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Doxycycline

About Doxycycline

Doxycycline belongs to a group of medications called tetracycline antibiotics, used to treat bacterial infections. Doxycycline treats urinary tract infections, intestinal infections, respiratory infections, eye infections, sexually transmitted infections (like gonorrhoea, syphilis), gum infections, diseases (like periodontitis), and others. Besides this, Doxycycline also treats acne-like lesions caused by rosacea. However, it does not treat facial redness caused by rosacea. 

Doxycycline being an antibiotic prevents the growth of bacterial cells (the bad ones!) by preventing the formation of the outer protein layer of bacteria (cell wall) responsible for bacteria's growth and multiplication. It is a broad-spectrum antibiotic, i.e. it acts against various bacteria. It is a bacteriostatic antibiotic, i.e. it stops bacteria growth but does not kill them.

Doxycycline should only be taken if advised by your doctor. It can be taken with or without food but should be consumed at a fixed time for the best results. You should complete the course of Doxycycline as your doctor prescribes for better results. Some common side effects of Doxycycline are nausea (feeling or being sick), vomiting, diarrhoea etc. Please consult your doctor if these side effects become troublesome.

Doxycycline is pregnancy category D (high risk) medicines, so its use in pregnant and nursing mothers is not recommended. Use of Doxycycline during tooth development (last half of pregnancy, infancy, and childhood up to the age of 8 years) may cause teeth staining (yellow-grey-brown). Do not consume alcohol as it may cause excessive drowsiness when taken along with Doxycycline. Before using Doxycycline, tell your doctor if you ever had an allergy to Doxycycline, have kidney problems, liver problems, swollen food pipe (esophagitis) or muscle disease (myasthenia gravis). Please do not drink alcohol with Doxycycline as it may increase the unpleasant side effects like drowsiness and dizziness. 

Uses of Doxycycline

Bacterial infections

Medicinal Benefits

Doxycycline is a type of tetracycline class of antibiotic which is effective against a wide range of bacteria, including gram-negative, gram-positive bacteria, anaerobes, and some parasites. It is prescribed for treating various bacterial infections of the respiratory tract (influenza, pneumonia), genitourinary area (syphilis, gonorrhoea), anthrax infection, sinuses, eye, and skin. Besides this, it is also indicated in the tick-borne infections (typhus fever) caused by the Rickettsia group of bacteria like typhus fever. Off-label, usage includes the prophylaxis or prevention of malaria in the prone area and the treatment of acne. Sometimes your doctor might prescribe you Doxycycline as an alternative medicine to penicillin when penicillin is contraindicated.

Directions for Use

Tablet/capsule: Swallow it as a whole with water; do not crush, break or chew it. Dispersible Tablet: Check the label for directions before use. Disperse the tablet in the prescribed amount of water and swallow the contents. Do not crush, chew or swallow as a whole.

Storage

Store in a cool and dry place away from sunlight

Side Effects of Doxycycline

  • Nausea (feeling sick)
  • Vomiting
  • Diarrhoea

Drug Warnings

Iron and antacid (like magnesium hydroxide and aluminium hydroxide) may bind to Doxycycline in the gastrointestinal tract, lowering its efficiency. So, a gap of at least 2 hours should be maintained between intake of Doxycycline and iron supplements and antacids. Prolonged use of Doxycycline during tooth development (last half of pregnancy, infancy, and childhood to the age of 8 years) may cause permanent discolouration of the teeth (yellow-grey-brown). Besides this, in some cases, the use of Doxycycline causes antibiotic-associated diarrhoea. Doxycycline may cause sensitive skin to sunlight and ultraviolet rays, causing an exaggerated sunburn reaction. Hence it is advisable to apply sunscreen before going outside. Its use has also been associated with an increased risk of fungal skin infections like (vaginal candidiasis - thrush). Tetracycline and Doxycycline can form a stable calcium complex in bone-forming tissue, thereby affecting the growth of fibula bones in young children and bone development in the foetus. Using a Doxycycline with isotretinoin should be avoided as it has been reported to cause pseudotumor cerebri (increased pressure inside the brain). Long-term use of Doxycycline may affect your blood, kidney, and liver health, so yearly diagnostics test of these parameters is recommended. Doxycycline does not completely prevent malaria caused by P. falciparum as a Doxycycline is given only for the prophylactic regimen (protection) whenever anyone enters a malaria-prone area.

