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Why it's used

Doxycycline is a prescription medicine that is used to prevent & treat certain types of infections such as sexually transmitted infections, respiratory tract infections, bacterial infections, eye infections, an infection spread through the bite of infected ticks, lice, mites (rickettsial infections) and serious infections caused by bacterium Bacillus anthracis (anthrax including inhalational anthrax). This medicine may also be used to treat acne, malaria, and parasitic infection of the intestine (intestinal amoebiasis). This medicine works by preventing the growth and reproduction of bacteria by blocking the protein synthesis. Doxycycline is also used to treat a serious gum infection that damages gums and can destroy the jawbone (periodontitis).
Doxycycline may also be used along with other medicines in the treatment of certain conditions as recommended by the doctor. It is used with Amebicides to prevent & treat Amebicide can be used in combination with Doxycycline to treat parasitic infection of the colon (acute intestinal amebiasis), and severe acne problems. This medicine works by the combined action of preventing the bacterial growth (bacteriostatic) and by killing parasites (amebicides). It is also used together with Streptomycin to prevent & treat an infection that spreads from animals to humans, mostly by unpasteurized dairy products (brucellosis) due to Brucella species.
Tetracycline class antibacterial
Doxycycline belongs to the Tetracycline class antibacterial class of medicines. Tetracycline class antibacterial.

How to use

Read the medicine guide provided by your pharmacist, your doctor, or the medicine company. If you have any questions related to Doxycycline, ask your doctor or pharmacist. Use Doxycycline as per the instructions provided by your doctor.
Doxycycline is used before food. Doxycycline should be taken at least one hour before meals. If irritation in stomach occurs, Doxycycline can be given with food or milk. Swallow the Doxycycline whole with a sufficient quantity of fluids (at least 100 ml of water). It should be taken in upright sitting or standing position. Doxycycline is used usually before bedtime. In case the patients experience stomach and intestinal side-effects.
The typical dose of Doxycycline for adults is 200 mg daily on the first day of treatment (taken as 100 mg every 12 hours) followed by a maintenance dose of 100 mg/day. The usual dose for children is 2 mg/lb (4.4 mg/kg) of body weight divided into two doses on the first day of therapy, followed by 1 mg/lb (2.2 mg/kg) body weight given as a single dose daily or divided into two doses after wards. For more severe infections dose up to 2 mg/lb of body weight can be used. This medicine is generally used for a period of 10 days for streptococcal bacterial infections, 7 days for uncomplicated urethral, endocervical, or rectal infection, 7 days for inflammation of urethra without gonorrheal infection, 2 weeks for bacterial infection by sexual contact (syphilis), 10 days for inflammation of the epididymis that can extend into the testis (acute epididymo-orchitis), and 60 days for inhalational anthrax (post-exposure). Doxycycline is commonly used at the same time every day. This medicine is not known to be addictive or habit-forming.
This medicine is to be used for longer periods of time. Doxycycline should be used as directed by the doctor even if you feel well, or even if you think that there is no need for you to use your medicine.
Discuss with your doctor if your condition persists or worsens or if you develop new symptoms.
Your doctor may prescribe a lower starting dose of this medicine to understand the impact on the body. Please follow your doctor's recommendations. Taking a higher dose of this medicine may increase the risk of side-effects. A lower dose of this medicine may be recommended to reduce the risk of side-effects.
If you are giving Doxycycline to a child, be sure to use a product that is for use in children. Use the child's weight or age to find the right dose from the product package or medicine label. You can also read the dosage section of this page to know the correct dose for your child. Else, consult with your doctor and follow their recommendation.
If using the delayed-release form of this medicine, do not crush or chew the medicine, unless indicated on the package. Crushing or chewing of the medicine can result in unpleasant taste resulting in patients not following the medicine schedule. Crushing or chewing can also release all of the medicine at once, resulting in a decrease of effectiveness and a possible increase in side-effects.
If using the liquid form of this medicine, measure the dose using the provided measuring cup, spoon, or dropper. Before pouring the medicine into the measuring device, you should check the measurement markings carefully. Then, pour the dose amount into the device. After use, clean and store the measuring device in a safe place for your next use. You should not use a tablespoon or teaspoon as the dose measuring devices since it can result in an incorrect dose. If indicated on the product package, shake the medicine before use.
Your doctor may request that specific lab tests be performed before you start using Doxycycline. Your doctor may ask you to undergo Antibiotic Susceptibility test. Antibiotic susceptibility test is required to help in selecting an appropriate antibacterial drug for treatment. Your doctor may request Automated Immunoassays for Syphilis Antibodies test. When coexistent syphilis is suspected then follow the dark-field examination (laboratory test) and blood serology repeatedly for at least four months.
Medicines may be recommended for uses other than those listed in the medicine guide. You should not use Doxycycline for conditions or symptoms for which it was not prescribed. Do not give Doxycycline to other people, even if they have the same conditions or symptoms that you have. The use of this medicine without the advice of a doctor may cause harm.
Follow storage instructions on the product package if available. Store Doxycycline at 25°C (77°F); 15°-30°C (59° - 86°F), and away from moisture. Store this medicine away from children and pets.

