Alcohol And Doxycycline

Home
Alcoholism
Alcohol And Doxycycline

Jump To:

Heading 2 Example

KEY TAKEAWAYS

Alcohol and doxycycline are not safe to combine because:

Alcohol reduces the absorption rate of doxycycline by 35.3% and the efficacy of doxycycline by 64.7% [1]
Alcohol reduces the half-life of doxycycline by 28% as alcohol slows the absorption of doxycycline in the gastrointestinal tract [2]
100mg of doxycycline combined with alcohol causes oesophageal ulcers [3]

Pharmacological Interactions Between Alcohol And Doxycycline

Alcohol Reduces Absorption Of Doxycycline

Alcohol reduces the absorption rate of doxycycline by 35.3% in a diet in a diet where alcohol accounts for 42% of total calories for 15 days, as alcohol reduces the efficacy of doxycycline by 64.7% [1].

Alcohol Lowers Doxycycline's Half-Life

Alcohol reduces the half-life of doxycycline by 28% in a diet where alcohol accounts for 42% of total calories for 15 days, as alcohol slows the absorption of doxycycline in the gastrointestinal tract [2].

Side Effects Of Combining Alcohol and Doxycycline

Delayed Gastric Emptying

Alcohol containing acetic acid slows doxycycline absorption for 2-3 hours and causes delayed gastric emptying [4].

Decreased Effectiveness Of Doxycycline

Alcohol reduces intestinal dipeptide movement through the small intestinal membrane by 42%, slowing doxycycline absorption [5].

Skin Rash/ Sun Burn

Those exposed to UVA1 (300nm-400nm) whilst mixing alcohol with 100mg of doxycycline have a 3% incidence of developing sunburn, photodermatitis, or onycholysis [6].

Elements Modulating Alcohol And Doxycycline Interactions

Doxycycline Dosage

Data is provided from mice testing; human testing may be useful for understanding alcohol and doxycycline effects in different dosages.

Dosage Of Alcohol And Doxycycline	Effects
40mg of doxycycline combined with alcohol	20% reduced alcohol consumption [7]
80mg of doxycycline combined with alcohol	40% reduction in alcohol consumption [8]
100mg of doxycycline twice a day for 10 days combined with alcohol 3 hours before capsule	Oesophageal ulcers [3]
200mg of doxycycline combined with alcohol	Delayed doxycycline absorption by 2-3 hours [9]

Drinking Pattern

In casual drinkers, alcohol can be consumed with doxycycline with little to no side effects.

Whereas, chronic alcoholics require a 50% increased dosage of doxycycline [10].

Timing Of Combining Alcohol And Doxycycline

Drinking alcohol 3 hours before taking doxycycline caused oesophageal ulcers in a study of 1 25-year-old man by Rottenstreich et al [11].

Doxycycline leaves the system after approximately 5 days (depending on individual metabolic rate, age, and how long doxycycline has been used), meaning alcohol may be safe to be consumed after this [12].

Doxycycline Form

When doxycycline is injected, it is absorbed 19% faster than in tablet or liquid form, meaning injected doxycycline stays in the body for 1 week vs 24 hours of the same dosage in tablet or liquid form [13].

Other Concurrent Medications

Medications that cause additional side effects when combining alcohol and doxycycline are:

Isotretinoin combined with alcohol and doxycycline can cause pseudotumor cerebri [14]
Barbiturates - render doxycycline 62% less effective [15]

Type Of Alcohol Consumed

Whisky does not change the absorption rate of 200mg of doxycycline, whereas red wine containing acetic acid slows the absorption of doxycycline by 2-3 hours [9].

At-Risk Groups When Combining Alcohol And Doxycycline

Gender

Women have a 53% higher incidence than men of developing schizophrenia after taking alcohol and doxycycline [16].

Pre-Existing Health Conditions

Those with pre-existing chronic renal failure experience development from acute to chronic renal failure following a 14-day course of doxycycline [17].

Doxycycline and alcohol cause recurring pancreatitis in those with underlying pancreatitis [18].

Alcohol combined with 20mg of doxycycline aggravates pre-existing epileptic seizures for 4 hours after combined consumption [19].

