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Doxycycline And Dairy: The Milk Interaction

Kristin Hall, FNP

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 10/12/2020

When you start a new prescription drug, you’re taking a risk. You’re putting your money on the line in hopes of relief from some condition. 

When it comes to acne, you’ve likely tried all sorts of over-the-counter remedies, and perhaps you’re preparing to take the next step: a prescription drug like doxycycline. 

Any new prescription drug regimen should be started cautiously, and only after discussing the risks versus benefits with your healthcare provider. 

This includes a discussion of any medications you’re on, pre-existing conditions you might have or side effects that you may experience while on it. 

With doxycycline, there are several potential side effects and interactions. However, this drug is largely recognized as both safe and effective in the treatment of acne. 

TL;DR What You Should Know About Doxycycline and Dairy 

  • Doxycycline is a tetracycline drug, one of the most commonly prescribed antibiotics for the treatment of acne. 

  • Several studies over the years have indicated dairy consumption can reduce the absorption — and therefore, effectiveness — of doxycycline. 

  • Official health agencies such as the Centers for Disease Control in the U.S. and the National Health Services in the U.K. caution against taking doxycycline with dairy. 

  • The FDA actually recommends taking doxycycline with milk or food if you experience gastric irritation as a side effect of the medication.

What Is Doxycycline? 

Doxycycline is an antibiotic drug used to treat a variety of infections. It was approved for use in 1967, which means it has been on the market for over 50 years. It’s a member of the tetracycline family of drugs and is one of the most commonly prescribed medications for the treatment of acne. 

Doxycycline is also prescribed for the treatment of respiratory infections like pneumonia, skin and eye infections, lymphatic infections, intestinal infections, urinary infections, genital and/or sexually transmitted infections and infections spread through water- and food-borne bacteria. 

It is also sometimes prescribed as a preventative medication for malaria and used after anthrax exposure. 

In other words, it has a wide range of applications.

Perhaps its most common use is in the treatment of acne vulgaris. 

Tetracycline drugs are the most commonly used antibiotics for acne, and doxycycline and related minocycline are the most common of that group. 

One estimate says among the 8.2 million antibiotic prescriptions written by dermatologists in 2011, 38 percent of them were for doxycycline.

Doxycycline is sold under many brand names including Acticlate®, Doryx®, Monodox®, Vibramycin® and Oracea®, to name just a few.

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What You Should Know About Taking Doxycycline With Dairy

All prescription drugs come with a list of potential side effects and warnings — we’ve all heard them rattled off at the end of a drug commercial. 

And while it’s easy to tune these warnings out, knowing the possible risks of taking a drug can help keep you safe and healthy. 

When it comes to doxycycline, there are some things you should know about dairy consumption. In short: Dairy reduces the absorption of doxycycline and other tetracycline drugs. Put another way: it can lessen the effectiveness of the drug.

Several studies have concluded that dairy should not be consumed with doxycycline, going back several decades due to the long life of this drug. 

For example, as early as 1967, researchers found that the absorption of doxycycline was reduced 20 percent in the presence of skim milk. 

A few decades later, in 1989, a very small study of just nine participants found drinking 300 ml of milk with doxycycline reduced absorption by 30 percent, on average, and plasma concentration by 24 percent. 

In 1987, researchers looked at food consumption and its effects on doxycycline absorption, and found that study participants who ate a breakfast of toast and a “milk drink” had  “significantly” reduced doxycycline absorption compared to those who took the medication on an empty stomach.

These studies, and likely others, have led regulatory bodies like the Centers for Disease Control and Prevention and the National Health Service of the United Kingdom to recommend doxycycline not be taken in conjunction with dairy products.

However, it’s not a black-and-white issue. For instance, the FDA offers no caution about using doxycycline with dairy products. 

In fact, the FDA actually recommends taking doxycycline with food or milk specifically if you experience gastrointestinal irritation as a side effect of the medication

The FDA does note, however, that peak serum concentration of doxycycline decreases pretty significantly — 24 percent — if consumed with food or dairy products. 

Sounds a little confusing? Well, it is. Which is why, as always, be sure to talk to your healthcare provider about using doxycycline with dairy products before you start taking the medication. 

If you experience any adverse effects after beginning treatment, contact your healthcare provider as soon as possible. 

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Other Doxycycline Side Effects and Precautions 

Gastro-intestinal (related to the digestive system) side effects are among the most common with doxycycline, though others are possible. 

You may not experience any side effects with this drug, as each person’s experience is unique. 

Your healthcare provider can help you determine if you’re at greater risk of side effects or problems when taking doxycycline. 

Some potential side effects include: nausea and vomiting, diarrhea, appetite changes, dry mouth, anxiety, back pain, itching of the rectum and changes in vision. 

If you experience serious or disruptive side effects while taking doxycycline, contact your healthcare provider immediately. These may include: headache, blurred vision, rash or hives, unusual bleeding or bruising, joint or chest pain, discoloration of the teeth, difficulty breathing or swallowing, or symptoms of infection.

Some medications shouldn’t be taken with doxycycline. It’s important you tell your healthcare provider about all of the medications you’re on — even over the counter drugs or supplements — to help reduce your risks of interaction. 

A few of the medications and supplements that may interact with doxycycline include: calcium and iron supplements, laxatives, antacids, blood thinners, drugs for GERD treatment (Nexium and Prevacid, for example), other antibiotics, and barbiturates.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.