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How to take Doxycycline

Your dose may depend on several personal factors. You should consult with your doctor to find out the dose that is best for you. The dose of Doxycycline depends on the following factors:
  • patient's age
  • patient's weight
  • patient's health
  • medicines recommended by your doctor
  • any other medicines in use

Doxycycline Dosage

Dosage for long term infections of urinary tract

Adult
  • Recommended: 200 mg should be given on the first day of treatment followed by a maintenance dose of 100 mg once a day or it can be given as 50 mg twice a day
Children (above 8 years and weight less than or equal to 45 kg (100 lb))
  • Recommended: 4.4 mg/kg (2 mg/lb) twice a day on the first day of treatment, followed by 1 mg/lb (2.2 mg/kg) given on subsequent days
Children (above 8 years and weight more than 45 kg (100 lb))
  • Recommended: 200 mg should be given on the first day of treatment followed by a maintenance dose of 100 mg once a day or it can be given as 50 mg twice a day

Dosage for inflammation of the urethra without gonorrheal infection (nongonococcal urethritis)

Adult
  • Recommended: 100 mg by mouth twice a day for 7 days

Dosage for bacterial infection by sexual contact (syphilis)

Adult
  • Recommended: 100 mg by mouth twice a day for two weeks

Dosage for bacterial infection by sexual contact (syphilis)

Adult (patients of more than one-year duration of syphilis)
  • Recommended: 100 mg by mouth twice a day for four weeks

Dosage for prevention of malaria

Adult
  • Recommended: 100 mg daily
Children (above 8 years)
  • Recommended: 2 mg/kg (1 mg/lb) once daily as a starting before 1-2 days of traveling and should be continued up to 4 weeks

Dosage for serious lung infections caused by bacterium Bacillus anthracis (anthrax including inhalational anthrax),

Adult
  • Recommended: 100 mg twice a day given by mouth for up to 60 days
Children (weighing less than 45 kg (100 lb))
  • Recommended: 2.2 mg/kg (1 mg/lb) twice a day by mouth for up to 60 days
Children (weighing equal to or more than 45 kg (100 lb))
  • Recommended: 100 mg twice a day by mouth for 60 days

Dosage for inflammation of the gums (periodontitis)

Adult
  • Recommended: 20 mg twice daily for up to 3 months

Dosage for inflammatory disease of male reproductive system (acute epididymo-orchitis)

Adult
  • Recommended: 100 mg twice a day given by mouth for at least 10 days

Dosage for bacterial infections caused by Streptococcus species (Streptococcal infections)

Adult
  • Recommended: 200 mg should be given on the first day of treatment followed by a maintenance dose of 100 mg once a day or it can be given as 50 mg twice a day
Children (above 8 years and weight less than or equal to 45 kg (100 lb))
  • Recommended: 4.4 mg/kg (2 mg/lb) twice a day on the first day of treatment, followed by 1 mg/lb (2.2 mg/kg) given on subsequent days for ten days
Children (above 8 years and weight more than 45 kg (100 lb))
  • Recommended: 200 mg should be given on the first day of treatment followed by a maintenance dose of 100 mg once a day, or it can be given as 50 mg twice a day for ten days

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

Forms

Tablet
Strength: 20 mg, 75 mg, 50 mg, 100 mg and 150 mg
Tablet, coated
Strength: 75 mg and 150 mg
Tablet, film coated
Strength: 20 mg, 75 mg, 100 mg and 150 mg
Tablet, delayed release
Strength: 50 mg, 60 mg, 75 mg, 100 mg, 120 mg, 150 mg and 200 mg
Syrup
Strength: 50 mg/5ml
Powder
Strength: 100 mg
Powder for suspension
Strength: 25 mg/5ml

Special Instructions

Oral formulations
Take 200 mg on the first day of treatment (100 mg every 12 hours) followed by a maintenance dose of 100 mg/day
Delayed-release tablets
In delayed-release tablet form of Doxycycline, carefully break up the tablet and sprinkle the contents of the tablet on a spoonful of cold or room temperature applesauce. Do not crush or damage the pellets while breaking up the tablet. Eat the mixture right away and swallow without chewing.

