The commercially available drug minocycline hydrochloride is sold under the brand name Arestin in microsphere form. While many dentists who treat periodontal disease have found this product to be effective, the cost per application site can make it an expensive treatment. The expense that must be passed on to the patient is especially high if multiple sites need to be treated. Having a topical antibiotic for treating periodontal disease does not need to be expensive though. Minocycline is a tetracycline antibiotic that has been used for many years and is available in formulations from a compounding pharmacy. Dentists have found our 2% minocycline gel to have the same effectiveness as Arestin and some have found it to be more effective.
Antibiotic Treatment for Periodontal Disease
Antibiotics have been shown to be effective as adjunct treatments for multiple types of periodontal disease. In some cases they are prescribed in oral form but more commonly are made into topical gels. A topical gel is usually preferred as it reduces the risks of systemic effects from oral antibiotics and treatment is targeted to the area of infection.
A topical antibiotic gel can control the re-colonization of bacteria after instrumentation. This is the FDA indication for the commercially available product Arestin. Arestin is a form of the antibiotic minocycline that reduces pocket depth when combined with scaling and root planing. Minocycline is a tetracycline antibiotic that has both anti-bacterial and anti-inflammatory properties. It also helps prevent tissue destruction and bone loss by blocking the protein collagenase.
Minocycline 2% Gel
Arestin is dental antibiotic in microsphere form that is administered directly to the periodontal pocket. A minocycline 2% gel compounded by a pharmacy can be used as an alternative. The gel is placed into the periodontal pocket after scaling and root planing to kill bacteria that are causing gum disease. Dentists we work with have found the gel to be just as effective as Arestin and more affordable.
Minocycline 2% gel must be mixed by the dentist to ensure stability of the medication. Our kits come with two Luer lock syringes: one with the minocycline powder and one with the gel. The two must be mixed together in the office then drawn into 1.2cc syringes for application. After mixing, the gel has an expiration date of 5 days. If the medication is not activated it has a 6-month expiration date. Whether the medication is activated or not it should always be kept refrigerated.
An Adjunct to Scaling and Root Planing
Studies have demonstrated the effectiveness of combining minocycline gel with regular periodontal treatment. Follow-up visits for periodontal treatment will result in less bleeding on probing and less inflammation when minocycline 2% gel is used as an adjunct treatment. Although has not been extensive research done on minocycline gel as a monotherapy, it has been shown to work well when combined with regular scaling and root planing. Instrumentation alone is not likely to remove all pathogens in infected pockets, which makes minocycline 2% gel an effective way to manage periodontal disease between office visits.
Minocycline Gel vs. Arestin Price
If your office has been looking to buy Arestin you may be surprised at the high cost per treatment. The cost of Arestin is significantly higher than the cost of obtaining minocycline 2% gel from a pharmacy. Especially when using the product on multiple treatment sites, it may be a huge cost savings to use compounded minocycline gel.
Minocycline Gel vs. Arestin Effectiveness
It’s clear that minocycline 2% gel from our compounding pharmacy is much more affordable than Arestin. In addition to price, some dentists we work with have told us that the gel is actually more effective. With the low cost of our product, many dentists find that it is worth it to try and compare the gel with the commercially available Arestin powder.