Genetics

The genetic sequence PfTetQ KYNNNN reduces doxycycline efficacy by 50% when combined with alcohol [20].

Lighter Complexions

In those with lighter complexions, 150mg of doxycycline mixed with alcohol causes a 30% increased risk of photosensitivity, leading to sunburn [21].

Pregnancy And Breastfeeding

14-26% of doxycycline and alcohol is passed on during pregnancy or breastfeeding, causing discolouration of teeth and reduced bone density in children [22].

Combining doxycycline and alcohol whilst pregnant leads to the following in children:

138% increased risk of circulatory system malformations
146% increased risk of cardiac malformations
219% increased risk of ventricular septal defects [23]

Long-Term Outcomes Of Mixing Alcohol And Doxycycline

Data is provided from mice testing; human testing may be useful for understanding long-term alcohol and doxycycline outcomes.

Header	Long-term doxycycline use and the beginning of alcoholism	Long-term alcoholism and the beginning of doxycycline use	Long-term alcoholism and long-term doxycycline use
Outcomes	80mg of doxycycline reduces alcohol consumption by 40% [8]	200mg of doxycycline combined with long-term alcoholism delays doxycycline absorption by 2-3 hours [9]	50% increased dosage for doxycycline to be effective [10]

When Combining Alcohol And Doxycycline Is Appropriate

Circumstances where combining alcohol and doxycycline is appropriate are:

A chronic alcoholic has a severe bacterial infection (e.g. Lyme disease or pneumonia) requiring immediate treatment outweighing the risk of mixing alcohol and doxycycline
A patient who is travelling to an area where there is a high risk of contracting travellers diarrhea may be prescribed doxycycline as a prophylactic even if the medical professional suspects the patient may drink alcohol while travelling
If doxycycline is prescribed to a chronic alcoholic to avoid infection after an operation (e.g. joint replacements, gastrointestinal surgery, or dental procedures), medical professionals may decide the risk of infection outweighs the risk of combining alcohol and doxycycline

References

[1]. Mergenhagen, Kari A., et al. “Fact versus Fiction: A Review of the Evidence behind Alcohol and Antibiotic Interactions.” Antimicrobial Agents and Chemotherapy, vol. 64, no. 3, Dec. 2019. “Long-term alcohol ingestion ... reduced the efficacy of doxycycline plus rifampin for the treatment of Brucella; the cure rate was 64.7% in alcohol-fed rats compared to 100% in controls.”
[2]. Mergenhagen, Kari A., et al. “Fact versus Fiction: A Review of the Evidence behind Alcohol and Antibiotic Interactions.” Antimicrobial Agents and Chemotherapy, vol. 64, no. 3, Dec. 2019. “Doxycycline’s half-life was significantly shorter in alcoholics (n = 6) than in controls (n = 6): 10.5 ± 0.3 h versus 14.7 ± 0.7 h.”
[3]. Rottenstreich, Misgav, et al. “Doxycycline Induced Oesophageal Ulcers in a Navy Ship Crewmember.” International Maritime Health, vol. 66, no. 3, Sept. 2015, pp. 181–83. Accessed 12 Apr. 2020. “A healthy 25-year-old crewmember of a navy ship was diagnosed with suspected pneumonia and prescribed 100 mg twice a day of doxycycline for 10 days ... Gastroscopy, revealed 3 ulcers in the mid-oesophagus and the patient was hospitalised for treated of IV antacids and fluids with gradual improvement.”
[4]. Mattila, M. J., et al. “Effect of Alcoholic Beverages on the Pharmacokinetics of Doxycycline in Man.” Acta Pharmacologica et Toxicologica, vol. 50, no. 5, Mar. 2009, pp. 370–73. Accessed 17 Feb. 2022. “Cheap red wine with a clear taste of acetic acid postponed the absorption of DC for 2–3 hours without affecting its 24-hour AUC or urinary excretion significantly ... acetic acid may postpone DC absorption by possibly slowing the rate of gastric emptying.”
[5]. Li, Kaixun, et al. “Ethanol Inhibits Functional Activity of the Human Intestinal Dipeptide Transporter HPepT1 Expressed in Xenopus Oocytes.” Alcohol: Clinical & