How Long Does Doxycycline Take to Work? Plus, 6 More Doxycycline FAQs

Doxycycline (Vibramycin, Monodox, Acticlate) is an antibiotic medication that treats a variety of bacterial infections, including acne, malaria, and rosacea. It’s part of a group of medications called tetracycline antibiotics.

If you’ve been prescribed doxycycline, knowing some key information can help you get the most out of the medication. Here, we’ll answer seven frequently asked questions about the medication, including how long it takes doxycycline to work and how long doxycycline stays in your system.

1. How long does it take doxycycline to work?

How long it takes doxycycline to work depends on what’s being treated. Some infections and some infection symptoms can take longer to treat than others.

For example, it may take up to 24 to 48 hours (1 to 2 days) for a fever, a common symptom of bacterial infections, to improve. But this can vary based on the infection you’re treating and how severe it is.

It typically takes 1 to 2 weeks for doxycycline to completely clear an infection. With conditions like acne and rosacea, however, it can take several months for your skin to fully clear. Though, you might start seeing improvement within a couple of weeks.

2. How long does doxycycline stay in your system?

Doxycycline may stay in your system for several days after you finish treatment. But, even though doxycycline lasts a while in the body, it’s important not to skip doses. In order for the medication to work, your blood levels of doxycycline need to be high enough. This is why doxycycline is often taken twice a day. It ensures that your levels of doxycycline are high enough to actively treat your infection.

For other conditions, like acne and rosacea, taking doxycycline once a day is usually OK. These conditions can be effectively treated with doxycycline levels that aren’t as high.

3. Should you take doxycycline with food?

With most doxycycline products, it’s up to you if you want to take your dose with or without food. But taking it with food may help stomach upset, one of the most common doxycycline side effects.

With any doxycycline product, you should take your dose with a full glass of water and avoid laying down for 30 minutes after taking it. (That means not taking the medication right before bedtime). This will help you avoid throat irritation and the development of ulcers in your esophagus (esophagitis).

Good to know: Some specific formulations of doxycycline, including Oracea, should be taken on an empty stomach (at least 1 hour before or 2 hours after meals). Taking Oracea on an empty stomach helps it be absorbed better. But if you experience stomach upset that keeps you from taking your doses, talk to your provider about whether it’s OK to take the medication with food.

4. Can you take doxycycline alongside your other medications?

Some medications can increase or decrease doxycycline levels in the body. Increased doxycycline levels can raise your risk of side effects. Decreased doxycycline levels can lead to undertreatment of your infection.

Examples of medications that may interact with doxycycline include:

• Bismuth subsalicylate (Pepto Bismol)

• Warfarin (Coumadin, Jantoven)

• Penicillin antibiotics like amoxicillin

• Some seizure medications like carbamazepine (Tegretol)

While these medications can interact with doxycycline, you may need to take one of them anyway. Make sure to follow your healthcare provider’s dosage instructions if they recommend combining one or more of these medications with doxycycline. Your provider will likely monitor you closely for side effects that could indicate an interaction, too.

Certain medications and products should be separated from your doxycycline doses. This includes medications and over-the-counter (OTC) products that contain:

• Aluminum

• Calcium

• Magnesium

• Iron

Examples of products that contain these nutrients include common antacids, like Tums (calcium carbonate) and Mylanta Maximum Strength (aluminum hydroxide / magnesium hydroxide / simethicone). Many multivitamins and supplements also contain these nutrients.

You should take doxycycline at least 1 to 2 hours before or after ingesting any products that contain aluminum, calcium, or magnesium, including dairy products like milk and yogurt. And you should take doxycycline at least 2 hours before or 3 hours after taking any iron-containing medications.

Make sure your healthcare provider and pharmacist have an updated list of all the medications and supplements you take. They can check for doxycycline interactions and talk to you about how to manage them.

For more information, check out this GoodRx article on doxycycline interactions. 

5. What happens if you miss a dose of doxycycline?

If you miss a dose of doxycycline, try to take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and take the next one as scheduled. 

If you miss or skip several doses, this can decrease doxycycline’s effectiveness. So let your healthcare provider know if you’ve missed more than one dose. They may ask you to take doxycycline for an extra day or more.

6. Do you need to finish the full course of doxycycline, even if you feel better?

Yes, you should always take the full course of doxycycline that you’re prescribed. You may start to feel better before you’ve finished treatment, but don’t stop taking the medication until you’ve finished the course. 

If you stop taking it too soon, bacteria may continue to spread and your infection could be left undertreated or come back. Additionally, stopping antibiotic treatment too early could lead to antibiotic resistance and the development of “superbugs.” Antibiotic resistance is when an antibiotic becomes ineffective against bacteria it used to be able to treat. Superbugs are bacteria that have become resistant to many different antibiotics.

Why are superbugs and antibiotic resistance so dangerous? If antibiotics lose their effectiveness, people with infections caused by superbugs are at higher risk for severe health issues and death.

Good to know: Some people may need to take doxycycline for many weeks. For example, if you're prescribed doxycycline for malaria prevention, you should continue to take it for 28 days after you leave the area with elevated malaria risk. This is because people have been found to develop malaria up to 4 weeks after being exposed.

7. What if you experience side effects from doxycycline?

Many doxycycline side effects can be managed at home. Some tips for preventing or managing these doxycycline side effects include:

• Taking doxycycline with food to prevent nausea and stomach upset

• Avoiding direct sun exposure, and wearing sunscreen and protective clothing when you’re outside, to prevent sunburn (since doxycycline makes your skin more sensitive to the sun)

• Taking a probiotic supplement or eating probiotic-rich foods (like yogurt, kefir, etc.) to replenish healthy bacteria and avoid diarrhea while taking doxycycline

Other doxycycline side effects are more serious. They may require a call to your healthcare provider or, in some cases, immediate medical care. If you experience any of the following side effects, call 911 or seek emergency medical care:

• Bloody or uncontrolled diarrhea

• Skin rashes, especially any that involve blistering, pain, or peeling

• Intense nausea or vomiting that won’t go away

• Trouble swallowing that isn’t accompanied by signs of an allergic reaction, such as hives or trouble breathing

For more information, check out this GoodRx article on doxycycline side effects.

Ways to save on your doxycycline prescription

There are many ways to save on doxycycline, including:

• Saving with GoodRx: GoodRx may be able to help you save over 70% off the average retail price of generic forms of doxycycline. Doxycycline hyclate’s price at certain pharmacies may be as low as $6.72 with a free GoodRx coupon. And doxycycline monohydrate's price may be as low as $5.74 with a free GoodRx coupon.

• Saving with a copay savings program: If you have commercial insurance and meet eligibility requirements, Oracea and Doryx MPC may cost as little as $0 through the manufacturers’ copay savings programs.

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Written by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed 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.

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