Which is better minocycline or doxycycline

In their study, approximately drugs were screened. Several drugs were identified that had superior activity compared to doxycycline, including other tetracyclines, fluoroquinolones, and rifamycins rifampin [ 18 ].

The most promising agents were subsequently tested in a nematode-infected mouse model using Litomosoides sigmodontis, which is a filarial nematode used in a mouse model for studying filarial infections. In this assay, minocycline treatment significantly reduced the Wolbachia load and produced significantly greater response than the equivalent doxycycline treatment. The authors of the study attributed the higher activity of minocycline in this assay to the higher lipophilicity of minocycline over doxycycline [ 19 ].

Higher lipophilicity of minocycline may account for higher concentrations of the drug reaching the tissues, such as the nematode hypodermal cords in which the Wolbachia organisms reside.

An in vitro study to test antimicrobial agents for anti- Wolbachia activity using an Onchocerca gutturosa assay in cultured monkey kidney cells was used by Townson and colleagues [ 20 ]. Onchocerca gutturosa can be used to screen for antifilarial drug activity but is also valid for screening antibiotics for anti- Wolbachia activity. In this study, several antibiotics were tested for their anti- Wolbachia activity. Although doxycycline showed filaricidal activity, minocycline was more quickly and completely effective, and at lower concentrations.

Interestingly, the other tetracycline tested, oxytetracycline, was inactive. A follow-up study by the anti- Wolbachia Consortium examined minocycline as a repurposed anti- Wolbachia macrofilaricide [ 9 ]. This study tested anti- Wolbachia activity of antibiotics in the filarial nematode, Brugia malayi- infected mice model.

Doxycycline produced greater pharmacokinetic exposure after equivalent doses higher area under the curve, AUC. However, despite an approximately 3-fold less exposure with minocycline, it was more effective. The PK-PD analysis showed that minocycline is expected to be 1. That study used the mouse data and Monte Carlo simulations to evaluate effective dosages of minocycline for treating filarial infections in people.

Here, the same approach is used to predict effective dosages for dogs with heartworm disease. The analysis reported here to predict effective anti- Wolbachia minocycline and doxycycline dosages for treating heartworm infections in dogs used similar methods that were employed in the study by Sharma et al.

In the Sharma study [ 9 ], pharmacokinetic values from human studies of doxycycline and minocycline were used to derive equivalent dosages for mice. A standard doxycycline or minocycline dose to treat infections in people is either or mg per person per day. They used the dosages of these agents derived for mice to test the anti- Wolbachia activity in the filarial nematode infection model. The results are shown in Table 3 , with The percent reduction in their study [ 9 ] was derived from measuring Wolbachia loads per female worm compared with untreated controls.

For this analysis, an equivalent dose for dogs was derived to obtain the same AUC that would provide similar exposure for the highest efficacy demonstrated in the mouse model. To derive the optimum dose to obtain these AUC values, the pharmacokinetic parameters available for dogs were used Table 1 and entered into Eq. The h term implies that the AUC for a h interval was used. These values were entered into a forecasting program Crystal Ball, Oracle, version Using Crystal Ball, Monte Carlo simulations were generated for trials, and daily doses ranging from 1.

Probability of target attainment PTA for doxycycline administered twice daily. Probability of target attainment certainty is shown for AUC values of Probability of target attainment PTA for minocycline administered twice daily.

Probability of target attainment certainty is shown for AUC values of 7. Based on the Monte Carlo simulations and data presented in Table 4 and Fig. Based on the same analysis and data presented in Table 4 and Fig. Based on this analysis there is a high probability of target attainment PTA for treating Wolbachia by administering common oral doses of the tetracyclines used in dogs, doxycycline and minocycline.

The target concentrations for this analysis were the AUC values for minocycline and doxycycline that were shown to be effective against Wolbachia in a mouse model. The doses identified for dogs to attain these targets were 3. Obviously, as seen in Table 3 and Fig.

The Monte Carlo simulations performed used the total drug concentrations both protein bound and unbound fraction for these tetracyclines. Because only the unbound fraction of an antibiotic is microbiologically active, high protein binding can significantly reduce the effective exposure.

In the studies reported by Sharma et al. Therefore, this analysis for dogs did not account for protein binding. If the AUC is adjusted for free drug, the exposure for doxycycline free fraction 0.

