Nuzyra (Omadacycline) - Oral

What Is Nuzyra?

Nuzyra (omadacycline) is an oral prescription drug used to treat community-acquired bacterial pneumonia and acute bacterial skin and skin structure infections.

Community-acquired bacterial pneumonia is pneumonia (a type of lung infection) that is acquired in the community setting, not in the medical or hospital setting. Nuzyra is in a drug class called tetracycline antibiotics. It works by preventing bacteria from growing and spreading.

Nuzyra is available in tablet form to take by mouth. There is also an injectable form administered intravenously, but this article will focus on the oral version.

Drug Facts

Generic Name: Omadacycline

Brand Name(s): Nuzyra

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Tetracycline antibiotics

Available Generically: No

Controlled Substance: N/A

Active Ingredient: Omadacycline

Dosage Form(s): Tablets

What Is Nuzyra Used For?

The Food and Drug Administration (FDA) approved Nuzyra to treat adults 18 and older with:

  • Community-acquired bacterial pneumonia (CABP)
  • Acute bacterial skin and skin structure infections (ABSSSI)

Nuzyra is not approved for use in children and adolescents under 18. It also does not treat viral infections such as the common cold, flu, or COVID-19.

How to Take Nuzyra

If you are prescribed Nuzyra, read the prescription label and the information leaflet that comes with your medication. Consult your healthcare provider if you have any questions.

Use Nuzyra exactly as directed by your healthcare provider, and do not skip doses.

Take the tablets with water on an empty stomach, at least four hours after you last had anything to eat or drink besides water.

After taking Nuzyra:

  • Do not eat or drink anything except water for at least two hours.
  • Do not consume dairy (e.g., milk, cheese, yogurt) for at least four hours.
  • Do not take iron-containing vitamins or minerals for at least four hours.
  • Do not take an antacid (such as Rolaids or Tums) for at least four hours.

Take your medication for the full course of treatment, even if you start to feel better. Skipping doses or stopping the medicine too soon can make your infection return or cause antibiotic resistance. This means the medicine may not work the next time you need it.

Nuzyra can make you more likely to burn in the sun. Avoid the sun and tanning beds. If you are outside, wear protective clothing and sunscreen of at least SPF 30, and reapply frequently.

Storage

Store Nuzyra at room temperature (68 F to 77 F), away from direct light, heat, and moisture. Keep this medicine in its original labeled container, and keep it out of reach of children and pets to prevent accidental consumption. Make sure the bottle is tightly closed when not in use.

How Long Does Nuzyra Take to Work?

Nuzyra is generally prescribed for seven to 14 days for skin and skin structure infections or a minimum of five days for community-acquired pneumonia. You may start to feel better in a few days, but be sure to finish the full course of treatment to ensure the infection completely clears and does not return.

What Are the Side Effects of Nuzyra?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Like other medications, Nuzyra can cause side effects. Tell your healthcare provider about any side effects you experience while taking this medication.

Common Side Effects

The most common side effects of Nuzyra are:

  • Headache
  • High blood pressure (hypertension)
  • Increased liver enzymes enzyme counts on liver function tests
  • Stomach problems, like nausea, vomiting, diarrhea or constipation
  • Trouble sleeping (insomnia)

Nuzyra can also cause side effects of permanent discoloration of the teeth, problems with the tooth enamel (the hard outer layer), and bone growth issues when taken during pregnancy or childhood. Therefore, Nuzyra should not be prescribed to those who are pregnant or breastfeeding or anyone under the age of 18.

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Hypersensitivity reaction or anaphylaxis: Symptoms can include rash, hives, swelling around the lips, tongue, and face, difficulty breathing, and require emergency medical attention. 
  • Sun sensitivity: Wear protective clothing while outside. Apply (and frequently reapply) sunscreen of at least SPF 30. Avoid the sun and tanning beds.
  • C. difficile-associated diarrhea: This type of diarrhea can occur with any antibiotic. It can cause severe, watery, and/or bloody diarrhea and stomach pain. This diarrhea can occur several months after finishing an antibiotic and can range from mild to life-threatening and, in some cases, can cause death if not treated.
  • Pseudotumor cerebri: Increased pressure in the skull; symptoms may include severe headaches, ringing in the ears, dizziness, nausea, vision disturbances, and pain behind the eyes.
  • Anemia: Low red blood cells - symptoms may include tiredness, weakness, pale skin, chest pain, and cold hands and feet.
  • Superinfection: A second infection that occurs after the first infection, such as a yeast infection.
  • Atrial fibrillation: Symptoms may not be present, but if they are, they may include palpitations (feeling like your heart is racing or pounding), shortness of breath, and tiredness.