Drug Interactions

Drug-Drug Interactions: Doxycycline is contraindicated in persons who have shown hypersensitivity to any of the tetracycline or penicillin, retinoid medications taken by mouth (such as acitretin, isotretinoin), blood thinners (such as warfarin), heart disease medicine (digoxin), anti-seizure medications (such as phenytoin, carbamazepine), antacids (especially those containing aluminium, calcium, or magnesium, bismuth subsalicylate), iron supplements, and oral birth control pills. 

Drug-Food Interactions: Food containing calcium and iron should be avoided within 2 hours of Doxycycline as it may affect Doxycycline effectiveness. Avoid alcohol intake as it may lead to drowsiness and affect Doxycycline absorption.

Drug-Disease Interactions: Doxycycline should not be given to people with kidney problems, liver problems, swollen food pipe (esophagitis), lupus disease (an autoimmune disease), muscle disease (myasthenia gravis).

Drug-Drug Interactions Checker List:

  • ACITRETIN
  • ISOTRETINOIN
  • WARFARIN
  • DIGOXIN
  • PHENYTOIN
  • CARBAMAZEPINE
  • BISMUTH SUBSALICYLATE
  • Safety Advice

    • Safety Warning

      Alcohol

      unsafe

      Doxycycline should not be taken until prescribed if you are taking alcohol. Keep your doctor informed if you drink alcohol.

    • Safety Warning

      Pregnancy

      unsafe

      Doxycycline is a Pregnancy Category D. There are no adequate and well-controlled studies on the use of doxycycline in pregnant women. In some cases, taking Doxycycline during pregnancy may affect tooth and bone development in the unborn baby. So, if you are pregnant or planning for pregnancy contact the doctor before using a Doxycycline.

    • Safety Warning

      Breast Feeding

      caution

      Doxycycline is excreted in the breast milk however, the extent of absorption of Doxycycline, by the breastfed infant is not known. Hence, the nursing mother before using a Doxycycline should contact the doctor.

    • Safety Warning

      Driving

      safe if prescribed

      The effect of doxycycline on the ability to drive or operate heavy machinery has not been fully studied but there is no evidence to suggest that doxycycline may affect the ability to drive. Discuss with your doctor if you have any concerns or are having unusual sleepiness or drowsiness after taking Doxycycline.

    • Safety Warning

      Liver

      caution

      Doxycycline to be taken with caution, especially if you have a history of liver diseases/conditions. Dose may have to be adjusted by your doctor.

    • Safety Warning

      Kidney

      safe if prescribed

      At the recommended doses, Doxycycline is safe to use in patients with kidney disease and no dose adjustment is warranted. If prescribed by a doctor, Doxycycline can be safely used. But it is best to discuss with your doctor if you have a known kidney disease/condition.

    • Safety Warning

      Children

      unsafe

      Use of Doxycycline during tooth development in infants and children below 8 years of age may cause permanent staining of teeth (yellow-grey-brown). So, it is not recommended for children below 8 years of age.

    Habit Forming

    No

    Diet & Lifestyle Advise

    • It would be best to take probiotics after taking the full course of Doxycycline to restore some healthy bacteria in the intestine that may have been killed. Taking probiotics after antibiotic treatment can reduce the risk of antibiotic-associated diarrhoea. Certain fermented foods like yoghurt, cheese, sauerkraut and kimchi can help restore the intestine's good bacteria.
    • Include more fibre-enriched food in your diet, as it can be easily digested by gut bacteria which helps stimulate their growth. Thus fibre foods may help restore healthy gut bacteria after taking a course of antibiotics. Whole grains like whole-grain bread, and brown rice, should be included in your diet.
    • Avoid taking too much calcium enriched foods and drinks as it might affect the working of Doxycycline.
    • Avoid intake of alcoholic beverages with Doxycycline as it can make you dehydrated and affect your sleep. This can make it harder for your body to aid the Doxycycline in fighting off infections.