This analysis in dogs showed that it may be possible to obtain higher efficacy for treating Wolbachia in dogs with minocycline, despite lower exposure. The study by Sharma and colleagues [ 9 ] showed that minocycline was 1. Additional analysis by their group and PK-PD analysis showed that the transfer rate constant to the effect site was fold higher for minocycline in comparison to doxycycline. Sharma and colleagues [ 9 ] analyzed other factors that may explain the higher efficacy for minocycline compared with doxycycline.

They performed an analysis of physiochemical properties of doxycycline and minocycline to examine parameters that are associated with permeability across membranes.

The lipophilicity determined by LogP and number of hydrogen bond donors were superior for minocycline, consistent with higher permeability across membranes. Minocycline also has approximately twice the lipophilicity of doxycycline which is consistent with higher permeability across membranes [ 19 ]. Furthermore, minocycline has a molecular polar surface area PSA that is aligned with recommended values for permeable compounds. These properties of minocycline, in addition to lower protein binding higher free fraction available , may have contributed to the greater anti- Wolbachia activity in their mouse model.

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Oxford Academic. Joe Pardo. Department of Pharmacy. Jose Montero. Internal Medicine. Kristy M. Cite Cite Nicholas W. Select Format Select format. Permissions Icon Permissions. Abstract Doxycycline, a commonly prescribed tetracycline, remains on intermittent shortage. Figure 1. Open in new tab Download slide. Table 1. Reported Treatment s. Potential for Bias. Open in new tab. Figure 2.

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One of the most common mutual indications for these two drugs is acne rosacea. A randomized controlled trial , published in , sought to compare the efficacy and safety of these two drugs in the treatment of rosacea.

Eighty patients with mild to severe rosacea were randomized to either doxycycline 40 mg or minocycline mg. The results of the study found that improvement scores were significantly better for the minocycline group. The minocycline group also had fewer relapses in symptoms and had a longer remission period. There was no significant difference in safety between the two drugs.

A systematic review of literature was done to also compare and evaluate the safety and adverse events between minocycline and doxycycline. The review looked at 15 years of data. Doxycycline was prescribed three times more often than minocycline. While adverse events for either drug are relatively low, doxycycline was associated with fewer adverse events than minocycline.

Minocycline is a prescription drug that is typically covered by both commercial and Medicare prescription drug plans. Doxycycline is a prescription drug that is also typically covered by commercial and Medicare prescription drug plans. Minocycline and doxycycline each have a tendency to cause gastrointestinal side effects including nausea, vomiting, diarrhea, and anorexia. These side effects can be difficult to tolerate over longer periods of time and may be responsible for premature termination of therapy due to intolerability.

Minocycline has been associated with rare instances of liver failure and hepatitis. Patients with known hepatic impairment should avoid minocycline or be monitored closely while taking. Doxycycline has been associated with the rare but serious adverse event of Stevens-Johnson syndrome.

It is a very serious condition that requires immediate medical attention. The following list is not intended to be a complete list of adverse events. Please consult a pharmacist, doctor, or another medical professional for a complete list of possible side effects. Minocycline and doxycycline are both antibiotics from the same class of tetracyclines, and their list of potential drug interactions is similar. Common antacids containing aluminum hydroxide, such as Gaviscon, may impair the absorption of minocycline and doxycycline.

This can lead to a decreased efficacy of minocycline and doxycycline. To avoid this interaction, antacids should not be taken with these antibiotics. Ideally, there would be at least two hours between the administration of an antacid and either minocycline or doxycycline. Tetracycline antibiotics such as minocycline and doxycycline interfere with the bactericidal action of another common antibiotic class, penicillins. This class includes common antibiotics such as amoxicillin and penicillin.

There are instances where patients may need to take more than one antibiotic at a time, and it is important to be aware of this interaction when selecting therapies. The following list is not intended to be a complete list of drug interactions. It is best to consult your provider or pharmacist for a complete list. Minocycline and doxycycline are categorized by the Food and Drug Administration FDA as a category D drug, meaning that there is positive evidence of potential fetal risk.

These drugs should be used only when there is a life-threatening risk to the mother. There is evidence of a negative impact on the skeletal development of the fetus. The use of tetracycline antibiotics during tooth development may cause permanent discoloration of the teeth to a yellow, gray, or brown color. This effect is most common with long-term use, though it has been noted with short-term use as well.

When possible, the use of tetracycline antibiotics should be avoided during the last half of pregnancy through the age of 8 whenever possible.