Doxycycline Alternatives: Other Treatment Options and Additional Ways to Save

Doxycycline (Vibramycin, Doryx, others) is a popular prescription antibiotic that’s been around since the 1960s. It’s a versatile medication because it treats several types of bacterial infections. Tick-borne illnesses and sexually transmitted infections (STIs) are just a couple of examples. But doxycycline may not be the right option for everyone.

You may be curious about what doxycycline alternatives are available. Knowing more about your options can help you and your healthcare provider decide on the best treatment plan for your situation. 

What is doxycycline?

Doxycycline is a prescription antibiotic. It’s FDA approved to treat a wide range of bacterial infections. Depending on the infection, doxycycline may be chosen as a first-choice treatment. In other cases, it may serve as a back-up option. Approved uses include:

• Infections caused by ticks, like Rocky Mountain spotted fever (RMSF) 

• Acne that’s caused by bacteria

• Urinary tract infections (UTIs)

• STIs, like chlamydia and gonorrhea  

• Respiratory tract infections

• Anthrax

• Cholera

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Oracea, a specific form of doxycycline, is approved to treat rosacea — a skin condition that causes facial redness. Doxycycline is also approved to prevent malaria. Malaria is a disease spread by parasites found in certain mosquitoes.  

It’s technically an off-label use, but doxycycline is also a go-to medication for treating Lyme disease. Lyme disease is caused by tick bites, but it’s slightly different from RMSF.

How is doxycycline dosed and given?

Doxycycline comes as a capsule, tablet, and delayed-release tablet. It’s also available as an oral suspension (liquid) if you have trouble swallowing pills. It’s less common, but doxycycline can also be given as an infusion into your vein at the hospital.

Doxycycline’s dosage — along with the length of treatment — typically depends on your age and what you’re taking it for. For adults, the typical dosage is 100 mg (1 capsule) by mouth once or twice daily. If your child needs to take doxycycline, your healthcare provider will calculate the dose based on their body weight. Kids weighing 45 kg (99 lbs) or more can receive the adult dose. But the typical dosage for kids weighing less than 45 kg is 2.2 mg per kg of body weight, taken once or twice daily.

Your healthcare provider and pharmacist can determine the right doxycycline dose for you or your child.

How does doxycycline work?

Doxycycline belongs to a group of medications known as tetracycline antibiotics. It works by preventing bacteria from growing and spreading in the body.

Doxycycline is available in two forms: doxycycline monohydrate (Monodox, others) and doxycycline hyclate (Vibramycin, others). While they’re considered equally effective, there is one key difference to be aware of. Doxycycline monohydrate is absorbed more slowly in the stomach than doxycycline hyclate. Because of this, there may be a slightly lower risk of experiencing stomach upset with doxycycline monohydrate.

I can’t afford my doxycycline prescription — what are my options?

A few times a year, insurance companies update the list of prescription medications their plans will cover — adding and removing certain medications from their formularies. Through the years, doxycycline has been moved on and off different formularies. This has caused the price of doxycycline to fluctuate.

It’s natural to feel overwhelmed if you can’t afford your doxycycline prescription. One option is switching to a more affordable version of doxycycline — such as changing from doxycycline hyclate to doxycycline monohydrate. Your pharmacist and healthcare provider can help you with this. Another option is to try a different medication altogether.

Is doxycycline available over the counter?

No. Doxycycline isn’t available as an over-the-counter (OTC) medication. It’s only available with a prescription from your healthcare provider. However, certain doxycycline alternatives are available OTC.

Depending on your situation, your healthcare provider may prescribe doxycycline hyclate, doxycycline monohydrate, or another treatment.

What alternatives are there for doxycycline?

Finding the right antibiotic can be tricky. You may have trouble tolerating doxycycline’s side effects. Or it may not work for your infection. As mentioned, cost and accessibility can also be factors.

Thankfully, there are a variety of doxycycline alternatives available. Your healthcare provider may decide to switch you to another tetracycline antibiotic, such as minocycline. Antibiotics from other classes are also an option. But alternative medications will depend on your condition, symptoms, and medical history.

Doxycycline alternatives for acne and rosacea

There are a variety of OTC doxycycline alternatives that can help manage acne. Benzoyl peroxide and Differin Gel (adapalene) are two examples of OTC topicals available for acne treatment.

What’s more, several prescription medications for acne and/or rosacea management are available:

• Minocycline tablets, capsules, and foams: Acne and rosacea

• Clindamycin topical products (Cleocin-T): Acne

• Azithromycin tablets (Zithromax): Acne

• Metronidazole gels (MetroGel): Rosacea

Doxycycline alternatives for chlamydia and gonorrhea

Doxycycline is a first-choice medication for treating chlamydia in teens and adults. Two different antibiotics, azithromycin and levofloxacin, are considered doxycycline alternatives. 

However, if you or a loved one have gonorrhea that hasn’t spread to other areas of your body (uncomplicated gonorrhea), other antibiotics are recommended over doxycycline. A one-time injection of ceftriaxone into the muscle is a top choice for treating uncomplicated gonorrhea. Gentamicin plus azithromycin is another option.  

Doxycycline alternatives for UTIs

Doxycycline is approved to treat UTIs, but it isn’t always a go-to option. The following antibiotics are possible examples of first-choice treatment options for managing UTIs: 

• Sulfamethoxazole/trimethoprim (Bactrim)

• Amoxicillin/clavulanate (Augmentin)

• Nitrofurantoin (Macrobid, Macrodantin)

Doxycycline alternatives for Lyme disease and RMSF

If you’ve ever noticed a tick bite, you may be curious about treatment options. Doxycycline is an option in some situations.

There are doxycycline alternatives for treating Lyme disease, a common tick-borne illness. They include:

• Amoxicillin

• Cefuroxime

• Ceftriaxone

• Azithromycin

For RMSF, doxycycline should be used whenever possible. It’s the only medication shown to be effective. The antibiotic chloramphenicol is the only doxycycline alternative. But it carries a risk of serious side effects. These include anemia and gray baby syndrome — a life-threatening reaction to chloramphenicol in infants.  

How to save on doxycycline

If your healthcare provider does decide doxycycline — available as a brand-name and generic medication — is the right medication for you, know there are many ways to save. 

• Save with GoodRx. GoodRx can help you save over 90% off the average retail price of the generic version of doxycycline. Generic doxycycline hyclate’s price at certain pharmacies is as low as $6.72 with a free GoodRx discount. Generic doxycycline monohydrate's price at certain pharmacies is as low as $5.74 with a free GoodRx discount.

• Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Oracea’s patient assistance program, which offers the medication free of cost.

• Save with a copay savings card. If you have commercial insurance and meet eligibility requirements, Oracea’s price may be as little as $0 using a savings card from the manufacturer. Doryx MPC’s price may also be as low as $0 with a savings card from the manufacturer.

Why trust our experts?

Written by:

Jennifer Gershman, PharmD, CPh, PACS

Jennifer Gershman, PharmD, is a licensed pharmacist in Florida. She has worked in the pharmacy industry for more than 15 years and is currently a medical writer.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

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