6 Doxycycline Side Effects You Should Know About

Doxycycline (Vibramycin, Doryx) is an antibiotic in the tetracycline family. It’s a broad-spectrum antibiotic, meaning it can treat many types of infections. Many people take it for acne or to prevent Lyme disease after a tick bite. But it’s also useful for other infections like pneumonia and chlamydia.

While effective, doxycycline can cause side effects. So it’s important to know what to expect before taking the medication. In this article, we’ll discuss six doxycycline side effects to be aware of and how to manage them. Keep in mind, this isn’t a comprehensive list. So talk to your healthcare provider if you’re concerned about potential side effects.

1. Stomach-related side effects

Stomach-related side effects are some of the most common doxycycline side effects. These side effects can look different depending on the person. Some people may experience an upset stomach, nausea, or even vomiting after taking doxycycline. Others may have a loss of appetite or mild diarrhea.

Here are a few at-home remedies to help manage the stomach-related side effects of doxycycline:

• Avoid eating spicy or greasy foods.

• Stay hydrated.

• Eat smaller, more frequent meals.

• Consider trying ginger or peppermint tea.

• Ask your pharmacist if there are over-the-counter (OTC) medications for an upset stomach that would be OK for you to take.

Most forms of doxycycline can be taken with or without food. Taking these forms with food can help limit stomach-related side effects. But there are some versions of doxycycline, such as Oracea, that should only be taken on an empty stomach. Check with your pharmacist to see if your form of doxycycline is OK to take with food.

If you experience mild diarrhea with doxycycline, there are a few ways to manage it. These include:

• Avoiding fatty, fried, and high-fiber foods

• Drinking plenty of fluids

• Following a bland diet if you’re taking doxycycline for a short period of time

• Asking your pharmacist about OTC diarrhea medications, such as loperamide (Imodium A-D)

If you’re only taking doxycycline for a short period of time, any stomach-related side effects you experience should stop once you finish your course of treatment. But if you take doxycycline daily, such as for acne, you may want to consider making some of the changes listed above to help manage side effects. And let your healthcare provider know if you’re having severe or persistent symptoms.

2. Severe diarrhea

While mild diarrhea with doxycycline can usually be managed at home, severe diarrhea warrants a call to your healthcare provider. This is considered a serious doxycycline side effect.

All antibiotics have a risk of severe diarrhea caused by a bacteria called Clostridioides difficile, or C. diff. This is called C. diff-associated diarrhea (CDAD). Antibiotics can sometimes affect your natural balance of gut bacteria. And this can allow C. diff to thrive, causing symptoms like watery diarrhea, fever, and cramping.

If you experience severe diarrhea while taking doxycycline, contact your provider right away. You’ll likely need treatment with an antibiotic that targets C. diff. And they may suggest that you stop taking doxycycline.

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3. Sensitivity to the sun

When you’re taking doxycycline, your skin may be more sensitive to the sun. This means you may get sunburned more easily. You may also get more severe sunburns. In rare cases, some people have experienced damage to their fingernails or toenails after sun exposure. Skin sensitivity should return to normal about 10 to 14 days after stopping treatment with doxycycline.

While taking doxycycline, try to avoid direct sunlight. Be sure to apply sunscreen and wear protective clothing, such as a wide-brimmed hat, when you’re outdoors. This is important year-round, not just during the warmer or sunnier months. You should also avoid exposure to tanning beds and other similar light sources.

4. Irritation of the esophagus

Doxycycline can cause irritation or ulcers to form along the esophagus (the tube connecting the mouth and stomach). This can also be called esophagitis. Symptoms of this side effect include trouble swallowing and burning or pain in the throat, chest, or upper stomach area.

This doxycycline side effect is rare. And it should go away on its own if you stop taking the medication. Taking your dose shortly before lying down can raise your risk of esophagitis. If you have a history of swallowing difficulties, you may also have a higher risk.

Don't take doxycycline immediately before bedtime. You should also take each dose with a full glass of water. If you take doxycycline regularly, ask your healthcare provider whether you should take medication to prevent esophagitis. They may suggest something like omeprazole (Prilosec) or famotidine (Pepcid) to help protect your esophagus.

Unlike an allergic reaction, trouble swallowing caused by esophagitis isn’t accompanied by symptoms like hives or trouble breathing. If you notice symptoms of an allergic reaction, seek medical help right away. Call 911 if you’re experiencing trouble breathing or swelling of the throat.

5. Yeast infections

Vaginal fungal (“yeast”) infections are common after taking antibiotics, including doxycycline. Fungal infections of the mouth or throat (oral thrush) are also possible with doxycycline. This is because doxycycline kills some of the good bacteria that normally protects the body. And this allows fungi to grow more easily, leading to an infection.

To help prevent vaginal yeast infections, it’s best to wear cotton underwear and looser-fitting pants while taking the medication. Avoid douching and using vaginal sprays or deodorants, as well. It’s better to use mild, unscented soaps and only on the external areas around your vagina.

If you develop a yeast infection, keep taking your doxycycline and contact your healthcare provider for treatment recommendations. They may suggest OTC or prescription-only treatments for vaginal yeast infections. For oral thrush, you’ll likely need to take a prescription-only antifungal to help treat it.

6. Severe skin rashes

Very rarely, people have developed severe skin rashes like Stevens-Johnson syndrome (SJS) while taking doxycycline. Symptoms can include a widespread rash, along with blisters, a fever, or flu-like symptoms. These rashes can become life-threatening if not treated quickly enough.

It can take weeks after starting doxycycline for these severe skin reactions to develop. If you notice any skin rashes while taking doxycycline or in the weeks after finishing it, contact your healthcare provider right away. In severe cases, treatment in a hospital may be needed.

Can doxycycline cause tooth staining?

It’s unlikely that doxycycline causes tooth staining. But you’ll still see warnings about it.

Doxycycline has a warning about the potential to cause teeth staining if taken by children younger than 8 years old. This tooth discoloration was first reported in the 1950s in children taking tetracycline (an antibiotic in the same class as doxycycline).

More recent studies suggest that doxycycline doesn’t have an increased risk of tooth staining in children. While promising, larger studies would be needed to confirm this. To be safe, it’s best for children to only take doxycycline for short amounts of time.

When should I contact my healthcare provider about doxycycline side effects?

Common doxycycline side effects, like stomach-related issues, can be frustrating, but they’re usually not serious. Most doxycycline side effects can be managed at home and go away when you stop taking the medication.

If any doxycycline side effects become too bothersome, talk to your healthcare provider about other options. But don’t stop taking doxycycline on your own. Stopping antibiotics too soon can lead to infections that are harder to treat.

Serious doxycycline side effects are rare, but they can happen. Seek immediate medical care if you notice symptoms of a serious side effect, such severe diarrhea or skin rashes.