Experiences with
Doxycycline

Doxycycline is an antibiotic that's used to treat infections including:

chest and dental infections
skin infections and conditions like rosacea
sexually transmitted infections (STIs)
other rare infections

It can also be used to prevent malaria if you're travelling abroad.

Doxycycline is available on prescription. It comes as capsules, tablets and tablets which dissolve in water (dispersible).

Who can take doxycycline

Doxycycline is usually taken by adults and children over 12 years old. For some infections, doxycycline can be taken by younger children.

Who may not be able to take doxycycline

Doxycycline is not suitable for some people. To make sure it's safe for you, tell your doctor if you:

have ever had an allergic reaction to doxycycline or any other medicine
have kidney or liver problems
have an inflamed food pipe (oesophagitis)
have lupus, an autoimmune disease
have myasthenia gravis, a condition that causes severe muscle weakness
are pregnant or breastfeeding

Dosage

Your dose of doxycycline depends on why you are taking it. The usual dose is 100mg to 200mg, taken once or twice a day.

You might take a lower dose, such as 40mg once a day or 20mg twice a day, for rosacea or gum infections.

Children younger than 12 years old may need to take a lower dose than adults. The dose depends on your child's age and weight. If you're taking doxycycline more than once a day, try to space your doses evenly throughout the day.

Dose for malaria

You'll usually take 100mg once a day in the morning.

Carry on taking doxycycline until you've completed the course, even if you feel better. If you stop your treatment early, the infection could come back, or you may no longer be protected against malaria.

If you're taking a lower dose of 40mg of doxycycline a day for rosacea or gum infections, take it at least 1 hour before food.

If you're taking a higher dose of 100mg or more for other types of infection, you can take it with or without food. But you're less likely to feel sick if you have it with food.

It's important to take doxycycline while you're in an upright position. You can be sitting, standing or walking. This will stop the medicine irritating your food pipe or stomach. Avoid lying down for at least 30 minutes after taking doxycycline.

If you take it twice a day, this could be first thing in the morning, and in the evening – before you go to bed. Try to avoid lying down for at least 30 minutes after taking doxycycline. This helps to prevent any irritation.

If you're taking doxycycline for malaria, start your treatment 1 or 2 days before going to an area with malaria. Stop taking it 4 weeks after leaving the area. Check with your doctor or pharmacist that doxycycline is the best medicine to prevent malaria in the country you are travelling to.

How to take capsules or standard tablets

Swallow your doxycycline whole with at least 150ml of water. Not swallowing them with enough water can cause swelling and irritation in your throat (oesophagitis).

How to take dispersible tablets

Dissolve the tablet in a small amount of water. Let the tablet break up fully then swallow the drink.

If you forget to take it

If you forget to take a dose, take it as soon as you remember, unless it's nearly time for your next dose. If that happens, just leave out the dose you missed and take your next dose at the usual time.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember to take your medicines.

If you take too much

Taking 1 extra dose of doxycycline is unlikely to harm you. But speak to your pharmacist or doctor if you're worried, or you have taken more than 1 extra dose.

Common side effects

These common side effects of doxycycline happen in around 1 in 10 people. There are things you can do to help cope with them:

Make sure you rest and drink plenty of fluids. Painkillers, such as paracetamol and ibuprofen, are safe to take with doxycycline.

Stick to simple meals without rich or spicy food. It might help to take doxycycline after a meal or snack or with a drink of milk instead of water.

If you are being sick, take small sips of water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee.

Do not take any medicines to treat vomiting without speaking to a pharmacist or doctor first.

If you take the combined contraceptive pill or the progestogen-only pill and you're being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.

When you go outside, wear clothes that cover you up, a hat and sunglasses. Use sunscreen or sunblock on your skin, with a high sun protection factor (SPF) of at least 30 to prevent sunburn. If you have fair skin, you may need a higher number of up to SPF 50.

Use a sunscreen product for your lips. Do not use sunlamps or tanning beds.

Speak to a doctor or pharmacist if the advice on how to cope does not help and the side effect is still bothering you or does not go away.

Serious side effects

Serious side effects are rare and happen in less than 1 in 1,000 people.

Call 111 or call a doctor now if you have:

bruising or bleeding you cannot explain (including nosebleeds), a sore throat, high temperature and feeling tired or generally unwell – these can be signs of blood problems
diarrhoea (possibly with stomach cramps) that contains blood or mucus – if you have severe diarrhoea that lasts longer than 4 days, also speak to a doctor
ringing or buzzing in your ears
pale poo and dark pee, and the whites of your eyes turn yellow or your skin turns yellow (although this may be less obvious on brown or black skin) – these can be signs of liver problems
joint or muscle pain since starting doxycycline
severe headaches, vomiting and problems with your vision – these could be signs of pressure around your brain (intracranial hypertension)
a fingernail that starts coming away from its base – this could be a reaction to sunlight called photo-onycholysis
a sore or swollen mouth, lips or tongue
severe pain in your stomach, with or without bloody diarrhoea, nausea and vomiting – these can be signs of pancreatitis
difficulty or pain when you swallow, a sore throat, acid reflux, a smaller appetite or chest pain which gets worse when you eat – these could be signs of an inflamed food pipe (oesophagitis) or oesophageal ulcer

Serious allergic reaction

In rare cases, doxycycline can cause a serious allergic reaction (anaphylaxis).

Meds New IA (H4) - serious allergic reaction

These are not all the side effects of doxycycline. For a full list see the leaflet inside your medicines packet.

Doxycycline and pregnancy

Doxycycline is not recommended during pregnancy. It can affect tooth and bone development in your baby. Talk to your doctor about taking a different antibiotic.

Doxycycline and breastfeeding

If your doctor or health visitor says your baby is healthy, you can take doxycycline for a short time (less than 3 weeks) while breastfeeding.

Doxycycline passes into breast milk in fairly small amounts. However, the calcium in your milk sticks to the doxycycline so the baby cannot absorb very much.

When used for a short time, doxycycline is unlikely to cause side effects in your baby. When used for longer, there is a small chance that it can affect teeth and bone development. However, this has only happened when babies have been given doxycycline directly. It has not happened when babies have doxycycline through breast milk.

If you need to take doxycycline for longer than a few weeks, talk to your doctor or pharmacist.

If your baby is not feeding as well as usual, has a rash, has stomach upset, or has oral thrush (a fungal infection in their mouth), or if you have any other concerns about your baby, talk to your doctor, pharmacist, health visitor or midwife.

Doxycycline and fertility

There's no clear evidence to suggest that taking doxycycline reduces fertility in either men or women.

Speak to a pharmacist or your doctor if you're trying to get pregnant, as doxycycline is not recommended in pregnancy and other treatments may be more suitable.

Meds New IA (H2) - Pregnancy non-urgent care card

Cautions with other medicines

There are some medicines that do not mix well with doxycycline. Before taking it, tell your doctor if you're already taking any of these medicines:

indigestion remedies (antacids)
stomach ulcer medicines that contain bismuth such as Pepto-Bismol
other antibiotics, such as rifampicin
acne medicines containing vitamin A, such as isotretinoin
warfarin, a medicine to help prevent blood clots
medicines for epilepsy, such as phenytoin or carbamazepine
ciclosporin, a medicine that calms down your immune system

A typhoid vaccine given by mouth (orally) may not work properly if you're taking doxycycline. It is OK to have the typhoid vaccine that comes as an injection when taking antibiotics, as it is not a live vaccine.