Lymecycline 408mg (Acne)

How it works

It inhibits bacterial protein synthesis by binding the 30S ribosomal subunit and also has anti-inflammatory properties, reducing Cutibacterium acnes and inflammation within the pilosebaceous unit.

Prescribing in practice

• Contraindicated in pregnancy, breastfeeding and in children under twelve because tetracyclines cause permanent tooth discolouration and affect bone development.
• It can cause photosensitivity, so advise sun protection and avoidance of excessive UV exposure.
• Absorption is reduced by calcium, iron, antacids and dairy, so separate dosing from these and review concurrent use of oral retinoids.

Monitoring

Monitoring is largely clinical over a defined treatment course, reviewing acne response and tolerability and watching for rare but serious reactions such as benign intracranial hypertension.

Counselling the patient

• Do not take if you are or might become pregnant, and use reliable contraception.
• Protect your skin from strong sunlight as this medicine can make you burn more easily.
• Report severe headache with visual disturbance, which needs urgent assessment.

Evidence & guidelines

Oral tetracyclines such as lymecycline are recommended by NICE as a systemic option for moderate-to-severe acne, typically combined with a topical agent.