Long-Term Side Effects

While many people tolerate Nuzyra well, some long-term effects may occur:

  • C. difficile-associated diarrhea: See the above section for more information. This type of diarrhea may occur after antibiotic treatment and up to two months after the last dose. C. difficile-associated diarrhea is expected to be a rare occurrence with Nuzyra. However, it is important to be alert for the symptoms.
  • Nuzyra can cause permanent discoloration of the teeth during a child's or fetus' tooth development. This includes during pregnancy, breastfeeding, infancy, and childhood up to age 8. For these reasons, Nuzyra should not be used during pregnancy, breastfeeding, or for anyone under 18 years old. Therefore, Nuzyra is only approved for adults ages 18 years and older.
  • Nuzyra can affect bone growth. This effect is reversible, meaning that when the drug is stopped, bone growth should no longer be affected. Still, the prescribing information recommends that Nuzyra should not be used during pregnancy, breastfeeding, or for anyone under 18.

Report Side Effects

Nuzyra may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Nuzyra Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For acute bacterial skin and skin structure infections:
      • Adults and children 8 years of age and older—450 milligrams (mg) once a day on Day 1 and 2, then 300 mg once a day for 7 to 14 days.
      • Children younger than 8 years of age—Use is not recommended.
    • For community-acquired bacterial pneumonia:
      • Adults and children 8 years of age and older—300 milligrams (mg) once a day for 7 to 14 days.
      • Children younger than 8 years of age—Use is not recommended.

Modifications

You may need to use caution if you are 65 years or older, especially if you have other medical conditions.

Pregnant people should not use Nuzyra because it can cause the baby to have permanent teeth discoloration, enamel problems, and bone growth problems.

People of childbearing age who need to take Nuzyra should use effective contraception (birth control) during antibiotic treatment. Consult your healthcare provider if you need more information about effective contraception to prevent pregnancy. If you are taking Nuzyra and find out you are pregnant, contact your healthcare provider right away.

Individuals should not breastfeed while taking Nuzyra and for at least four days after the last dose of Nuzyra.

Missed Dose

If you miss a dose of Nuzyra, take it as soon as possible. If it is almost time for the next dose, skip the missed dose. Do not take two doses together to make up for a missed dose. If you are unsure what to do, consult your healthcare provider.

Overdose: What Happens If I Take Too Much Nuzyra?

What Happens If I Overdose on Nuzyra?

If you think you or someone else may have overdosed on Nuzyra, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Nuzyra, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

If your symptoms do not improve within a few days, or if they become worse, check with your doctor.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away.

This medicine may cause serious allergic reactions, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after using this medicine.

Omadacycline may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you stop taking this medicine. Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.

This medicine may cause intracranial hypertension (increased pressure in the head). Tell your doctor right away if you have a headache, blurred vision, or other change in vision.

Omadacycline may cause your skin to be more sensitive to sunlight than it is normally. Exposure to sunlight, even for short periods of time, may cause skin rash, itching, redness or other discoloration of the skin, or a severe sunburn. When you begin taking this medicine:

  • Stay out of direct sunlight, especially between the hours of 10:00 a.m. and 3:00 p.m., if possible.
  • Wear protective clothing, including a hat. Also, wear sunglasses.
  • Apply a sunblock product that has a sun protection factor (SPF) number of at least 15. Some patients may require a product with a higher SPF number, especially if they have a fair complexion. If you have any questions about this, check with your doctor.
  • Apply a sunblock lipstick that has an SPF of at least 15 to protect your lips.
  • Do not use a sun lamp or tanning bed or booth.

If you have a severe reaction from the sun, check with your doctor right away.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn't Take Nuzyra?

Nuzyra is not appropriate for everyone. You should not take this medication if you are allergic to omadacycline, tetracycline antibiotics (including tetracycline, doxycycline, or minocycline), or inactive ingredients in Nuzyra.

Other people who should not take Nuzyra include:

  • Pregnant people
  • Breastfeeding people (do not breastfeed while taking Nuzyra and for four days after the last dose)

Nuzyra may be prescribed with caution in some people only if the healthcare provider determines it is safe. This includes:

  • Women, including those that are overweight, of childbearing age
  • People of childbearing age with a history of intracranial hypertension (increased pressure in the skull)
  • Older adults (65 years and older)
  • People with community-acquired pneumonia, especially those at higher risk for death
  • People with lupus
  • People with a history or risk of fungal infections
  • People who have recently had C. difficile-associated diarrhea

What Other Medications May Interact With Nuzyra?

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter (OTC) medications and vitamins or supplements. While taking Nuzyra, do not start any new medications without approval from your healthcare provider.

