Sarecycline
Sarecycline hydrochloride
The second considered answer to the antibiotic problem in this register: keep the antibacterial activity, narrow the spectrum, and write the twelve-week limit into the label.
The marker is the strength the trials were actually run at. The bar is the span this register has recorded, approved and compounded together. Anything below the marker is a dose nobody has tested; anything above it is an assumption about a dose–response curve nobody has drawn.
The shaded band is the depth this molecule is understood to reach. Anything below it is out of scope, whatever the label says.
Mechanism
A tetracycline-class antibacterial designed with reduced activity against enteric Gram-negative organisms — the part of the spectrum responsible for the collateral damage broad-spectrum tetracyclines cause. Dosed once daily by body weight.
HOUSE NOTES
- The limitations of use state that efficacy beyond twelve weeks and safety beyond twelve months have not been established, that it has not been evaluated in the treatment of infections, and that it should be used only as indicated to limit resistance.
- Weight-banded dosing across three tablet strengths, so the dose matches the patient rather than the convention.
- Never compared with doxycycline or minocycline in a trial. The spectrum advantage is a mechanism-level argument, priced as though it were an established outcome.
- Its trial population was 51% adults and 15% Black or African American — better representation than most programmes in this register.
Layering
- Pregnancy and breastfeeding
- Children under eight
- Any use beyond twelve weeks without a reason
- A topical retinoid
- Benzoyl peroxide