Nausea minocycline

Vestibular reactions like dizziness, vertigo, nausea and vomiting are particular for minocycline. Especially in pregnant women and when given in high doses hepatotoxicity has been described. Also patients with preexisting liver disease are susceptible. In patients with kidney disease renal function can further deteriorate. 

Dizziness, vertigo, nausea, and vomiting have been noted particularly with doxycycline at doses above 100 mg. With dosages of 200-400 mg/d of minocycline, 35-70% of patients will have these reactions. 

Vestibular problems These side effects (for example, dizziness, nausea, vomiting) occur with minocycline, which concentrates in the endolymph of the ear and affects function. 

Vestibular toxicity appears to be unique to minocycline. Lightheadedness, loss of balance, dizziness, nausea, and tinnitus beginning 2 to 3 days after starting therapy can occur in up to 70% of patients. Although these side effects are usually reversible after discontinuing the drug, they have severely limited the use of minocycline. 

Gastrointestinal reactions that may occur during tetracycline administration include nausea, vomiting, diarrhea, epigastric distress, stomatitis, and sore throat. Skin rashes also may be seen. A photosensitivity (phototoxic) reaction may be seen witli tliis group of dni, manifested by an exa rated sunburn reaction when the skin is exposed to sunlight even for brief periods. Demeclocychne seems to cause the most serious photosensitivity reaction, whereas minocycline is least likely to cause this type of reaction. 

Immnnologic A 56-year-old woman had three episodes of anaphylaxis while taking oral minocycline [66 ]. After an oral challenge test with minocycline she developed urticaria, angioedema, nausea, vomiting, hypotension, and dyspnea within 4 minutes and was given intramuscular adrenaline, an intravenous antihistamine, and a glucocorticoid, but developed similar symptoms after 50 and 110 minutes. 

A 12-year-old girl with a history of macrocephaly was initiated on minocycline for acne treatment. One week after she started taking minocycline, she presented with headaches, vision loss and nausea. She stopped the antibiotic after a 3-week course, but her headaches continued and progressed to bilateral vision loss. A lumbar puncture was done and she was found to have elevated intracranial pressure (ICP). The patient experienced a subsequent progressive loss of vision. She was treated with IV methylprednisolone and acetazolamide. The authors discuss other literature that supports the fact that elevated ICP can persist for 2-5 days after the drug is stopped. Patients need to be monitored closely and treated aggressively in order to prevent loss of vision [6 ]. 

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