Quick Answer
Doxycycline is an antibiotic that can commonly cause diarrhea as a side effect. However, diarrhea caused by doxycycline is usually mild and goes away on its own. It is generally recommended to continue taking doxycycline as prescribed even if you develop diarrhea, unless the diarrhea becomes severe. Discuss any concerns about diarrhea with your doctor before stopping doxycycline.
What is Doxycycline?
Doxycycline is a broad-spectrum antibiotic that belongs to a class of antibiotics called tetracyclines. It is used to treat a wide variety of bacterial infections, including respiratory infections like pneumonia and sinusitis, skin infections, eye infections, and sexually transmitted diseases like chlamydia and gonorrhea.
Some common brand names for doxycycline include Vibramycin, Monodox, and Adoxa. It comes in oral tablet, capsule, and liquid suspension forms.
Doxycycline works by preventing bacteria from reproducing. It binds to the 30S ribosomal subunit of bacteria and blocks the synthesis of proteins that the bacteria need to survive.
Common Uses of Doxycycline
Doxycycline is commonly prescribed for:
- Respiratory infections like pneumonia, bronchitis, sore throat, tonsillitis, sinus infections
- Skin infections like acne, rosacea, rashes
- Eye infections like conjunctivitis, blepharitis, keratitis
- Dental infections like gingivitis, periodontitis
- Sexually transmitted infections like chlamydia, gonorrhea, syphilis
- Lyme disease
- Malaria prevention
- Some urinary tract infections
- Other bacterial infections
Doxycycline is sometimes prescribed long-term at lower doses to treat inflammatory conditions like acne, rosacea, and osteoarthritis.
What Are the Side Effects of Doxycycline?
Like all medications, doxycycline can cause side effects. Some of the more common side effects of doxycycline include:
- Digestive issues: Nausea, vomiting, diarrhea, loss of appetite
- Skin irritation: Rash, photosensitivity (increased sensitivity to sun)
- Yeast infections: Oral thrush, vaginal yeast infections
- Tooth discoloration: Yellow-gray staining of developing teeth in children under 8 years old
- Headache, dizziness
Up to 20% of people taking doxycycline may experience diarrhea. The diarrhea is often mild but can sometimes be more severe.
Why Does Doxycycline Cause Diarrhea?
There are a few reasons why doxycycline may cause diarrhea:
- Doxycycline can irritate the stomach lining and alter gastrointestinal motility, resulting in loose stools or diarrhea.
- Doxycycline can change the normal balance of bacteria in the intestines, allowing some harmful bacteria like Clostridium difficile to overgrow, resulting in diarrhea.
- Doxycycline is partially broken down by intestinal bacteria. Changes to the microbiome from doxycycline can affect digestion and stool consistency.
- Doxycycline may stimulate increased bile acid secretion into the intestines, leading to secretory diarrhea.
For most people, doxycycline-related diarrhea is mild and resolves on its own within a few days without intervention. However, if diarrhea becomes severe, it’s important to contact your doctor.
Should I Stop Taking Doxycycline if I Get Diarrhea?
Mild diarrhea is common with doxycycline and not usually a reason to stop taking the medication. However, if the diarrhea becomes severe, you may need to stop doxycycline temporarily.
Here are some general guidelines on what to do if you develop diarrhea while taking doxycycline:
- Mild diarrhea – loose stools up to 3 times daily: You can continue taking doxycycline as long as you stay well hydrated.
- Moderate diarrhea – loose stools 4-6 times daily: Continue doxycycline but drink more fluids. Consider taking an over-the-counter anti-diarrheal medication like loperamide (Imodium). Call your doctor if diarrhea persists more than 24 hours.
- Severe diarrhea – loose stools 7 or more times daily: Stop taking doxycycline and call your doctor right away. Severe diarrhea can lead to dehydration and electrolyte imbalances. You may need IV fluids and electrolyte replacement.
- Bloody diarrhea with fever and abdominal pain: This could indicate a serious condition like C. diff infection. Stop doxycycline and see your doctor immediately.
Key Points
- Continue doxycycline if you have mild diarrhea – up to 3 loose stools daily.
- Call your doctor if diarrhea persists more than 24 hours or you have 4 or more loose stools per day.
- Stop doxycycline immediately and call your doctor if you have severe diarrhea with 7+ stools daily or bloody diarrhea with fever and abdominal pain.
Always drink plenty of water or electrolyte beverages like Gatorade to prevent dehydration from diarrhea. Avoid dairy products, greasy or spicy foods, alcohol, and caffeine until diarrhea improves.
How Long Does Doxycycline-Related Diarrhea Last?
For most people, diarrhea caused by doxycycline is temporary and resolves within a few days of stopping the medication.
However, the duration can vary:
- Mild cases may resolve within 24-48 hours
- Moderate cases may last 3-5 days
- Severe cases linked to an infection like C. diff may persist for weeks after doxycycline is stopped
If diarrhea lasts more than 3-5 days after finishing your doxycycline prescription, contact your doctor. You may need additional treatment to resolve the issue.
