5 Common Tetracycline Side Effects You Should Know About

Tetracycline is one of the oldest antibiotics in use today. It was discovered in the late 1940s, several years after penicillins and sulfa antibiotics.

You may have heard certain antibiotics referred to as tetracycline antibiotics. That’s because there are other medications that work very similar to tetracycline. These include doxycycline (Vibramycin, Doryx) and minocycline (Minocin). These newer antibiotics tend to be more commonly used than tetracycline. But, tetracycline can still treat certain bacterial infections.

If you’re prescribed tetracycline, it’s most likely being used to treat acne. However, tetracycline can cause many different side effects. So, it’s important to know what to expect before taking this medication.

In this article, we’ll discuss some tetracycline side effects to be aware of. Plus, we’ll review a common concern with tetracycline: teeth staining in kids.

What does tetracycline do in the body?

When taken by mouth, your body absorbs tetracycline into the bloodstream, which then flows throughout the body. When the medicine comes in contact with certain types of bacteria, it enters the bacteria cells. Then, it attaches to certain proteins inside the bacteria. This stops them from growing.

As an example of how tetracycline works, let’s consider its effect on Propionibacterium acnes (P. acnes). This is a type of bacteria that causes acne. After you take tetracycline, it can attack P. acnes and help stop it from growing. Once the bacterial growth stops, your body’s immune system can get rid of the bacteria.

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Tetracycline also helps to lower inflammation (swelling) in our cells, which helps lessen the redness experienced with acne. These actions help relieve acne symptoms, like pimples.

5 tetracycline side effects to know about

Like all medications, tetracycline has a possibility of causing side effects. Many common side effects are mild. But some are more serious or long-term and may need medical attention.

1. Gastrointestinal side effects

Tetracycline can affect the gastrointestinal tract (stomach and intestines). It can cause side effects like nausea, vomiting, and diarrhea. 

Some people have also reported trouble swallowing, black hairy tongue, and inflammation of the intestines (enterocolitis). But these tend to be less common than other gastrointestinal effects.

2. Esophagus damage

Tetracycline can cause inflammation of the esophagus (the tube that connects the mouth and stomach). The risk of this side effect is higher when people take a dose shortly before bed. Tetracycline can also cause ulcers in the esophagus, but this is rare. 

3. Sun sensitivity and skin side effects

If you’re taking tetracycline, your skin may be more sensitive to the sun. This means you may get sunburned more easily. While taking tetracycline, you should try to avoid direct sunlight. Be sure to use sunscreen when you’re outdoors. This is important year round, not just during the warmer months.

Skin rash and nail discoloration have also been reported with tetracycline. If you develop a wide-spread skin rash, or a rash along with a fever, contact your healthcare provider right away. These are symptoms of more serious medication-related rashes.

4. Teeth staining

Teeth staining is a tetracycline side effect you may have heard of before. If taken while your teeth are still growing, this medication can cause permanent teeth staining. We’ll discuss this side effect in more detail below. 

5. Bone development problems

Tetracycline can cause problems with developing bones in unborn babies. This can lead to severe birth defects. For this reason, tetracycline should be avoided in pregnancy.

Tetracycline can also cause bone problems for premature infants (babies born earlier than expected). But this side effect is typically reversible for this group once the antibiotic is stopped.

What are the long-term side effects of tetracycline?

If you take tetracycline for a long time, it can cause more serious side effects. Long-term tetracycline side effects include:

• Liver damage, especially in people with kidney problems

• Kidney damage for people with kidney problems

• Low white blood cells or low platelets in the blood

• Severe diarrhea

If you’re taking tetracycline long-term, you may need regular blood tests. This can help watch for problems with your kidneys, liver, or blood cells. Regular blood tests can help prevent serious problems by catching them early.

How can tetracycline affect your teeth?

Tetracycline can cause teeth staining. It can also cause loss of tooth enamel. These teeth-related side effects were first reported in children in the 1950s. Teeth staining tends to happen with long-term tetracycline treatment. But repeated short-term treatments can also stain your teeth. Experts believe this side effect happens to 3% to 6% of people taking tetracycline or minocycline (a similar antibiotic).

Teeth staining can happen with tetracycline any time during tooth development. This side effect can also happen to unborn babies if they’re exposed to the medication during pregnancy. This is why tetracycline isn’t recommended for pregnant women or children 8 years of age and younger. There are some reports of adults experiencing teeth staining with tetracycline, too. But this side effect hasn’t been well-studied in adults.

If you think you have teeth staining from taking tetracycline, there are a few ways to fix it. But they may be costly. Your dentist may be able to professionally bleach teeth or scrape off discolored areas. They can also cover the areas with crowns or veneers. Some people need a combination of treatments to fix tetracycline teeth staining. It’s best to speak with a dentist to discuss which options would be best for you.

What should be avoided when taking tetracycline?

As mentioned earlier, you should avoid direct sunlight when taking tetracycline. You should also avoid taking tetracycline within a few hours of taking antacids, iron, or zinc. They can lower absorption of tetracycline.

Tetracycline can also interact with other medications. This includes penicillin and oral birth control pills. It’s important to share a complete medication list with your pharmacist and healthcare provider. They can let you know if you need to make any medication changes to help limit these interactions.

As discussed above, you should also avoid taking tetracycline if you’re pregnant. Tetracycline is one of the antibiotics typically avoided during pregnancy. If you’re taking tetracycline and have become pregnant, contact your healthcare provider right away to discuss next steps.

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Written 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.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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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