a 15-year-old boy after 24 months of minocycline therapy for acne. One other case of late-onset drug fever occurred after 1 year of treatment. Other reported cases of drug fever generally occurred after 2 to 4 weeks of minocycline exposure.

Musculoskeletal side effects have included arthralgia, arthritis, bone discoloration, joint discoloration, joint swelling, myalgia, myopathy, and hypersensitivity-associated rhabdomyolysis.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using minocycline and call your doctor at once if you have any of these serious side effects: severe headache, dizziness, blurred vision; fever, chills, body aches, flu symptoms; severe blistering, peeling, and red skin rash; urinating less than usual or not at all; pale or yellowed skin, dark colored urine, fever, confusion or weakness; severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate; loss of appetite, jaundice (yellowing of the skin or eyes); or easy bruising or bleeding, unusual weakness. Less serious side effects may include: sores or swelling in your rectal or genital area; mild nausea, vomiting, diarrhea, or stomach upset; white patches or sores inside your mouth or on your lips; swollen tongue, trouble swallowing; or vaginal itching or discharge. This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Dermatologic side effects have included pruritus, alopecia, erythema multiforme, erythema nodosum, exfoliative dermatitis, fixed drug eruptions, maculopapular and erythematous rashes, photosensitivity, Stevens-Johnson syndrome, toxic epidermal necrolysis, and vasculitis. Brownish or bluish-black pigmentation of the skin, bones, mucous membranes, teeth, tongue, nail beds, and structures of inner organs have also been reported, usually occurring during prolonged therapy. Minocycline has rarely been associated with Sweet's syndrome (acute febrile neutrophilic dermatosis).

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