Bacterial infections of various types continue to afflict a significant percentage of the global population. Various medications are presently used to treat the conditions, including combination treatments comprising two or more drugs. One of the commonly prescribed antibiotic formulations includes doxycycline, that is typically used in the treatment of STDs, various skin, eye, respiratory and other infections. Following subsections offer a detailed view of the drug and possible side effects of doxycycline to help users identify, prevent or mitigate the undesirable outcomes of the drug.

Overview of doxycycline

Belonging to the category of tetracycline antibiotics, doxycycline is prescribed to treat various bacterial infections. In addition to infections, the drug is also used as a drug to prevent malaria, and is part of combination treatment for acne. The suitability of the drug for various infections depends on the susceptibility of the bacterial strains to the formulation. The medication is available in oral form either as a capsule, tablet or solution. It is also available as a solution to be administered as an injection in a hospital. The oral tablets come both in immediate release and delayed release formulations. The advantage or standout property of the medication as a second-generation tetracycline, is the relatively lesser toxicity when compared with first-generation medications belonging to the tetracycline category.

How does the medication work?

The medication is known to have a bacteriostatic property in fighting infections. Replication of bacteria happens on the ribosome, and medications belonging to the category of tetracyclines prevent translation initiation of proteins. This is achieved by binding tRNA to the bacterial ribosomal subunit, blocking the initiation of protein synthesis.  This in turn prevents the replication of bacteria, thereby helping fight the infection effectively.

The tablet can be taken either with food or without food. The tablets may be cut, depending on the dosage or inability of patients to swallow whole tablets. Excessive dosage or incorrect schedule are considered as common reasons for side effects in medications. It is therefore necessary to follow dosage instructions with utmost care to prevent undesirable effects. Patients who have missed a dose during the scheduled dosage are not to take a double dose to make up for the missed dosage. This is likely to cause strong undesirable effects and when the drug is in the body for a longer time, the effects may linger longer.

Commonly reported side effects of doxycycline

All medications come with the possibility of undesirable effects in addition to the expected outcomes. Doxycycline is no exception and has its own share of possible unexpected outcomes, despite being labelled as a medication with relatively lesser toxicity. Side effects are generally of two categories – mild or moderate effects and serious or adverse effects. The mild or moderate effects are known to resolve faster without the need for any medical intervention. The serious or adverse effects require medical attention, and depending on the type of effects may also require emergency medical attention.

The mild effects are known to be commonly occurring in nature, while the serious effects are relatively rare. Not all users are likely to experience effects, with a section of users known to be free from all side effects whatsoever. The intensity and type of the effects depend on various factors; for instance, the strength of the dosage, the schedule, the duration, the condition being treated, the age of the patient, the gender, overall health of the patient, existing conditions and medications in use. It is therefore necessary for all patients to clearly explain their conditions and use of medications to the specialist to help prevent undesirable effects. The following compilation of effects is neither exhaustive nor complete in nature and is intended to list out broad categories of undesirable effects.

Frequently occurring effects

Patients on the drug are likely to experience a sudden loss of appetite, and as a result may end up losing weight. Additional effects include possible vomiting sensation that may accompany feelings of nausea. The outbreak of rashes on the skin are also a possible outcome, and individuals may experience discernible changes similar to that of hives. Other effects include sensitivity to exposure to sunlight. Patients who experience this effect are to wear a suitable sunscreen, apart from appropriate clothing, to prevent sunburn and rashes.

Diarrhea is another possible outcome, which needs to be monitored with care. Diarrhea that is persistent is a cause for concern, as explained in detail in subsequent sections. Discoloration of the teeth is another condition that may be experienced with the medication. Adults with discolored teeth will find that the effect is temporary and can be handled with professional cleaning after the medication is discontinued. However, children below the age of eight experience a different effect, explained in subsequent sections.