Missed Dose

A missed dose should be taken as early as you remember it. However, if the time for the next dose is almost there, then the missed dose should be skipped, and the regular dosing schedule should be continued. Avoid taking a repeated dose to make up for a missed one.

Overdose

What to do if you overdose on Doxycycline?
Clinicians should have in mind that a significant proportion of overdoses are likely to produce blood levels of Doxycycline within the therapeutic range of antimicrobial therapy, for which there is a large number of data confirming the safety of the drug. In cases of significant overdosage, Doxycycline treatment should be stopped immediately. Treatment according to the symptoms and supportive measures should be undertaken in case of overdose with Doxycycline. The harmful effects of Doxycycline can be reduced by cleaning out the harmful substances of the stomach (gastric lavage). Intestinal absorption of unabsorbed Doxycycline should be reduced by producing non-absorbable chelate complexes by the intake of magnesium or calcium salt-containing antacids.
Symptoms of an overdose of Doxycycline
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
  • inflammation in the pancreas
  • kidney damage
  • long-term liver disease
If you think you have overdosed on Doxycycline, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Doxycycline

Before you use Doxycycline, discuss with your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Tell your doctor if you are allergic any of the following substances: doxycycline hyclate, or other tetracyclines.
Before you use Doxycycline, tell your doctor of your medical and health history including the following: diarrhea, liver problems, a rare muscle weakness disorder, a yeast infection (thrush), diabetes, acne, or group of rare genetic blood disorders (porphyria). Before having surgery during the use of Doxycycline, discuss with your doctor and dentist about the medicinal products you use including prescription/non-prescription/herbal medicines.
The use of this medicine may change blood urea. Increase in the blood urea levels has been reported with the use of tetracyclines including Doxycycline.
Doxycycline can make you feel sleepy. Be careful when using any machinery, driving a vehicle, or doing any other activity that needs you to be fully alert. The consumption of alcohol with Doxycycline can worsen the sleepiness.
Pregnant/breastfeeding women should not use this medicine. Doxycycline is not for use by women. Taking tetracyclines including Doxycycline during the second and third trimester of pregnancy may result in permanent discoloration of the teeth in the child. Women who are breastfeeding a baby should not use this medicine. This medicine passes into breast milk. Doxycycline may impact fertility in women. If you are trying to conceive, discuss with your doctor on the use of this medicine.
Consult with your doctor on the consumption of alcohol with Doxycycline.
This medicine may increase your sensitivity to sunlight. If this happens, use a sunscreen and cover your skin when you are outdoors. Limit your time in the sun. If you get a sunburn on your skin, consult with your doctor.
Doxycycline may cause an increased risk of side-effects in children. Children using this medicine may see an increased risk of permanent discoloration of teeth.
If Doxycycline is used for long-term, it may cause permanent discoloration of the teeth.