    Special Advise

    • Doxycycline is preferably taken empty stomach or 1-2 hours before meals but it can lead to stomach upset. To avoid this, you may take Doxycycline with meals but ensure you drink plenty of water to keep yourself hydrated.
    • To prevent throat irritation take Doxycycline in an upright position. Do not lie down for at least 30 minutes of taking it. 
    • Even if you feel better after taking Doxycycline, do not stop taking it until your doctor says so. This might cause the symptoms to reappear and will make the infection difficult to treat due to antibiotic resistance.
    • Doxycycline can affect growing teeth, so it should be avoided during pregnancy and in children less than 8 years old.
    • Doxycycline should not be consumed beyond its expiry date as after that it breaks down into harmful chemicals which can damage the kidney.
    • Make sure you drink plenty of fluids when you are sick. This will in general help you clear out the infection faster, protect you from dehydration, and will help you overcome some unpleasant side effects of taking Doxycycline.
    • Wear sunglasses and sunscreen when you go out in the sun as Doxycycline can make your skin sensitive to light.

    Patients Concern

    Disease/Condition Glossary

    Bacterial infection: A bacterial infection is a condition in which harmful bacteria enter, multiply and infect our body. It can target any body part and multiple very quickly. When you get infected with bacteria, you can experience generalized symptoms like fevers, chills, and fatigue. Bacteria are of various forms comprising commonly spherical, rod, and spiral-shaped. Bacterial infections vary from minor illnesses like sore throat and ear infections to severe brain infections like meningitis and encephalitis. Few harmful bacteria that cause infections include Streptococcus, Staphylococcus, and E.coli. Anyone can become infected with a bacterial infection. But, people with weak immune systems or taking immunosuppressive medicine can make you more prone to bacterial infection.

    Rosacea: Rosacea is a skin infection that causes a persistent redness in the centre of your face. Small blood vessels on the cheeks and nose are often inflamed and red. Many people with rosacea also develop pimples on their faces, similar to acne.

    Antibiotic-induced diarrhoea: Antibiotic-induced diarrhoea or Antibiotic-associated diarrhoea refers to the occurrence of diarrhoea (passing loose, watery stools more than 3 times per day) after taking antibiotics. It happens because antibiotics also kill beneficial intestinal bacteria (gut flora) which aids in the food digestions and fighting off infections.  

    FAQs

    Doxycycline being an antibiotic prevents the growth of bacterial cells (the bad ones!) by preventing the formation of the outer protein layer of bacteria (cell wall) responsible for bacteria's growth and multiplication. It is a broad-spectrum antibiotic, i.e. it acts against various bacteria. It is a bacteriostatic antibiotic, i.e. it stops bacteria growth but does not kill them.

    No, Doxycycline should not be stopped even if you feel better as it is an antibiotic medication and completing the full course if very necessary, otherwise the infection might re-appear in a more severe form and will also become difficult to treat due to antibiotic resistance.

    The expiration date of any drug is the last day the manufacturer takes a guarantee of the full potency of the drug. Doxycycline should not be taken after its expiry date as it can cause kidney damage if taken after its expiry.

    If you are taking Doxycycline, avoid taking antacids containing aluminium, calcium or magnesium or other drugs containing these cations; oral zinc, iron salts or bismuth preparations within 2 hours of consumption of Doxycycline as they may affect the absorption of Doxycycline from the stomach. Avoid taking dairy products within 2 hours of taking Doxycycline as they also impair the absorption of Doxycycline.

    Acohol may reduce the effect of Doxycycline. It is therefore advisable to avoid drinking any alcohol while you are taking Doxycycline.

    Use of Doxycycline during tooth development (last half of pregnancy, infancy, and childhood to the age of 8 years) may cause permanent staining of teeth (yellow-grey-brown). So, it is not recommended for pregnant women, breastfeeding mothers, and children below 8 years of age.

    Yes. Intake of Doxycycline may increase your skin sensitivity to the sun rays or ultraviolet lights. So, it is better to apply any sunscreen lotions on your skin whenever you step out of your home.

    Yes. Intake of Doxycycline may lead to overgrowth of fungal skin infections like candida. This happens because Doxycycline also kills good or beneficial bacteria that protect against thrush. If such symptoms occur reach out to your doctor.

    Doxycycline generally does not affect any contraception, including the birth control pill and emergency contraceptive pills. However, if you develop vomiting or have diarrhoea, your birth control pill may not protect you from pregnancy. Please consult your doctor if you have any concerns regarding using the Doxycycline.

    Available Medicines for

    Doxycycline

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