Side Effects of Doxycycline

Common Side Effects

The American Academy of Dermatology notes that anorexia, glossitis, dysphagia, and enterocolitis can occur in patients taking doxycycline 1
The American Academy of Dermatology and Thorax report that esophagitis and esophageal ulcerations are notable risks, particularly when tablets/capsules are taken immediately before lying down 1, 2
Vaginal candidiasis can occur with any antibiotic therapy, including doxycycline, as reported by the American Academy of Dermatology 4

The American Academy of Dermatology and Thorax warn that Stevens-Johnson syndrome, toxic epidermal necrolysis, and erythema multiforme are rare but potentially life-threatening side effects of doxycycline 1, 2
Exfoliative dermatitis has been reported by the American Academy of Dermatology, although it is uncommon 1
Photo-onycholysis (nail separation due to light exposure) can occur, as reported by Thorax 2
Hemolytic anemia, thrombocytopenia, neutropenia, and eosinophilia have been reported by the American Academy of Dermatology and Thorax 1, 2

The Centers for Disease Control and Prevention recommend taking doxycycline with a full glass of water (8 ounces) and remaining upright for at least 1 hour after administration to prevent esophagitis 6, 7
Patients should be advised to avoid direct sun exposure or UV radiation during treatment to prevent photosensitivity, as recommended by the American Thoracic Society and the Centers for Disease Control and Prevention 2, 6

The American Academy of Dermatology recommends monitoring patients for skin reactions throughout the entire treatment course, with particular vigilance during the first 2 weeks 3
For long-term therapy (>1 month), routine toxicity monitoring with complete blood count, renal function, and liver function tests should be performed intermittently, as recommended by Thorax 2

The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists note that doxycycline is contraindicated in pregnancy (Category D) except for life-threatening illness 1, 8
Doxycycline is distributed into milk, and nursing or the drug should be discontinued, as recommended by the American Academy of Pediatrics 1
The American Academy of Pediatrics warns that children <8 years of age are at risk of permanent tooth discoloration and enamel hypoplasia 1, 2, 6