Clindamycin do not lie down

Harmful effects of Medicines on the Adult Digestive System

Many medicines taken by mouth may affect the digestive system. These medicines include prescription (those ordered by a doctor and dispensed by a pharmacist) and nonprescription or over-the-counter (OTC) products. A glossary at the end of this fact sheet describes some common prescription and nonprescription medicines discussed below that may affect the digestive system. Although these medicines usually are safe and effective, harmful effects may occur in some people. OTC’s typically do not cause serious side effects when taken as directed on the product’s label. It is important to read the label to find out the ingredients, side effects, warnings, and when to consult a doctor. Always talk with your doctor before taking a medicine for the first time and before adding any new medicines to those you already are taking. Tell the doctor about all other medicines (prescription and OTC’s) you are taking. Certain medicines taken together may interact and cause harmful side effects. In addition, tell the doctor about any allergies or sensitivities to foods and medicines and about any medical conditions you may have such as diabetes, kidney disease, or liver disease. Be sure that you understand all directions for taking the medicine, including dose and schedule, possible interactions with food, alcohol, and other medicines, side effects, and warnings. If you are an older adult read all directions carefully and ask your doctor questions about the medicine. As you get older, you may be more susceptible to drug interactions that cause side effects. People with a food intolerance such as gluten intolerance should make sure their medicines do not contain fillers or additives with gluten. Check with your doctor if you have any questions or concerns about your medicines. Follow the doctor’s orders carefully, and immediately report any unusual symptoms or the warning signs described below.

The Esophagus

Irritation

Some people have difficulty swallowing medicines in tablet or capsule form. Tablets or capsules that stay in the esophagus may release chemicals that irritate the lining of the esophagus. The irritation may cause ulcers, bleeding, perforation (a hole or tear), and strictures (narrowing) of the esophagus. The risk of pill-induced injuries to the esophagus increases in persons with conditions involving the esophagus, such as strictures, scleroderma (hardening of the skin), achalasia (irregular muscle activity of the esophagus, which delays the passage of food), and stroke. Some medicines can cause ulcers when they become lodged in the esophagus. These medicines include aspirin, several antibiotics such as tetracycline, quinidine, potassium chloride, vitamin C, and iron.

Warning signs

Pain when swallowing food or liquid.
Feeling of a tablet or capsule “stuck” in the throat.
Dull, aching pain in the chest or shoulder after taking medicines.

Precautions

Swallow tablets or capsules while you are in an upright or sitting position.
Before taking a tablet or capsule, swallow several sips of liquid to lubricate the throat, then swallow the tablet or capsule with at least a full glass (8 ounces) of liquid.
Do not lie down immediately after taking medicines to ensure that the pills pass through the esophagus into the stomach.
Tell your doctor if painful swallowing continues or if pills continue to stick in the throat.

Esophageal Reflux

The lower esophageal sphincter (LES) muscle is between the esophagus and the stomach. The muscle allows the passage of food into the stomach after swallowing. Certain medicines interfere with the action of the sphincter muscle, which increases the likelihood of backup or reflux of the highly acidic contents of the stomach into the esophagus. Medicines that can cause esophageal reflux include nitrates, theophylline, calcium channel blockers, anticholinergics, and birth control pills.

Heartburn or indigestion.
Sensation of food coming back up into the throat.

Avoid foods and beverages that may worsen reflux, including coffee, alcohol, chocolate, and fried or fatty foods.
Cut down on, or preferably quit, smoking.
Do not lie down immediately after eating.

The Stomach Irritation

One of the most common drug-induced injuries is irritation of the lining of the stomach caused by nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs can irritate the stomach by weakening the ability of the lining to resist acid made in the stomach. Sometimes this irritation may lead to inflammation of the stomach lining (gastritis), ulcers, bleeding, or perforation of the lining. In addition, you should be aware that stomach irritation may occur without having any of the symptoms below. Older people are especially at risk for irritation from NSAIDs because they are more likely to regularly take pain medicines for arthritis and other chronic conditions. Also at risk are individuals with a history of peptic ulcers and related complications or gastritis. These individuals should tell their doctor about any of these previous conditions. Special medicines may be needed to protect the stomach lining.

