Dude, Where’s My Doxy? Tips to Survive the Shortage of Doxycycline

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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In the states most affected by Lyme disease, there have been shortages of doxycycline, resulting in panic and high costs. If you are unlucky enough to contract Lyme disease this year you may pay a ton for your doxycycline, if you can find it. But I think I can help.

Doxycycline is used for the treatment of early Lyme disease and as a result, there is a shortage in states like Maine where Lyme disease is common. Some folks are paying 500 times the regular cost of doxycycline. Another concern is that doxycycline is the drug of choice for several other conditions, like Chlamydia and acne, so those folks may suffer too.

Here is what you should talk to your doctor about if you can’t get your doxy or don’t want to pay hundreds for it.

1. If you have Lyme disease, two other antibiotics have been shown to work just as well. In good clinical trials, oral doxycycline, amoxicillin, and cefuroxime axetil (Ceftin) were shown to have equivalent efficacy for the treatment of early Lyme disease. That’s good. Having said that, if you can get doxy and it’s not too expensive, get it, because of those oral medications doxycycline has the best penetration into the central nervous system.

2. If you need doxycycline for Chlamydia, a dose of azithromycin (Zithromax) is an equally good option.

3. If you take doxy for acne, ask about minocycline, azithromycin, erythromycin or other first line options to avoid high costs.

4. Shop around, and talk to your doctor about which form of doxycycline will work for you. Prices can vary quite a bit based on whether you need a capsule or a tablet, or doxcycline monohydrate or hyclate. You can still get 60 tablets of doxycycline hyclate 20 mg for $15 at Walgreens, or $9.99 at Rite-Aid, after their annual membership fees. At other grocery store or warehouse pharmacies, a coupon could bring your out of pocket cost to around $25 – $30 for 60 tablets of the 100 mg dose.

Yes, drug shortages stink, as many of you saw with the generic ADHD meds, so we need to be more proactive about predicting a spike in use so you don’t end up paying huge costs for doxycycline . . . which should cost pennies.

Dr O.

Cash prices for doxycycline are still very high, from around $100 to well over $500 for 60 pills, depending on the dose and form. If you can find it at the right pharmacy though, doxycycline may still be your best option, with some discounts or coupons as low as $10.
Dosage quantities will vary with other medications, but courses of azithromycin and amoxicillin are very affordable, typically under $20, sometimes lower, and they’re often included in pharmacy discount programs. Ceufuroxime axetil is a little bit more pricey, around $25 – $30. Minocycline and erythromycin are more expensive, starting at $50 and going up to $200, even with a coupon or discount; these may be better options if you can’t find doxycycline or if you have insurance that will cover your prescription.

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