How I slowly increased my dose of minocycline

[PhilC]

Some people are not able to tolerate 100 mg of minocycline at first and must start at 50 mg or even 25 mg. I was one of them. I had to start at 25 mg and slowly work my way up to 100 mg. Since I am unaware of any published guidelines on how to best accomplish this, I had to figure it out on my own. That being the case, I thought it might be helpful to others who are in a similar situation if I wrote up what I did. And now you’re reading it. 🙂

This PDF file shows how I slowly increased my dose of minocycline from 25 mg to 100 mg (three times per week). The 25 mg doses were created by cutting 50 mg minocycline tablets in half and putting the tablet halves into empty “00” capsules. The 75 mg doses were made in a similar way by placing half of a 50 mg minocycline tablet plus a whole tablet into each empty “00” capsule. Since there’s a possibility that the tablet halves may not go down smoothly, I used capsules to minimize the risk of getting a chemical burn of the esophagus from the minocycline. I used empty “00” capsules because those are what I had on hand; it is possible that a smaller-sized capsule would have worked just as well, but I am not sure about that.

The minocycline tablets I used were made by Par Pharmaceutical (Spring Valley, NY). My own subjective experience is that these tablets seem slightly more potent than Teva minocycline capsules, so I would say that Par tablets are at least as good (if not better) as Teva capsules. Although the minocycline tablets made by Par Pharmaceutical are a generic, price-wise they are on the high side. People without good prescription drug coverage may want to consider using a different generic minocycline tablet instead. Also, to avoid problems, one’s doctor needs to specify on the prescription which generic the pharmacist should use when filling the prescription. The prescription must also mention tablets; otherwise, the pharmacist will usually try to fill the prescription using capsules.

Even though each step of the progression I used was four weeks long, I would have extended any step by an additional four weeks (or longer) if I had felt the need to. Since the largest increase (percentage-wise) in dose occurs during the shift from 25 mg to 50 mg – a doubling of the dose – I believe it is primarily the early steps of the progression (especially the first) that may require extending. I took doxycycline for just over three years before starting on minocycline; people who are still in the early part of their treatment or who are in a lot of discomfort may need to proceed at a slower pace than I did.

The information in this post may also be helpful: Minocycline prescription tip

Phil

EDIT: Attachments were apparently lost during the forum move.
Here is a link to the PDF file:
http://apfiles.nozonenet.com/docs/Slow-Ramp-Up-of-Minocycline-Dose.pdf

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

[mary77]

Thanks for posting this, Phil…it might help those of us who struggle with reactions and sensitivity to meds. I believe that starting at a low dose and ramping up slowly is a very good approach to the AP. It might keep people on the protocol instead of giving up early due to difficulty with the higher dosing.

Nice chart for timing of the increases!
Mary

[Woods1977]

Hi Phil,

It’s been a few days since I’ve logged in- thanks for posting this for me! I’ve been really under the weather this past week fighting off an nasty upper respitory infection- finally started feeling better today.

As you know, I was on Minocin (Watson brand) 50 mg M-W-F 3x/wk. Due to the extreme headaches/dizziness I was experiencing, I decided to try an experiement and back down to 50 mg Monday & Friday. Although I’m not 100% better, I’d say I’m about 75% better, so this approach seems to agree with me for the time being. Also, I’m taking the Minocin at night on an empty stomach as opposed to the day time… I’m very careful to drink a full glass of water with my dose for obvious reasons.

I’m still going to have an MRI done at the advice of my doctor- I just want to rule anything brain related out. However, I’m going to continue my current dose for the next three weeks and monitor my progress- then once I’m feeling “good”, I’ll increase based on your protocol.