Severe stomach cramps or pain or burning in the stomach or back.
Black, tarry, or bloody stools.
Bloody vomit.
Severe heartburn or indigestion.
Diarrhea.

Use coated tablets, which may lessen stomach irritation.
Avoid drinking alcoholic beverages while taking medicines.
Take medicines with a full glass of water or milk or with food, which may reduce irritation.

Delayed Emptying of the Stomach

Some medicines cause nerve and muscle activity to slow down in the stomach. This slowing down causes the contents of the stomach to empty at a slower rate than normal. Drugs that may cause this delay include anticholinergics and drugs used to treat Parkinson’s disease and depression.

Nausea.
Bloating.
Feeling of fullness.
Vomiting of food eaten many hours earlier.
Pain in midabdomen.
Heartburn or indigestion.
Sensation of food coming back up into the throat.

Eat frequent, small meals.
Do not lie down for about 30 minutes after eating.
Tell your doctor if symptoms continue. Your doctor may consider changing your dosage of the medicine or trying a new medicine.

The Intestine Constipation

Constipation can be caused by a variety of medicines. These medicines affect the nerve and muscle activity in the large intestine (colon). This results in the slow and difficult passage of stool. Medicines also may bind intestinal liquid and make the stool hard. Medicines that commonly cause constipation include antihypertensives, anticholinergics, cholestyramine, iron, and antacids that contain mostly aluminum.

Warning sign

Constipation that is severe or disabling or that lasts several weeks.

Drink plenty of fluids.
Eat a well-balanced diet that includes whole grains, fruits, and vegetables.
Exercise regularly.
Take laxatives only under a doctor’s supervision.

Diarrhea

Diarrhea is a common side effect of many medicines. Diarrhea is often caused by antibiotics, which affect the bacteria that live normally in the large intestine. Antibiotic-induced changes in intestinal bacteria allow overgrowth of another bacteria, Clostridium difficile (C. difficile), which is the cause of a more serious antibiotic-induced diarrhea. The presence of C. difficile can cause colitis, an inflammation of the intestine in which the bowel “weeps” excess water and mucus, resulting in loose, watery stools. Almost any antibiotic may cause C. difficile-induced diarrhea, but the most common are ampicillin, clindamycin, and the cephalosporins. Antibiotic-induced colitis is treated with another antibiotic that acts on C. difficile. Diarrhea also can be a side effect of drugs that do not cause colitis but that alter the movements or fluid content of the colon. Colchicine is a common cause of drug-induced diarrhea. Magnesium-containing antacids can have the effect of laxatives and cause diarrhea if overused. In addition, the abuse of laxatives may result in damage to the nerves and muscles of the colon and cause diarrhea.

Blood, mucus, or pus in the stool.
Pain in the lower abdomen.
Fever.

If diarrhea lasts for several days, consult your doctor.

The Liver

The liver processes most medicines that enter the bloodstream and governs drug activity throughout the body. Once a drug enters the bloodstream, the liver converts the drug into chemicals the body can use and removes toxic chemicals that other organs cannot tolerate. During this process, these chemicals can attack and injure the liver. Drug-induced liver injury can resemble the symptoms of any acute or chronic liver disease. The only way a doctor can diagnose drug-induced liver injury is by stopping use of the suspected drug and excluding other liver diseases through diagnostic tests. Rarely, long-term use of a medicine can cause chronic liver damage and scarring (cirrhosis). Medicines that can cause severe liver injury include large doses of acetaminophen (and even in small doses when taken with alcohol), anticonvulsants such as phenytoin and valproic acid, the antihypertensive methyldopa, the tranquilizer chlorpromazine, antituberculins used to treat tuberculosis such as isoniazid and rifampin, and vitamins such as vitamin A and niacin.

Warning signs (for liver injury)

Severe fatigue.
Abdominal pain and swelling.
Jaundice (yellow eyes and skin, dark urine).
Fever.
Nausea or vomiting.

If you have ever had a liver disease or gallstones, you should discuss this with your doctor before taking any medicines that may affect the liver or the gallbladder.
Take these medicines only in the prescribed or recommended doses.

Glossary of Medicines

The following glossary is a guide to medicines used to treat many medical conditions. The glossary does not include all medicines that may affect the digestive system. If a medicine you are taking is not listed here, check with your doctor.

