Treatment Guides



Doxycycline is a member of the tetracycline family of antibiotics. Doxycycline is an adjunctive therapy used to treat moderate/severe acne. The typical length of treatment is 3 months. Near the completion of the oral antibiotic course, your Alpha clinician will recommend a maintenance regimen of skin care products to reduce your risk of recurrence of papules, pustules, and cysts.


Doxycycline should be taken exactly as directed. Skipping doses or not completing the full course of therapy or stopping your topical skin care regimen and taking doxycycline alone to treat acne may

  • Decrease the effectiveness of the immediate treatment
  • Increase the likelihood that bacteria will develop resistance and will not be treatable by doxycycline or other antibacterial drugs in the future.

You should not take doxycycline if you have a history of hypersensitivity to any of the tetracyclines.

Adverse effects/toxicities include:

Gastrointestinal: anorexia, nausea, vomiting, diarrhea, glossitis, dysphagia, enterocolitis, inflammatory lesions (with monilial overgrowth) in the anogenital region, hepatotoxicity, esophagitis, or esophageal ulcerations

Skin: toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme, maculopapular and erythematous rashes, exfoliative dermatitis, or photosensitivity

Renal: rise in blood urea nitrogen (dose-related)

Hypersensitivity reactions: urticaria, angioneurotic edema, anaphylaxis, anaphylactoid purpura, serum sickness, pericarditis, or exacerbation of systemic lupus erythematosus

Blood: hemolytic anemia, thrombocytopenia, neutropenia, or eosinophilia

Other: bulging fontanels, intracranial pressure

Interactions Antacids (e.g., aluminum, calcium, magnesium containing), oral contraceptive pills, oral anticoagulants, anticonvulsants, bismuth subsalicylate, iron-containing preparations, methoxyflurane, penicillins, proton-pump inhibitors, oral retinoids, and urinary catecholamine assay

While taking doxycycline, to reduce your risk of skin irritation and redness:

  • Avoid excessive sunlight or artificial ultraviolet light
  • Use sunscreen or sunblock,
  • wear a hat and UV-protected clothing

Discontinue therapy if phototoxicity (e.g., skin eruptions, etc.) occurs. Notify your Alpha clinician.

Drink fluids liberally along with doxycycline to reduce the risk of esophageal irritation and ulceration.

Absorption of tetracyclines is reduced when taken with foods, especially those that contain calcium. However, the absorption of doxycycline is not markedly influenced by simultaneous ingestion of food or milk.

Absorption of tetracyclines is reduced when taken with antacids containing aluminum, calcium or magnesium, bismuth subsalicylate, and iron containing preparations.

Diarrhea is a common problem caused by antibiotics which usually ends when the antibiotic is discontinued. Sometimes after starting treatment with antibiotics, patients can develop watery and bloody stools (with or without stomach cramps and fever) even as late as two or more months after having taken the last dose of antibiotic. If you experience this, contact your primary care clinician as soon as possible and notify your Alpha clinician.


  • Use of doxycycline might increase the incidence of vaginal yeast infections. To prevent a vaginal yeast infection, consider eating yogurt with live cultures (e.g., acidophilus) or douching with plain yogurt with live cultures or taking oral acidophilus tablets or probiotic suppositories while taking doxycycline.
  • Use of doxycycline may reduce the effectiveness of oral contraceptive pills, according to the FDA. Use a backup form of pregnancy prevention while on doxycycline. We recommend that you always use condoms to reduce your risk of sexually transmitted infections.

Pregnant Women

There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Nursing Mothers

Doxycycline is distributed into the milk. Discontinue nursing or the drug.

Pediatric Use

Safety and efficacy not established

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