Doxycycline Monohydrate

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Apr 26, 2023

Warnings

Doxycycline Monohydrate Risks, Warnings, and Complications

Doxycycline monohydrate can cause or worsen health problems in some people. Talk to your doctor or pharmacist about taking other antibacterial agents if you are at increased risk of adverse reactions or complications from this drug.

PERMANENT TOOTH DISCOLORATION: The use of tetracycline antibiotics, including doxycycline monohydrate, during tooth development (the last half of pregnancy, infancy, and up to 8 years of age) can lead to permanent teeth discoloration (brown, yellow, or gray). It can also cause enamel hypoplasia (thinning of the enamel). This is more likely to occur when the medicine is used for prolonged or repeated periods. Doxycycline monohydrate is not recommended for children younger than 8 years unless necessary to treat life-threatening infections.
CLOSTRIDIUM DIFFICILE-ASSOCIATED DIARRHEA: The use of antibiotics such as doxycycline monohydrate alters the normal gut flora and can cause the overgrowth of a bacteria known as Clostridium difficile (commonly called C.diff). This can cause mild diarrhea or a severe intestinal condition and bloody diarrhea, which can be fatal. It can happen anytime after starting doxycycline monohydrate and even 2 months after stopping treatment. Tell your doctor immediately if you develop diarrhea, bloody or watery stools, fever, stomach cramps, nausea, vomiting, or loss of appetite. People who are taking multiple antibiotics, those on long-term treatment with antibiotics, older adults, and those with a history of gut problems are at higher risk of this serious illness.
INCREASED INTRACRANIAL PRESSURE: Doxycycline monohydrate can cause intracranial hypertension or pseudotumor cerebri, a condition associated with increased pressure in the brain, which can cause permanent vision loss. The risk is higher in women of childbearing age who are overweight or have a history of this condition. The risk is also greater if you take doxycycline monohydrate with an acne medication called isotretinoin. The side effect usually disappears when you stop doxycycline monohydrate. Tell your doctor right away if you develop dizziness, headache, swelling in the eyes, or any vision changes such as blurred vision, double vision, or decreased vision.
HARM TO AN UNBORN BABY: Doxycycline monohydrate and other tetracyclines can be toxic to an unborn baby. This medication can cross the placenta and affect the growth and development of bones and teeth in the fetus. It can also affect bone growth in premature babies. Before starting this antibiotic, tell your doctor if you are pregnant. Call your doctor without delay if you become pregnant while on doxycycline monohydrate.
PHOTOSENSITIVITY: Doxycycline monohydrate can make your skin more sensitive to ultraviolet rays in sunlight, which can lead to severe sunburns. Avoiding direct exposure, wearing protective clothing such as hats, and using sunscreen even on cloudy days is recommended during treatment, as is avoiding tanning beds. Stop taking doxycycline monohydrate, and tell your doctor if you notice any skin changes, such as redness, irritation, or sunburn.
NEW INFECTIONS: Antibiotics, including doxycycline monohydrate, can lead to an overgrowth of other bacteria or fungi and new infections such as vaginal yeast infections. Tell your health care professional if you develop symptoms of an infection, such as fever, chills, sore throat, vaginal itching, or vaginal discharge.
SULFITE ALLERGY: The oral suspension of doxycycline monohydrate (Vibramycin) contains sulfite, which can cause an allergic reaction. Tell your doctor if you have a history of allergic reactions to sulfites, including life-threatening anaphylaxis (throat closing). Get emergency medical help if you have trouble breathing after taking this medication. This may be a sign of a serious drug reaction.

Precautions Before Starting Doxycycline Monohydrate

Tell your doctor if you are allergic to doxycycline monohydrate, any of the active or inactive ingredients in doxycycline monohydrate formulations, other tetracycline antibiotics, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription medications, over-the-counter medicines, vitamins, supplements, and herbal products. This can help avoid possible interactions.

Give your doctor a complete medical history. Doxycycline monohydrate may not be right for people with a medical condition such as lupus, intracranial hypertension or pseudotumor cerebri, mouth or vaginal yeast infections, stomach surgery, asthma, kidney disease, or liver disease.

Tell your health care professional if you are pregnant, could be pregnant, plan to get pregnant, or are breastfeeding.

Precautions During Use of Doxycycline Monohydrate

Keep all your medical and lab appointments while on this medication. Your doctor may want to order certain laboratory tests to see if your infection has cleared.

Read the prescription label carefully and take the correct dose exactly as prescribed. Do not take a larger or smaller dose or take it for a longer or shorter duration than advised by your doctor.

If you are taking products containing calcium, aluminum, or magnesium, such as antacids, calcium supplements, or laxatives, take them 1-2 hours away. Take iron supplements 2-3 hours away from doxycycline monohydrate. These products can interfere with doxycycline absorption.

You should know that doxycycline monohydrate can decrease the effectiveness of hormonal contraceptives, including birth control pills, patches, rings, and injections. Talk to your provider about other methods of birth control while you are on this antibiotic.

Tell your doctor if you become pregnant while on doxycycline monohydrate. Do not nurse an infant with breast milk while on this medicine.

Avoid unnecessary exposure to sunlight and wear protective clothing and sunscreen. Tell your doctor immediately if you develop a sunburn while on doxycycline monohydrate.

If you are taking doxycycline to prevent malaria, make sure you take other precautions, such as using insect repellent and mosquito nets, covering your body, and staying indoors between dusk and dawn for complete protection.

Tell all your doctors you are on doxycycline monohydrate before any surgery, including dental procedures.

Doxycycline Monohydrate Drug Interactions

Certain other drugs can affect how doxycycline monohydrate works. Possible drug interactions with other medicines can increase the risk of severe adverse effects. The following medications can have interactions with doxycycline monohydrate:

Retinoids such as acitretin and isotretinoin (Absorica, Myorisan, Zenatane) which are used to treat skin conditions such as psoriasis and severe acne

Anticoagulants or blood thinners such as warfarin (Coumadin, Jantoven)

Medications used to treat gastrointestinal discomfort, such as bismuth subsalicylate

Anticonvulsants such as carbamazepine (Tegretol, Epitol, others), phenobarbital, and phenytoin (Phenytek)

Other antibiotics such as penicillin

Proton pump inhibitors such as pantoprazole (Protonix), omeprazole (Prilosec, Zegerid, in Talicia), esomeprazole (Nexium, in Vimovo), lansoprazole (Prevacid), dexlansoprazole (Dexilant), and rabeprazole (Aciphex)

The above list may not describe all the potential interactions of doxycycline monohydrate. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, nonprescription drugs, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

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