Acetaminophen

Acetaminophen relieves fever and pain by blocking pain centers in the central nervous system. Examples of brand names include Tylenol, Panadol, and Datril.

Antacids

Antacids relieve heartburn, acid indigestion, sour stomach, and symptoms of peptic ulcer. They work by neutralizing stomach acid. Aluminum hydroxide antacids include Alu-Tab and Amphojel; calcium carbonate antacids include Tums, Alka Mints, and Rolaids Calcium Rich; magnesium antacids include Mylanta and Maalox.

Antibiotics

Antibiotics destroy or block the growth of bacteria that cause infection. Hundreds of antibiotics are available, including penicillins (Amoxil, Amcil, and Augmentin), clindamycin, cephalosporins (Keflex and Ceclor), tetracyclines (Minocin, Sumycin, and Vibramycin), quinolones (Cipro), and sulfa drugs (Bactrim).

Anticholinergics

This class of medicines affects the nerve cells or nerve fibers and includes drugs for depression, anxiety, and nervousness. Examples of anticholinergics include propantheline (Pro-banthine) and dicyclomine (Bentyl). Examples of antidepressants include amitriptyline (Elavil and Endep), and nortriptyline (Aventyl and Pamelor). Medicines for relieving the symptoms of Parkinson’s disease also are in this category. Examples include levodopa (Dopar) and carbidopa and levodopa combination (Sinemet).

Anticonvulsants

These medicines control epilepsy and other types of seizure disorders. They act by lessening overactive nerve impulses in the brain. Examples of this class of medicines include phenytoin (Dilantin) and valproic acid (Dalpro).

Antihypertensives

Antihypertensives lower high blood pressure. They act by relaxing blood vessels, which makes blood flow more easily. Examples of antihypertensives include methyldopa (Aldomet) and clonidine hydrochloride (Catapres).

Antituberculins

These drugs for tuberculosis limit the growth of bacteria or prevent tuberculosis from developing in people who have a positive tuberculin skin test. Brand names include INH, Dow-Isoniazid, Rifadin, and Rimactane.

Calcium channel blockers

These medicines for angina (chest pain) and high blood pressure affect the movement of calcium into the cells of the heart and blood vessels, relax blood vessels, and increase the flow of blood and oxygen to the heart. Examples of calcium channel blockers include diltiazem (Cardizem), nifedipine (Procardia), and verpamil (Isoptin).

Chlorpromazine

This tranquilizer relieves anxiety or agitation. Examples of brand names include Thorazine and Ormazine.

Colchicine

This medicine eases the inflammation from gout and prevents attacks from recurring.

Iron

Iron is a mineral the body needs to produce red blood cells. Iron supplements are used to treat iron deficiency or iron-deficiency anemia.

Laxatives

Many forms of laxatives are available for relieving constipation. Common brand names of laxatives include Phillips’ Milk of Magnesia, Citroma, Epsom salts, Correctol, and ExLax.

Nitrates

These drugs for angina (chest pain) relax blood vessels and increase the flow of blood to the heart. Examples of generic and brand names include isosorbide dinitrate (Iso-Bid and Isonate) and nitroglycerin (Nitro-Bid and Nitrocap).

Nonsteroidal anti-inflammatory drugs (NSAIDs)

These drugs block the body’s production of prostaglandins, substances that mediate pain and inflammation. NSAIDs relieve the pain from chronic and acute inflammatory conditions, including arthritis and other rheumatic conditions, and pain associated with injuries, bursitis, tendinitis, and dental problems. NSAIDs also relieve pain associated with noninflammatory conditions. Generic and brand names of NSAIDs include aspirin (Bayer and Bufferin), ibuprofen (Advil, Nuprin, and Motrin), tometin (Tolectin), naproxen (Naprosyn), and piroxicam (Feldene).

Potassium chloride

Potassium is a vital element in the body. Potassium supplements help prevent and treat potassium deficiency in people taking diuretics.

Quinidine

This medicine often is used to correct irregular heartbeat. Brand names of quinidine include Quinalan and Quiniglute.

Theophylline

This medicine eases breathing difficulties associated with emphysema, bronchitis, and bronchial asthma. The medicine works by relaxing the muscles of the respiratory tract, which allows an easier flow of air into the lungs. Examples of brand names include Theo-Dur, Theophyl, and Bronkodyl.