People who take blood thinners such as Jantoven (warfarin) may need a lower dose of the blood thinner while taking Nuzyra to prevent bleeding.

Antacids or supplements that contain aluminum, calcium, magnesium, bismuth subsalicylate, zinc, or iron, may interfere with the absorption of Nuzyra. Therefore, these medications must be taken at least four hours after taking Nuzyra.

Other examples of drugs that may interact with Nuzyra include:

Other drug interactions may occur with Nuzyra. Consult your healthcare provider for a complete list of drug interactions.

What Medications Are Similar?

Nuzyra is a tetracycline antibiotic. Other drugs in this class, which have various indications such as for bacterial infections and acne, include:

  • Demeclocycline
  • Amzeeq, Arestin, Dynacin, Minocin, Solodyn, Minolira, Ximino, and Zilxi (minocycline)
  • Seysara (sarecycline)
  • Tetracycline
  • Tygacil (tigecycline)
  • Vibramycin, Oracea, Monodox, and others (doxycycline)

Other oral antibiotics (used for bacterial infections) in different drug classes include:

This list is a list of drugs also prescribed for certain bacterial infections. It is NOT a list of drugs recommended to take with Nuzyra. Talk to your pharmacist or a healthcare provider if you have questions.

Frequently Asked Questions

  • What is Nuzyra used for?

    Nuzyra is a prescription antibiotic used to treat bacterial community-acquired pneumonia and skin and skin structure infections.

  • How does Nuzyra work?

    Nuzyra works by preventing bacteria from growing and spreading.

  • What drugs interact with Nuzyra?

    Nuzyra interacts with blood thinners like warfarin and various other drugs. Therefore, Nuzyra should not be taken within at least four hours of antacids, vitamins, or minerals containing iron, magnesium, zinc, or calcium. Before starting Nuzyra, tell your healthcare provider about all your medications, including prescription and OTC drugs, vitamins, and supplements.

  • How long does it take for Nuzyra to work?

    Nuzyra is generally prescribed for a seven- to 14-day course of treatment. You may start feeling better in several days, but be sure to finish the full course of treatment to ensure the infection completely clears and does not return.

  • What are the side effects of Nuzyra?

    Stomach problems like nausea, vomiting, diarrhea, or constipation may occur. Other common side effects may include headache, increased blood pressure, trouble sleeping, dizziness, and yeast infection of the mouth or vagina. Before taking Nuzyra, discuss potential side effects with your healthcare provider.

  • How do I stop taking Nuzyra?

    Your healthcare provider will tell you how long to take Nuzyra. Take it until the treatment is complete. Do not skip doses or stop taking your medication before your treatment is finished, even if you are starting to feel better.

How Can I Stay Healthy While Taking Nuzyra?

Before taking Nuzyra, discuss your medical history and all medication you take with your healthcare provider. Tell them if you have any allergies to medication.

When taking Nuzyra, follow your healthcare provider’s instructions for use. Read the patient information leaflet that comes with your prescription and discuss any questions with your healthcare provider.

While taking Nuzyra, avoid sunlight and tanning beds. Nuzyra can make it easier for you to get a sunburn. If you are spending time outside, wear protective clothing and sunscreen of at least SPF 30. Reapply sunscreen frequently, especially if you are swimming.

Nuzyra interacts with antacids and dairy products and must be consumed on an empty stomach, so it must be taken in a very specific way. Take Nuzyra with water at least four hours after you have eaten or drank anything besides water. Then, for the next two hours, do not eat or drink anything except water. For at least four hours after taking Nuzyra, avoid dairy products (such as milk, cheese, ice cream, and yogurt), antacids (such as Maalox or Milk of Magnesia), and vitamins or minerals that contain iron, calcium, magnesium, or zinc.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. DailyMed. Label: Nuzyra - omadacycline injection, powder, lyophilized, for solution, Nuzyra- omadacycline tablet, film coated.

  2. O'Riordan W, Cardenas C, Shin E, et al. Once-daily oral omadacycline versus twice-daily oral linezolid for acute bacterial skin and skin structure infections (OASIS-2): a phase 3, double-blind, multicentre, randomised, controlled, non-inferiority trial. Lancet Infect Dis. 2019;19(10):1080-1090. doi:10.1016/S1473-3099(19)30275-0

  3. Epocrates. Nuzyra.

  4. Opal S, File TM, van der Poll T, Tzanis E, Chitra S, McGovern PC. An integrated safety summary of omadacycline, a novel aminomethylcycline antibiotic. Clin Infect Dis. 2019;69(Suppl 1):S40-S47. doi: 10.1093/cid/ciz398

By Karen Berger, PharmD
Karen Berger, PharmD, is a community pharmacist and medical writer/reviewer.