Doxycycline Side-effects

The following side-effects may commonly occur when using Doxycycline. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
The following side-effects may commonly occur in children when using Doxycycline. Discuss with your doctor if any of these side-effects last for a long time or are severe:
  • permanent discoloration of teeth (yellow-grey-brown)
Rarely, the use of Doxycycline may cause the following side-effects:
  • brown-black microscopic discoloration of thyroid glands
  • constipation
  • discoloration of teeth (yellow-grey-brown)
  • dizziness
  • dry mouth
  • flat or raised red bump on the skin (maculopapular rashes)
  • group of genetic blood disorders (porphyria)
  • gum pain
  • hives
  • increase in blood urea nitrogen
  • increased number of eosinophils (eosinophilia)
  • increased pressure inside skull (benign intracranial high blood pressure in adults)
  • inflammation of the tongue (glossitis)
  • muscle pain
  • muscle weakness
  • scaling of the skin (exfoliative dermatitis)
  • stomach pain
  • tooth discoloration
The following severe side-effects may also occur when using Doxycycline:
  • skin disorders
    Symptoms: redness of the skin (erythematous rashes), flat or raised red bump on the skin (maculopapular rashes), scaling of the skin (exfoliative dermatitis) increased skin sensitivity to the sun (photosensitivity)
  • Symptoms: destruction of red blood cells (hemolytic anemia), low levels of thrombocytes low level of neutrophils (neutropenia)
  • reaction to endotoxin-like products during antibiotic treatment (Jarisch-Herxheimer reaction)
    Symptoms: blistering of the skin, blistering of mouth or throat, blistering of eyes blistering of genitals
    If such side-effects appear, contact the doctor immediately.
  • stomach and intestinal disorders (gastrointestinal disorders)
    Symptoms: severe eating disorder (anorexia), vomiting, diarrhea, difficulty in swallowing (dysphagia), inflammation of the intestine (enterocolitis), inflammation or irritation of the food pipe (esophagitis), ulcers in the food pipe (esophageal ulcerations) inflammation of the colon due to bacteria (pseudomembranous colitis)
  • severe allergic reaction
    Symptoms: wheezing, chest pain, sudden swelling, fever, skin rash, itching of the skin difficulty in breathing
    If such side-effects appear, contact the doctor immediately.
  • Symptoms: yellowing of the skin, yellowing of the eyes severe stomach pain
    If this happens, tell the doctor immediately.
  • severe skin disorder (Steven-Johnsons syndrome)
    Symptoms: fever, chills, headache, skin rash muscle pain
    If this happens, tell the doctor immediately.
Your doctor has prescribed Doxycycline because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious side-effects. This page does not list all possible side-effects of Doxycycline.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Discoloration of teeth

Children up to the age of 8 years are at an increased risk when using this medicine. Such patients have an increased risk of developing permanent discoloration of teeth (yellow-grey-brown) and tooth defect (enamel hypoplasia). These side-effects occur more commonly during long-term use of the medicine. The use of this drug should not be prescribed for children up to 8 years except for a rare and severe bacterial illness (anthrax) until and unless any other effective treatment is not available.

Inflammation of the colon due to the bacteria (pseudomembranous colitis)

Patients who are on treatment with antibacterial agents including Doxycycline are at an increased risk when using this medicine. Such patients may have an increased risk of developing mild diarrhea to fatal colitis due to the disturbed balance of useful bacteria in the intestine which results in overgrowth of bacteria responsible for diarrhea. In case any symptom appears, ongoing treatment with an antibiotic should be discontinued. Supplementation with protein, appropriate fluid and electrolyte management, antibiotic treatment of bacteria responsible for diarrhea (Clostridium difficile), and surgical evaluation if it is clinically indicated should be undertaken.

Increased sensitivity to sun (photosensitivity)

Patients who are on treatment with antibacterial agents including Doxycycline are at an increased risk to develop an enhanced sunburn reaction. Such patients should discontinue the use of the drug in case if they experience an allergic skin reaction (erythema).

Second infection which is superimposed on an earlier infection (superinfection)

Patients who are on treatment with antibacterials including Doxycycline are at an increased risk of developing superinfection by other organisms such as fungi. Such patients should discontinue the use of Doxycycline if superinfection occurs and should start an appropriate therapy.

Brain disorder due to increased pressure inside the skull (benign intracranial high blood pressure)

Patients using tetracyclines such as Doxycycline may develop a condition affecting the brain (bulging fontanels) in infants and benign intracranial high blood pressure in adults. The patients should discontinue the use of the drug after the appearance of these symptoms.

Growth and development

Patients who are on treatment with tetracyclines such as Doxycycline have increased chances for the formation of calcium complex with tetracyclines, and therefore the complex does not allow for the growth of bones in the unborn child (premature). These changes are reversible on discontinuation of the drug. In case any tetracycline such as Doxycycline is used during pregnancy or if any patient becomes pregnant while taking such medicine, the patient should be informed about potential harmful effects to the fetus.

Prevention of cell division process (antianabolic action)

The antianabolic action of the tetracyclines may cause an increase in the amount of urea nitrogen in the blood (blood urea nitrogen, BUN). Studies have indicated that this change is not found to occur with the use of Doxycycline in patients with the damaged functioning of kidneys.

Surgical procedures (incision and drainage)

The surgical procedures such as incision and drainage should only be performed when indicated.

Malaria

The use of Doxycycline does not entirely prevent the suppression of asexual blood stages of malaria-causing organisms (Plasmodium parasites).

Drug resistance

The use of Doxycycline in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication does not provide any benefit to the patients and increases the risk of the development of drug-resistant bacteria. Antibiotics should only be prescribed when the bacterial infection has been proven to be present.