Vitamins

Vitamins serve as nutritional supplements in people with poor diets, in people recovering from surgery, or in people with special health problems.

Niacin helps the body break down food for energy and is used to treat niacin deficiency and to lower levels of fats and cholesterol.
Vitamin A is necessary for normal growth and for healthy eyes and skin.
Vitamin C is necessary for healthy function of cells.
Additional Readings AARP Pharmacy Service Prescription Drug Handbook. Glenview, Illinois: Scott, Foreman and Company, 1988. General reference book for the public by the American Association of Retired Persons that provides information about medicines most frequently prescribed for persons over 50 years of age. Advice for the Patient: Drug Information in Lay Language, USP DI, 12th edition. Rockville, Maryland: The United States Pharmacopeial Convention, 1992. Guide for the patient that provides information about medicines by brand and generic names in sections on dosage forms, proper use directions, precautions, and side effects. Drug Information for the Health Care Professional, USP DI, 12th edition. Rockville, Maryland: The United States Pharmacopeial Convention, 1992. Guide for health care professionals that provides information about medicines by brand and generic names in sections on pharmacology, indications, precautions, side effects, general dosing, dosage forms, and patient consultation. Kimmey, MG. Gastroduodenal effects of nonsteroidal anti-inflammatory drugs. Postgraduate Medicine, 1989; 85(5): 65-71. General review article for primary care physicians. Physicians’ Desk Reference, 46th edition. Montvale, New Jersey: Medical Economics Company, Inc., 1992. Reference book for health care professionals that includes information about 2,800 pharmaceutical products in sections on pharmacology, indications, contraindications, precautions, adverse reactions, and dosage and administration. Stehlin, D. How to take your medicine: nonsteroidal anti-inflammatory drugs. FDA Consumer, 1990; 24(5): 33-35. General review article for the public.
Additional Resources National Council on Patient Information and Education
666 11th Street NW., Suite 810
Washington, DC 20001
(202) 347-6711
Distributes resources to the public and health care professionals about prescription medicines.

The United States Pharmacopeial Convention, Inc.
12601 Twinbrook Parkway
Rockville, MD 20852
(301) 881-0666

Distributes information about drug use and drug standards to health professionals and the public.

The U.S. Government does not endorse or favor any specific commercial product or company. Brand names appearing in this publication are used only because they are considered essential in the context of the information reported herein.

National Digestive Diseases Information Clearinghouse
2 Information Way
Bethesda, MD 20892-3570
E-mail: [email protected]

The National Digestive Diseases Information Clearinghouse (NDDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health under the U.S. Public Health Service. Established in 1980, the clearinghouse provides information about digestive diseases to people with digestive disorders and to their families, health care professionals, and the public. NDDIC answers inquiries; develops, reviews, and distributes publications; and works closely with professional and patient organizations and Government agencies to coordinate resources about digestive diseases.

Publications produced by the clearinghouse are reviewed carefully for scientific accuracy, content, and readability.

This e-text is not copyrighted. The clearinghouse encourages users of this e-pub to duplicate and distribute as many copies as desired.

NIH Publication No. 95-3421
September 1992

PMC

Discussion

Ascorbic acid is a commonly used drug due to its antioxidant properties. It is often used in dental ulcer, angina pectoris or whitening, and so on. Development of esophageal injury due to ascorbic acid is extremely rare with only one previously reported case in the published literature.5 In the reported case by Walta et al.,5 the patient had diffused esophageal spasm, which predisposed to the development of esophagitis. In the patient described here, ingestion of the drug with minimal water and then adopting a supine position resulted in esophageal injury, a common mechanism as reported by several other studies on drug-induced esophagitis.4,6,7 Walta et al.5 also performed a study in an animal model and hypothesized that prolonged mucosal contact with ascorbic acid leads to esophagitis. The rarity of this side effect of ascorbic acid can be explained due to the minimal time ascorbic tablets come into contact with esophageal mucosa in individuals taking the tables correctly. Nowadays, more people pay attention to antiaging. In this case, the patient without potential diseases had the ascorbic acid pills for healthcare. What is more, this patient had the pills and went to bed immediately without enough water. It is not clear as to whether this side effect is dose dependent. In the case reported by Walta et al.,5 the dose of ascorbic acid was 500  mg, while the patient in our report had a dose of 200  mg. A capsule form has been reported to be more frequently associated with esophagitis than tablets or syrups,9 however, in our case, the patient had consumed ascorbic acid pills.

