7 Doxycycline Side Effects You Should Know About

Doxycycline (Oracea, 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 conditions, such as pneumonia and preventing sexually transmitted infections.

No matter what you’re taking it for, doxycycline can cause side effects. It’s helpful to know what to expect before taking the medication and what steps to take if side effects occur.

Doxycycline side effects at a glance

Below, we’ve listed common and rare doxycycline side effects. Doxycycline comes in two forms: doxycycline monohydrate and doxycycline hyclate. But the side effects are similar, no matter which type you’re taking. Keep in mind that this isn’t a comprehensive list. So talk to your healthcare team if you’re concerned about any side effects you’re experiencing.

Mild doxycycline side effects include:

• Nausea or vomiting

• Diarrhea

• Sun sensitivity

• Sore throat or trouble swallowing

• Vaginal yeast infection

• Itchy skin and rash (urticaria)

Rare but serious doxycycline side effects include:

• Ulcers in the esophagus

• Severe skin rashes

• Liver problems

• Tooth discoloration in children

• Clostridioides difficile (C. diff) diarrhea

• Intracranial hypertension (high pressure around the brain)

• Low blood cell counts

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• Doxycycline interactions: Did you know that you shouldn’t take vitamins that contain iron with doxycycline? Learn more about possible doxycycline interactions.

Let’s take a closer look at seven doxycycline side effects and how to manage them.

1. Nausea and other stomach-related side effects

Stomach-related issues are some of the most common doxycycline side effects. These include nausea, vomiting, and loss of appetite. Mild diarrhea is also possible, but it isn’t common.

You can take most forms of doxycycline with or without food. Taking them with food can help limit stomach-related side effects. But some versions of doxycycline, such as Oracea, should only be taken on an empty stomach. Check with your pharmacist to see if it’s OK to take your form of doxycycline with food.

Other at-home remedies to help manage stomach-related side effects include:

• Avoiding spicy or greasy foods

• Staying hydrated

• Eating smaller, more frequent meals

• Drinking ginger or peppermint tea

If you’re only taking doxycycline for a short period of time, any stomach-related side effects you experience should go away once you finish your course of treatment. But if you’re taking doxycycline regularly, such as for acne, it may be more of an issue for you. 

Keep in mind that you should avoid taking antacids or Pepto-Bismol (bismuth subsalicylate) with doxycycline. They can prevent the antibiotic from working properly. If your stomach issues become bothersome and home remedies don’t help, talk to your healthcare team about options that won’t interact with doxycycline.

2. Sensitivity to the sun

When you’re taking doxycycline, your skin may become more sensitive to the sun. This means you may get sunburned more easily. Your sunburns can also be more severe than usual. 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.

If you do get a sunburn, keep your skin moisturized and do your best to avoid further sun exposure. A cool bath along with an anti-inflammatory medication, such as ibuprofen (Advil, Motrin) can help relieve pain if needed.

3. Sore throat or trouble swallowing

Doxycycline can be irritating to your throat as well as your stomach. In rare cases, it can cause irritation or ulcers along the esophagus (the tube connecting the mouth and stomach). This is also known as esophagitis. Symptoms include trouble swallowing and burning or pain in the throat, chest, or upper stomach area.

You can help prevent this side effect by taking doxycycline with a full glass of water (at least 8 oz). You should also remain upright for at least 30 minutes after taking it. Let your prescriber know if you have trouble swallowing pills, as this can raise your risk of throat issues while taking doxycycline.

If throat irritation happens, it should go away on its own after you stop taking doxycycline. But if you take doxycycline regularly, your prescriber may recommend taking an acid reducer, such as omeprazole (Prilosec) or famotidine (Pepcid AC), to help protect your throat and stomach. Remember to avoid antacids, as they can interact with doxycycline. If your throat pain becomes severe or you have trouble swallowing while taking doxycycline, let your prescriber know right away.

Good to know: Trouble swallowing can also be a sign of an allergic reaction to doxycycline. In this case, you may also notice a rash and have trouble breathing or a swollen mouth and tongue. If you think you’re having an allergic reaction to doxycycline, seek emergency care or call 911 right away.

4. Yeast infections

Vaginal yeast infections are common after taking antibiotics, including doxycycline. This is because doxycycline kills some of the good bacteria that normally protect the body. Without this protection, fungi can grow more easily, leading to an infection.

Symptoms of a vaginal yeast infection include itching, irritation, and unusual discharge. To help prevent vaginal yeast infections, it’s best to wear cotton underwear and avoid tight-fitting pants while taking doxycycline. Avoid douching and using vaginal sprays or deodorants, too.

Fungal infections of the mouth or throat (oral thrush) are also possible. Symptoms include white or yellowish patches on the tongue or throat, pain when eating or swallowing, and loss of taste. 

If you develop symptoms of a yeast infection, keep taking your doxycycline and contact your prescriber for a treatment recommendation. They may suggest an over-the-counter (OTC) treatment, or they may prefer a prescription option. You’ll likely need to take a prescription antifungal to treat oral thrush.

5. Severe diarrhea

Mild diarrhea from doxycycline can usually be managed at home. But in rare cases, doxycycline can cause a severe form of diarrhea known as clostridioides difficile colitis, or C. diff.

As with yeast infections, C. diff happens when antibiotics kill off the protective bacteria in your gut. If C. diff overgrows, it can cause severe, watery diarrhea along with a fever and stomach cramps.

This infection can be life-threatening if it isn’t treated. So if you experience severe diarrhea while taking doxycycline or within a month or two of finishing it, contact your prescriber or seek medical care right away.

6. Severe skin reactions

Very rarely, severe skin rashes, such as Stevens-Johnson syndrome (SJS), can occur while taking doxycycline. Symptoms include a widespread rash along with blisters, fever, or flu-like symptoms. 

If you notice any skin rashes while taking doxycycline or in the weeks after finishing it, contact your prescriber right away. These rashes can become life-threatening if not treated quickly.

7. Persistent headache or vision changes

While rare, a condition called intracranial hypertension (increased pressure on the brain) can happen while taking doxycycline. The risk of this side effect is higher for premenopausal women with overweight or obesity. Symptoms include a persistent headache, double vision, and vision loss. Nausea and vomiting are also possible.

If you experience a persistent headache or changes in your vision while taking doxycycline, contact your prescriber or seek medical care right away. In most cases, your symptoms will resolve with treatment.

Can doxycycline cause tooth staining?

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

Tooth discoloration was first reported in the 1950s in children taking tetracycline. Since doxycycline belongs to the same class of antibiotics, it also carries a warning about the potential to cause tooth staining in children under the age of 8. 

But more recent studies suggest that doxycycline doesn’t have an increased risk of tooth staining in children. While these results are promising, larger studies are needed to confirm them. To be safe, it’s best for children to only take doxycycline for short amounts of time when other antibiotics aren’t an option.

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Written by:

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP, has over a decade of experience as a pharmacist, professor, and researcher. She was a full-time clinical professor in the pharmacy practice department at D’Youville School of Pharmacy before subsequently joining the faculty of the pharmacy practice department at the University at Buffalo School of Pharmacy and Pharmaceutical Sciences.

Edited 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.

Reviewed by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

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