What to Know About Doxycycline

Vibramycin is one of many brand names for doxycycline, a commonly used antibiotic prescribed to treat a wide range of bacterial infections, from acne to urinary tract infections (UTIs). It belongs to a class of antibiotics called tetracylines, which work either by killing the bacteria that caused the infection or by preventing it from growing.

This medication comes in a variety of formulations, making it a versatile option:

• Powder for suspension (to be mixed with water)
• Tablets
• Capsules
• Delayed-release tablets and capsules
• Injections
• Syrup
• Besides being available as Vibramycin as well as generically, doxycycline is sold in the United States under other brand names, including Doryx, Monodox, and Oracea.

Uses

The Food and Drug Administration (FDA) has approved doxycycline to treat a wide range of infections:

• Acne
• Actinomycosis
• Acute intestinal amebiasis
• Cholera
• Clostridium
• Gram-negative infections
• Listeriosis
• Malaria prophylaxis
• Mycoplasma pneumonia
• Eye infections
• Periodontitis
• Chronic fever
• Respiratory tract infections
• Rickettsial infections
• Rosacea
• Sexually transmitted infections
• Skin infections
• Vincent infection
• Zoonotic infections

Off-Label Uses

Doxycycline also has a number of off-label uses. It may be prescribed to treat:

• Anaplasmosis
• Ehrlichiosis
• Bite wound infections
• Cellulitis
• Chronic obstructive pulmonary disease, acute exacerbations
• Epididymitis
• Hidradenitis suppurativa
• Lyme disease
• Malara, acute treatment
• Otitis media
• Pelvic inflammatory disease
• Pleurodesis
• Proctitis
• Prosthetic joint infection
• Surgical prophylaxis for uterine evacuation

Before Taking

Your healthcare provider is likely to prescribe doxycycline for you if tests show you have a bacterial infection or, sometimes, if they suspect you have one based on symptoms such as a fever, sweating, and chills.

Share your medical history with them as well as any current health problems, allergies, or other medications or supplements you are taking. It will be especially important to alert your practitioner if you've ever had a bad reaction to a tetracycline antibiotic.

[Standard disclaimer: Talk to your healthcare provider about all medications, supplements, and vitamins that you currently take. While some drugs pose minor interaction risks, others may outright contraindicate use or prompt careful consideration as to whether the pros of treatment outweigh the cons in your case.]

Precautions and Contraindications

Doxycycline is contraindicated for anyone who has ever had an allergic reaction to a tetracycline antibiotic in the past. If you know you have, tell your healthcare provider so they can prescribe a better medication for you.

Be aware that there are several chronic diseases and conditions that may preclude taking doxycycline or dictate it be used with caution. Tell your healthcare provider if you have candidiasis (yeast) infections.

Seniors may require special dosing of doxycycline—typically, relatively small doses that can be adjusted carefully for effectiveness. Women who are pregnant or breastfeeding and children younger than 8 years old should not take doxycycline.

Dosage

There are a variety of adult formulations and dosages of doxycycline for adults. The one your healthcare provider chooses for you will depend on your size, why you're taking the medication, and perhaps your preference:

• Capsules of 50, 75, and 100 milligrams (mg)
• Delayed-release capsules of 40 mg
• Intravenous solutions of 100 mg
• Oral solutions of 25 mg per 5 milliliters (mL)
• Tablets of 20, 50, 75, 100, and 150 mg
• Delayed-release tablets and capsules of 50, 75, 80, 100, 150, and 200 mg

Dosing for adults is 100 mg to 200 mg per day split between two doses, or given once a day.

Children under 8 years of age are not usually given doxycycline. In cases where the risks outweigh the benefits, the typical dosing for doxycycline depends on a child's age and weight:

• For children over 8 who weigh more than 45 kilograms (kg)—around 99 pounds: 100 mg twice daily for the first day, then 50 mg or 100 mg once or twice daily
• For children over 8 who weigh less than 45 kg, the typical dose is 4.4 mg/kg/day, divided into two doses on the first day, then 2.2 mg/kg/day in one or two doses each day thereafter
• For children under 8, a medical professional will calculate an individualized dosage of Vibramycin.

[Standard disclaimer: All listed dosages are according to the drug manufacturer. Check your prescription and talk to your healthcare provider to make sure you are taking the right dose for you.] 

Modifications

Seniors may require specialized dosages of doxycycline.

How to Take and Store

While you're taking doxycycline or giving it to your child, there are few things to keep in mind to ensure the drug is safe and effective.

• Doxycycline can cause an upset stomach. This is nothing to worry about but can be prevented by taking the drug with food or a beverage.
• If you've been prescribed a delayed-release tablet or capsule, swallow it whole: do not crush or chew it.
• Capsules that are not delayed-release may be opened and sprinkled over food.
• Shake liquids and suspensions before taking doxycycline or giving it to a child.
• If you miss a dose, take it as soon as you realize you've missed it, unless it's almost time for the next scheduled dose. In that case, don't worry about the missed dose and pick up your regular schedule with the next one. Do not double a dose of doxycycline.
• Store doxycycline in its original container to prevent mix-ups with other medications in your home. It should be kept out of sight and reach of children and away from moisture, heat, or direct light. A bathroom that can get steamy is not ideal.
• Do not stop taking doxycycline without checking with your healthcare provider first.

Side Effects

Vibramycin has been known to cause a number of side effects.

Common

Most of the common ones are mild and rarely something to worry about, but you should tell your healthcare provider about them anyway.

• Upset stomach
• Diarrhea
• Nausea
• Loss of appetite
• Clay-colored stools
• Sensitivity to sunlight
• Tooth discoloration in children
• Yeast infections, including oral thrush
• Skin discoloration

Severe

Call your healthcare provider immediately if you experience any severe symptoms while taking Vibramycin such as:

• A spike in your temperature
• Rash
• Trouble swallowing
• The feeling that your throat is closing
• Hives
• Joint pain
• Yellow (jaundice) skin or eyes
• Dizziness
• Racing heartbeat
• Confusion

Warnings and Interactions

While you're taking doxycycline, it's advisable not to take medications that can interact with it, such as:

• Amoxicillin
• Ampicillin
• Etretinate
• Isotretinoin
• Methotrexate
• Penicillin of any type

You have an increased risk absorption changes in one or both medications, if you take any of the following medications or substances while taking Vibramycin:

• Alcohol
• Aluminum (all forms)
• Aminolevulinic acid
• Bismuth subsalicylate
• Calcium
• Dihydroxyaluminum amino acetate or sodium carbonate
• Iron
• Magaldrate
• Magnesium (all forms)
• Rifampin
• Rifapentine
• Tobacco