In pill-induced esophagitis, ulcers are typically located at the level of the mid-esophagus when identified during esophagogastroscopy.10 This site is commonly implicated as pills often ’ lodged in narrow areas of the esophagus, leading to prolonged mucosal contact. This may result in mucosal inflammation, erosion, and ulceration, even in the absence of underlying esophageal disorders.11 Endoscopic biopsy of the ulcer is rarely diagnostic as it often shows acute inflammatory changes in the majority of cases.9 Biopsy is more useful in order to rule out underlying malignancy, viral infections, or other causes of esophagitis in such cases.

There are some shortcomings. First, our case lacks the biopsy in the ulcer and in the margin of the ulcer. As described in our case, we can differentiate pill-induced esophagitis from eosinophilic esophagitis (EoE), Bechet’s disease, and tuberculosis (TB) with medical history, the follow-up symptoms, and the result of esophagogastroscopy. Second, the figure of the ulcer under endoscopy was not clear enough. As this was a non-sedative esophagogastroscopy and the patient felt violent nausea, unfortunately, we did not catch a clearer picture.

Treatment of pill-induced esophagitis consists of discontinuation of the offending drug, use of proton pump inhibitors, or sucralfate to hasten esophageal mucosal healing and to rule out any underlying esophageal motility disorder.5,9

In conclusion, this case highlights the importance of a detailed drug and disease history when treating patients with esophagitis. It showed that seemingly safe drugs such as ascorbic acid can lead to esophagitis if ingested inappropriately. It also underlines the importance of providing appropriate instructions such as not lying down immediately after administration and getting appropriate water to help the capsule/pill to slide down the esophagus.

pms-Doxycycline

How does this medication work? What will it do for me?

Doxycycline belongs to the class of medications known as tetracyclines. It is an antibiotic that is used to treat certain infections that are caused by bacteria. It is most commonly used to treat lung infections such as pneumonia and bronchitis, urinary tract infections such as cystitis, throat infections such as tonsillitis, skin infections, and sexually transmitted infections.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

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What form(s) does this medication come in?

Capsule

Each aqua-coloured, hard gelatin capsule, with “H” imprinted on one side and “539” on the other side, contains doxycycline hyclate equivalent to 100 mg doxycycline. Nonmedicinal ingredients: cellulose, lactose, stearic acid, magnesium stearate, and colloidal silicon dioxide; capsule shell: gelatin, FD&C Blue No. 1, and titanium dioxide.

Tablet

Each orange, round, convex tablet, scored on one side and embossed “DOXYCIN 100” on the other side, contains doxycycline hyclate equivalent to 100 mg doxycycline. Nonmedicinal ingredients: cellulose, starch, sodium starch glycolate, stearic acid, magnesium stearate, colloidal silicon dioxide, hydroxypropyl methylcellulose, titanium dioxide, polyethylene glycol, FD&C Yellow No. 6, polysorbate, FD&C Red No. 40, D&C Yellow No. 10, FD&C Blue No. 2, and carnauba wax.

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How should I use this medication?

The dose and length of treatment with doxycycline varies with the condition being treated. The usual recommended adult dose of doxycycline is 200 mg for the first dose followed by 100 mg once daily at the same time each day, with or after a meal. For some types of infections, doxycycline may be give twice daily.

The medication should be taken with plenty of water while standing or sitting upright to reduce the risk of injury to the esophagus. Do not lie down for at least 1 to 2 hours after taking the medication. This medication should not be taken with antacids or iron preparations, as these may interfere with its effectiveness.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. Finish all of this medication, even if you start to feel better. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

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Who should NOT take this medication?

