9 Oral Minocycline Side Effects and How to Manage Them

Minocycline is a tetracycline antibiotic with many uses, from respiratory tract infections to severe acne. You can take it by mouth, apply it to your skin, or receive it as an intravenous infusion. If you’ve been prescribed oral minocycline, you may know it by one of its many brand names, including Dynacin, Solodyn, and Minolira.

Despite its many uses, oral minocycline has a long list of potential side effects. These can range from mild headaches and dizziness to serious skin reactions and increased pressure in the brain. Knowing what to expect and when to get help can help you manage these potential risks during treatment.

While it’s not an exhaustive list, we break down what you should know about nine oral minocycline side effects below.

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1. Headache

The most common oral minocycline side effect is headaches. If you’re taking minocycline for a short time, the headaches should go away on their own after you finish treatment. But if you need to take minocycline for longer, they may resolve over time. Let your healthcare provider know if they’re getting worse or won’t go away.

Keep in mind: Headaches from minocycline can be a sign of a more serious problem, such as increased pressure in the brain. We’ll discuss this in greater detail later.

2. Fatigue

Fatigue is another common minocycline side effect. The reason minocycline leads to fatigue isn’t clear. But it may improve over time as your body gets used to treatment.

However, long-term treatment with minocycline has been linked to autoimmune conditions, such as a drug-induced lupus-like syndrome. Symptoms may include fatigue, along with fever, rash, and achy joints. Let your healthcare provider know right away if these side effects develop. They will likely run some tests to confirm the cause.

3. Dizziness

Minocycline affects your brain more so than other tetracyclines. Because of this, side effects such as dizziness, lightheadedness, and spinning sensations may be more common.

Similar to other side effects, dizziness may improve over time. Taking minocycline at bedtime may help you feel less dizzy during the day. But it’s still important to see how minocycline affects you before engaging in certain activities, such as driving. And you should change positions (like moving from sitting to standing) slowly to avoid falls. If your dizziness continues or gets worse, let your healthcare provider know.

4. Itching

Some people experience itching while taking minocycline. It’s usually a mild and temporary side effect. If it’s bothersome, your healthcare provider or pharmacist may suggest an over-the-counter anti-itch cream or other management tips, such as a cold compress.

However, itching after starting minocycline can indicate an allergic reaction or a severe skin reaction. If you experience itching that progresses to swelling of the face and throat, fever, or other body-wide symptoms, get immediate medical attention.

5. Tooth discoloration

If your teeth are still developing, such as during early childhood, minocycline can cause permanent tooth discoloration. For this reason, minocycline and other tetracycline antibiotics aren’t recommended for children under 8 years old. This is also one of the reasons why you shouldn’t take them if you’re pregnant.

However, discoloration or darkening of the teeth, gums, nails, or other tissues in the body is possible for other people taking minocycline. If you notice these changes, let your healthcare provider know right away.

6. Sun sensitivity

Tetracycline antibiotics, including minocycline, can make you more sensitive to the sun. But this may be more likely with other tetracycline antibiotics, such as doxycycline.

Exposure to natural or artificial sun (such as from tanning beds) while taking minocycline can increase the risk of a severe sunburn. To avoid serious sun damage, wear protective clothing in the sun, use sunscreen, and avoid tanning beds during treatment.

7. Liver damage

While uncommon, liver damage has been reported in some people taking minocycline. This risk may be higher if you have liver disease or take other medications that are hard on the liver. In some cases, chronic liver disease has developed, typically after long-term use.

Acute liver damage from minocycline usually shows up in the first 1 to 3 months of taking it. But chronic liver damage may develop after taking minocycline for a few years. Examples of liver damage symptoms include:

• Yellowing of eyes or skin (jaundice)

• Pain in the right upper abdomen

• Fatigue or lack of energy

• Loss of appetite or unexplained weight loss

• Nausea and vomiting

• Achy joints

If you need to take minocycline long term, your healthcare provider may monitor your liver health during routine follow-ups. But if you notice any of the symptoms mentioned above, let them know right away. You may need to stop taking minocycline.

8. Severe skin reactions

While rare, severe skin reactions can happen after starting minocycline. Examples include SJS (Stevens-Johnson syndrome) or DRESS (Drug reaction with Eosinophilia and Systemic Symptoms). Both reactions involve a severe skin rash with blisters that develops within the first few weeks of starting minocycline. For a DRESS reaction, it could be up to 8 weeks.

Along with the rash, you typically develop a fever. SJS or DRESS have other distinctive symptoms. For instance, SJS causes flu-like symptoms; its rash looks like a target or bullseye that is painful when burst open. On the other hand, a DRESS reaction causes swelling in the face and lymph nodes. Your organs may also be affected, leading to further complications.

Contact your healthcare provider immediately if you notice these changes to your skin. Stopping minocycline is the first step to clearing these skin reactions. Further testing and treatment, including hospitalizations, may also be required if symptoms worsen.

9. Increased pressure in the brain

Rarely, minocycline can lead to increased pressure in the brain (called pseudotumor cerebri). This can also happen with other medications used to treat severe acne, such as isotretinoin (Accutane). Because of this, you shouldn’t take minocycline and isotretinoin together.

Symptoms related to increased pressure in the brain include headaches and vision changes (such as blurry vision or vision loss). Contact your healthcare provider right away if these changes develop. In most instances, the symptoms will go away on their own after stopping minocycline. However, permanent vision loss has been reported by some people.

When should you contact your healthcare provider about minocycline side effects?

Let your healthcare provider know if any minocycline side effects become bothersome or concerning to you. They can offer management tips, decide to lower your dose, or switch you to a different medication. In some cases, they may want you to continue minocycline, but recommend other medications to help with the side effects.

As described above, some minocycline side effects can be more serious or even life threatening. Side effects such as liver damage, severe skin reactions, and high pressure in the brain require prompt medical attention.

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Written by:

Zuri C. Hawkins-Jarrett, PharmD, MPH, BCPS

Zuri Hawkins-Jarrett graduated with her doctorate in pharmacy from The University of Georgia College of Pharmacy. She completed her residency training with Piedmont Columbus Regional in ambulatory care.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

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