Thanks!
Michelle

[PhilC]

Since I was recently asked a question related to this topic, I thought I’d post a follow-up with some additional details. After I reached a minocycline dose of 100 mg MWF, I stayed on that dose for about three months before increasing my dose again to 100 mg every day. I stayed on a minocycline dose of 100 mg daily for about three months, and then began slowly increasing my minocycline dose again until I reached a dose of 200 mg daily. The attached PDF file contains details on the method I used to slowly increase my dose of minocycline from 100 mg daily to 200 mg daily.

I should point out that I’ve never taken minocycline more than once per day. The main reason for that is to keep my dose well away from my meals since I take a lot of supplements with my meals, and some of those supplements are minerals that should not be taken with minocycline. I only mention that to avoid possible confusion; I am not suggesting that anyone else do the same.

Phil

EDIT: Attachments were apparently lost during the forum move.
Here is a link to the PDF file:
http://apfiles.nozonenet.com/docs/Slow-ramp-up-of-minocycline-dose_part-2.pdf

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

[jasregadoo]

Thanks Phil,

I have the capsules, so at this point I can’t go to 150. I’m going to try 200 once a week and see how I do on that. if it’s a problem, I’ll talk to my doctor about getting 50mg dose.

Julie

[DMW]

PhilC, I am very sensitive to medications/supplements and I am trying to build up very slowly starting at 25 mg of minocycline like you did. I can’t open the link to your Prescription tip. I was wondering if you could post it….very interested in reading it. I am herxing on 25 mg and stopped for a couple days. I have also started a very small dose of cortef (5mg). Any advice would be appreciated. TIA.

I have tried for Lyme…minocycline, Cowden protocol, and cannabutter. I’ve had a herx with Folinic acid, magnesium, moducare, xylitol, apple cider vinegar, TADS (adrenal support), activated charcoal, LDN, herbal made by my LLND and a 50 billion probiotic. I have been clinically diagnosed with Bartonella and mycoplasma. My Lyme testing was inconclusive-band 41 was double starred and I had about 4 indefnite…but I was also on cannabutter at the time (a natural antibiotic). I have high reverse T3 and low T

[PhilC]

Hi DMW,

The forum move broke a lot of links and apparently caused all attachments to be lost. I have edited my above posts to correct for this.

Phil

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

[DMW]

Thanks Phil. I still am having a lot of herxing even with 25 mg….new symptom of pain mid back. I have started taking cortef (5mg). Any other suggestions to prevent joint damage from the inflammation? Thanks.

I have tried for Lyme…minocycline, Cowden protocol, and cannabutter. I’ve had a herx with Folinic acid, magnesium, moducare, xylitol, apple cider vinegar, TADS (adrenal support), activated charcoal, LDN, herbal made by my LLND and a 50 billion probiotic. I have been clinically diagnosed with Bartonella and mycoplasma. My Lyme testing was inconclusive-band 41 was double starred and I had about 4 indefnite…but I was also on cannabutter at the time (a natural antibiotic). I have high reverse T3 and low T

[PhilC]

Hi DMW,

If you’re having a strong reaction to 25 mg of minocycline, then I think switching to doxycycline would be a smart move. Doxy is a lot easier to tolerate than mino. You might be able to tolerate a dose of 100 mg, but considering your strong reaction to mino, starting at 50 mg would probably be the prudent thing to do. Perhaps you could ask your doctor to prescribe a dose of 50 mg twice daily. That would make it easier to adjust your dose. If possible, try to get 50 mg tablets of doxycycline.

Phil

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

[DMW]

Thanks Phil. Will talk to my LLND about trying that.

I have tried for Lyme…minocycline, Cowden protocol, and cannabutter. I’ve had a herx with Folinic acid, magnesium, moducare, xylitol, apple cider vinegar, TADS (adrenal support), activated charcoal, LDN, herbal made by my LLND and a 50 billion probiotic. I have been clinically diagnosed with Bartonella and mycoplasma. My Lyme testing was inconclusive-band 41 was double starred and I had about 4 indefnite…but I was also on cannabutter at the time (a natural antibiotic). I have high reverse T3 and low T

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