Effects that are a cause for concern

The following effects are a cause for concern and need to be addressed with the right kind of intervention. For instance, diarrhea with traces of blood in feces needs to be treated quickly before it goes out of hand and turns fatal. Similarly, diarrhea that is persistent or severe is a cause for concern and needs to be resolved. Patients experiencing pain the stomach that is similar to cramps are to report the same to the specialist. Other conditions that warrant medical attention include fever, and abnormal dehydration.

Any irritation in the esophagus is also to be reported. Symptoms that are indicative of this include a distinct burning sensation in the chest, or pain in the chest that is not attributed to any other condition. Anemia is also another condition that needs urgent attention before it turns serious in nature. Patients are also likely to end up with pancreatitis, and symptoms that are indicative of this condition include pain in the upper portion of the abdomen, and pain that increase when consuming food.  Similarly, skin reactions are also to be monitored with care to ensure that adverse reactions are dealt with, on time and appropriately.

Precautions to be taken when on doxycycline

Patients are advised to take suitable precautions when on the medication. This will help prevent or lessen the possibility of commonly reported experiences of users.

#1 Dental conditions

For instance, there is the possibility of a change in the color of teeth when on the medication. As this change is possibly permanent in nature, it is extremely important for users to be aware of the impact. Women in advanced stages of pregnancy need to know that children exposed to the drug, till the age of eight may end up with discoloration of the teeth.

#2 High blood pressure in skull

There are other potential warnings that need to be considered when on the drug. Patients may experience high blood pressure in the skull, in a condition that is medically known as intracranial hypertension. Consequently, the patient may experience an impact in vision, have frequent headaches, and could sometimes also lose partial vision. Individuals are expected to immediately intimate any tell-tale symptoms to the treating specialist, such as swelling in the eyes. 

#3 Allergies

Individuals on the medication may experience skin allergies or reactions during the course of treatment. This could be serious in nature, and it is essential for users to be fully aware of the possible reactions. This includes epidermal necrolysis, and idiosyncratic reactions such as DRESS, acronym for drug rash with eosinophilia and systemic symptoms. Patients may also experience another reaction, medically known as Stevens-Johnson syndrome. Users are to look out for any abnormal changes or symptoms that indicate skin reactions, and report the same to the specialist. There could be easily discernible and visible symptoms that can help treat the outcome early.

#4 Severe diarrhea and colon infection

The medication may also trigger diarrhea that could be either severe or mild in nature. This is a common condition that may be experienced with other antibiotics as well. Infection of the colon is also a possibility, and this is regarded as extremely serious as it could be life threatening in nature. Patients experiencing persistent diarrhea when on the medication, are to consider it as an extreme reaction and immediately report the same to the treating specialist.

#5 Impact on bone growth in children

The medication is also known to impact the bone growth of children. However, the silver lining of this effect is the reversible nature, wherein the delayed bone growth can be reversed when the medication is stopped. Pregnant women in advanced stages of pregnancy, on the medication, are likely to cause this condition in the new born, and are to take advice of the specialist regarding its use.

Drug interactions of doxycycline

In addition to side effects, drugs are also known to exhibit drug interactions when taken alongside other medications. This could be other prescription medications, OTC products, herbal formulations, supplements, natural remedies, and alternative treatment options. Unlike side effects of medications that are experienced differently by different patients, drug interactions are generally the same for all patients. For instance, drug interactions could be broadly classified into three different categories. When two or more drugs are taken at the same time for different health conditions, either or both the medications may end causing an increase in the potency of the drug(s). As a result, the actual outcomes may be more than the desired outcomes. Similarly, either or both the medications may have lesser than desired efficacy due to the interactions between the two products. The third outcome could be aggravation of existing side effects of either or both the medications.

It is therefore necessary for individuals on the medication to clearly list out all other drugs, formulations, OTC products, and supplements in use. Specialists avoid or mitigate the possible interactions by temporarily halting one of the two medications, by evaluating the importance of each. In the event that it is absolutely necessary to take both the medications, the dosage is modified, or the schedule is changed. This helps to lessen the intensity of the possible interaction. With the possible side effects of doxycycline listed above, it is now time to look at the interactions. This is not a complete list, and is intended to show categories of medicines that may interact with doxycycline in some manner.

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