How to Treat Doxycycline-Induced Diarrhea
Here are some methods you can try at home to treat mild diarrhea caused by doxycycline:
- Drink plenty of clear fluids to prevent dehydration. Water, broths, electrolyte beverages, juices without pulp.
- Eat bland foods like bread, crackers, applesauce, bananas, rice, toast.
- Avoid greasy, spicy, high-fiber, or very sugary foods until diarrhea improves.
- Take over-the-counter anti-diarrheals containing loperamide (Imodium) or bismuth subsalicylate (Pepto-Bismol). Use as directed.
- Consider probiotics with Lactobacillus and Saccharomyces strains to help restore normal gut bacteria.
- Rest your stomach by eating smaller, more frequent meals.
For severe dehydration, bloody stools, persistent fever, or inability to keep liquids down, seek medical care urgently. You may need IV fluids, electrolyte replacement, hospitalization, and more advanced treatments.
Medical Treatment
If home remedies don’t resolve doxycycline-related diarrhea, your doctor may recommend:
- Switching antibiotics
- Prescription anti-diarrheal medications
- Testing for infections like C. diff
- IV fluid and electrolyte replacement
- Medications to slow gut motility
- Probiotics to restore normal gut bacteria
How to Prevent Doxycycline Diarrhea
You can reduce your chances of developing diarrhea while taking doxycycline with these precautions:
- Take doxycycline with food, not on an empty stomach.
- Avoid alcohol and caffeine, which can worsen GI side effects.
- Stay well hydrated by drinking plenty of non-caffeinated fluids daily.
- Consider taking a probiotic supplement to support your gut microbiome.
- Avoid greasy, fatty, spicy or fried foods that are harder to digest.
- Call your doctor if diarrhea persists more than 24 hours.
Splitting your daily doxycycline dose may also help reduce diarrhea. For example, take 100 mg twice a day instead of 200 mg at once. Discuss the best dosing method with your doctor.
When to See a Doctor for Doxycycline Diarrhea
Contact your doctor right away if you experience:
- Severe diarrhea with 7 or more watery stools per day
- Persistent diarrhea lasting more than 3 days
- Bloody stools
- High fever over 101°F (38.3°C)
- Signs of dehydration – dizziness, dry mouth, infrequent urination
- Inability to keep down any fluids due to nausea/vomiting
- Abdominal cramping or tenderness
Severe dehydration and electrolyte imbalance from diarrhea can be dangerous. Seek medical care immediately in any emergency.
Frequently Asked Questions
Why do antibiotics cause diarrhea?
Antibiotics like doxycycline can cause diarrhea by killing off normal gut bacteria that aid digestion. This allows “bad” bacteria like C. difficile to overgrow, releasing toxins that damage the gut lining and cause inflammation and fluid leakage into the intestines.
Can you take a probiotic with doxycycline?
Yes, you can take a probiotic supplement while on doxycycline, as long as you space out the doses. Take doxycycline at least 2 hours before or after the probiotic. Probiotics can help restore the natural balance of bacteria in your gut.
What should you avoid eating when taking doxycycline?
Avoid greasy, spicy, fried, high-fiber, or very sugary foods. Stick to bland foods like rice, applesauce, toast, chicken, etc. Avoid caffeine and alcohol, which can worsen diarrhea. Drink plenty of clear fluids like water, broths, and electrolyte drinks.
How long after taking doxycycline does diarrhea start?
Doxycycline-related diarrhea usually begins within 1-2 weeks after starting the medication. It may resolve quickly once the drug is stopped, or last for several days afterward. Contact your doctor if diarrhea persists more than 3-5 days after finishing your prescription.
Can I take Imodium while on doxycycline?
Yes, taking loperamide (Imodium) or other over-the-counter anti-diarrheal agents can help control diarrhea from doxycycline. Use anti-diarrheals as directed, and stay hydrated by drinking extra fluids. Call your doctor if diarrhea remains uncontrolled with anti-diarrheal medication.
Conclusion
Diarrhea is a common side effect of the antibiotic doxycycline, occurring in up to 20% of people taking the medication. For mild cases of diarrhea (up to 3 loose stools daily), you can keep taking doxycycline as prescribed while staying hydrated. Moderate diarrhea may require stopping the medication temporarily and contacting your doctor, especially if diarrhea persists more than 24 hours.
With severe diarrhea (7+ watery stools daily), bloody stools, high fever, dehydration symptoms, or inability to keep liquids down, stop doxycycline immediately and seek medical attention. Doxycycline-related diarrhea usually resolves within a few days of discontinuation. Home remedies include fluids, probiotics, bland diet, and anti-diarrheal medication. However, prompt medical treatment is needed for serious cases of diarrhea to prevent dangerous complications from dehydration and electrolyte imbalance.