Syphilis testing

If syphilis along with existing bacterial disease is suspected during the treatment with this medicine, then follow dark-field examinations (laboratory test) before starting the treatment. Another method of laboratory testing (blood serology) should be done repeatedly for at least four months.

Monitoring of laboratory tests while long-term therapy with Doxycycline

In patients for whom long-term therapy is prescribed, laboratory examination of organ systems, including blood, kidney, and liver should be performed at regular time intervals.

Ulceration and irritation in food pipe (oesophageal irritation and ulceration)

Such patients are at an increased risk to develop ulcers and irritation in food pipe when using this medicine. These patients should take adequate fluids so as to avoid the risk of developing ulcers and irritation of food pipe.

Patients with history of fungal infection in the mouth (oral candidosis)

Such patients are at an increased risk of having a fungal infection in the vagina when using this medicine. Take necessary precautions while using this medicine in patients with the history of fungal infection in the mouth.

Abnormal functioning of the liver

Doxycycline should be taken cautiously in patients with abnormal functioning of the liver.

Interactions with Doxycycline

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
Doxycycline may interact with anticoagulant drugs, which help to prevent blood clots. Tetracyclines such as Doxycycline have been shown to depress the blood clotting time (blood prothrombin activity). Patients who are on therapy of anticoagulants may require downward dose adjustment of anticoagulant dosage. When Doxycycline is taken in combination with anticoagulants, coagulation parameters, including International Normalized Ratio (INR), should be monitored properly. The possibility of an increased risk of bleeding events should be known to the patient.
There may be an interaction of Doxycycline with penicillin, which is helpful against bacterial infections. Use of Doxycycline may interfere with the bactericidal activity of penicillin. It is advisable not to give Doxycycline with beta-lactam antibiotics (penicillins).
Doxycycline interacts with antacids, which are used to treat stomach acidity. Use of antacids with Doxycycline may impact the absorption of Doxycycline from the stomach and intestinal tract.
Special instructions need to be followed while taking this medicine along with oral contraceptives, which are used for birth control preventive measures. The combined use of Doxycycline with birth control pills (oral contraceptives) may decrease the drug effect of oral contraceptives.
Your doctor's guidelines may need to be followed while taking this medicine along with barbiturates, which are used to depress central nervous system and anti-epileptics, which are used to prevent seizures. These medicines may enhance the decomposition of Doxycycline in the liver.
Doxycycline may interact with penthrane, which is used as an inhalational anesthetic to provide rapid short-term relief from pain. The combined use of Doxycycline with penthrane (methoxyflurane) may lead to fatal conditions of kidney damage.
There may be an interaction of Doxycycline with drug/laboratory test interactions. Due to interference with the fluorescence test, a false increase of urinary catecholamines may occur with the use of Doxycycline.
Doxycycline interacts with rifampicin, which is used to treat several types of bacterial infections such as tuberculosis. Rifampicin may enhance the decomposition of Doxycycline in the liver.
Special instructions need to be followed while taking this medicine along with cyclosporin, which is used to prevent organ rejection in transplantation procedures. When Doxycycline is used with cyclosporin decrease in the half-life of Doxycycline has been reported.
Your doctor's guidelines may need to be followed while taking this medicine along with didanosine, which is used to treat HIV/AIDS. Didanosine may decrease the absorption of Doxycycline due to the increase of pH value in the stomach. Didanosine should, therefore, be used at least 2 hours after intake of Doxycycline.
Doxycycline may interact with isotretinoin, which is used in the treatment of severe acne problems. When Doxycycline is taken shortly before, during or after the course of isotretinoin, may lead to increased pressure in the intracranial cavity (pseudotumor cerebri). The combined use of Doxycycline with isotretinoin should be avoided.
There may be an interaction of Doxycycline with quinapril, which is used in the treatment of high blood pressure and congestive heart failure. Quinapril may reduce the absorption of Doxycycline due to the presence of high magnesium content in the quinapril tablets.
Doxycycline interacts with sulfonylurea oral antidiabetic agents, which are used in the management of high glucose level. Doxycycline has been shown to increase the low blood sugar (hypoglycaemic) effect of sulfonylurea oral antidiabetic agents. If Doxycycline is taken in combination with antidiabetic drugs, blood sugar levels should be monitored properly and if necessary, the doses of both the drugs should be reduced.
This page does not contain all the possible interactions of Doxycycline. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Doxycycline is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Doxycycline .
Bacterial Infections
Sexually Transmitted Diseases
Eye Infections
Anthrax

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