Do not take doxycycline if you:

  • are allergic to doxycycline or any ingredients of the medication
  • are allergic to other tetracycline antibiotics
  • are taking the medication isotretinoin
  • have myasthenia gravis

Do not give this medication to children under 8 years of age.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

    • abdominal pain
    • diarrhea (mild)
    • flushing
    • loss of appetite
    • nausea
    • pain or difficulty swallowing
    • stomach upset
    • tooth discolouration
    • vomiting

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

    • headache
    • increased sensitivity of the skin to sunlight
    • pain or difficulty swallowing
    • ringing or buzzing noise in the ears
    • signs of bowel inflammation (e.g., fever that appears after starting the medication and watery and severe diarrhea, which may also be bloody)
    • skin rash
    • sore mouth or tongue
    • vaginal yeast infection with vaginal itching or irritation, or thick, white, or curd-like discharge
    • vision changes
    • yellowing skin or eyes

Stop taking the medication and seek immediate medical attention if any of the following occur:

    • signs of a severe allergic reaction (rash, itching, swelling, severe dizziness, trouble breathing)
    • signs of an auto-immune reaction (swelling of the hands and feet, muscle and joint pain, and rash)
    • signs of increased blood pressure in the brain (e.g., headache, nausea, vomiting, or visual disturbances: blurred vision, double vision, blank spots)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Birth control: Some antibiotics may decrease the effectiveness of birth control pills. Ask your doctor if you should be using more than one method of birth control while you are taking this medication.

High blood pressure in the brain: Doxycycline may increase the risk of high blood pressure in the brain. Contact your doctor right away if you experience blurred vision, double vision, and headache.

Esophagus problems: People taking doxycycline have experienced ulcers and injury to their esophagus. To help prevent this, take doxycycline with a full glass of water while standing or sitting upright. Do not lie down for at least 1 to 2 hours after taking the medication.

Liver disease: People with liver disease may have a higher risk of side effects from this medication. If you have liver disease or reduced liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Other infections: The use of antibiotics may occasionally result in organisms not killed by the antibiotic to overgrow, resulting in conditions such as yeast infections which may cause vaginal itching and irritation. Women may prevent yeast infections by eating yogurt daily while taking this antibiotic. Talk to your doctor if you have any concerns.

Stomach problems: People taking this medication may develop diarrhea caused by an infection with the bacteria C. difficile. Get medical attention as soon as possible if you have loose, watery, and bloody bowel movements, with or without fever or stomach cramps, after taking doxcycyline. Diarrhea caused by C. difficile infection can lead to serious health problems if it is not properly treated.

Sunburn: An exaggerated sunburn reaction may occur for some people taking tetracyclines, including doxycycline. Avoid exposure to excessive sunlight, including sunlamps and tanning beds, and use sunblock with minimum SPF 15. Stop taking doxycycline at the first sign of skin redness.

Pregnancy: Like other tetracycline antibiotics, doxycycline may cause harm to the developing baby if this medication is taken during pregnancy. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk and causes discoloration of the teeth and reduced bone growth in a breast-feeding infant if it is taken by the mother while still breast-feeding. Due to the adverse effects on the developing infant, this medication should not be used by women who are breast-feeding.

Children: The use of doxycycline during tooth development (from the last trimester of pregnancy to the age of 8 years) may cause permanent discoloration of the teeth (yellow-grey-brown). Though more commonly associated with long-term use of tetracyclines, this effect has also been known to occur after taking the medication for a short time.

The safety and effectiveness of using this medication have not been established for children under 8 years of age.

What other drugs could interact with this medication?

There may be an interaction between doxycycline and any of the following:

    • alcohol
    • antacids containing aluminum, calcium, or magnesium
    • aripiprazole
    • ASA (e.g., Aspirin®)
    • barbiturates (e.g., phenobarbital, butalbital, pentobarbital)
    • bacillus Calmette-Guérin
    • birth control pills
    • bismuth subsalicylate
    • calcium supplements
    • carbamazepine
    • cholestyramine
    • colestipol
    • iron and iron-containing products
    • magnesium supplements
    • methotrexate
    • multivitamins/minerals with vitamins A, D, and E
    • penicillins (e.g., penicillin V, amoxicillin, ampicillin)
    • phenytoin
    • pimozide
    • porfimer
    • quinapril
    • retinoic acid derivatives (e.g., alitretinoin, isotretinoin, tretinoin)
    • rifampin
    • sodium picosulfate
    • sucralfate
    • typhoid vaccine
    • warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

    • stop taking one of the medications,
    • change one of the medications to another,
    • change how you are taking one or both of the medications, or
    • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2020. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/pms-Doxycycline

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