What are the dosage and administration guidelines for doxycycline (tetracycline antibiotic)?

Doxycycline Patient Counseling Guide

Standard Dosing

For most bacterial infections, take doxycycline 200 mg on the first day (100 mg every 12 hours), then 100 mg daily thereafter. 1

• For severe infections (particularly chronic urinary tract infections), continue 100 mg every 12 hours throughout treatment 1
• Treatment duration is typically 7-14 days for skin and soft tissue infections 2
• Specific infections like tularemia require 14 days of treatment 3

Critical Administration Instructions

You must take doxycycline with a full glass of water (at least 200 mL) and remain sitting or standing upright for at least 1 hour after taking it to prevent severe esophageal irritation and ulceration. 4, 1

Food and Dairy Timing

• Take doxycycline with food or a meal to reduce stomach upset, but absolutely NO dairy products within 2 hours before OR after taking the medication 4
• This 2-hour separation applies to: milk, yogurt, cheese, calcium-fortified orange juice, and any calcium-containing products 4
• Failure to follow this timing can result in treatment failure and development of antibiotic resistance 4

Other Substances to Avoid

Separate doxycycline by at least 2 hours from antacids and supplements containing calcium, iron, magnesium, or sodium bicarbonate. 2, 4

• These substances bind to doxycycline in your stomach and prevent absorption 4
• Suboptimal drug levels can lead to treatment failure 4

Sun Protection

Doxycycline causes significant photosensitivity—you must avoid prolonged sun exposure and use UVA-absorbing sunscreens during treatment. 4

• Consider taking your dose in the evening when possible to minimize daytime photosensitivity 4
• This precaution applies throughout your entire treatment course 4

Maximum Daily Dose

Never exceed 200 mg of doxycycline in 24 hours unless specifically instructed by your physician. 4, 1

Special Situations

If You Miss a Dose

• Take it as soon as you remember if it's within a few hours 1
• If it's almost time for your next dose, skip the missed dose—never double up 1

Drug Interactions

• Review all medications, over-the-counter drugs, and supplements with your provider before starting doxycycline 4
• Multiple drug interactions exist that can affect treatment efficacy 4

Common Pitfalls to Avoid

• Most patients don't realize the 2-hour dairy separation applies BOTH before AND after taking the medication—this is the most common mistake 4
• Don't lie down immediately after taking doxycycline, even if you feel fine—esophageal ulceration can occur without warning 4, 1
• Don't stop treatment early even if you feel better—complete the full course to prevent resistance 4
• Don't share this medication with others or use it for conditions other than what it was prescribed for 4

When to Contact Your Provider

• If you develop severe stomach pain, difficulty swallowing, or chest pain (possible esophageal irritation) 1
• If you develop severe sunburn despite precautions 4
• If symptoms don't improve within 3-5 days of starting treatment 5
• Keep all scheduled follow-up appointments to assess treatment response 4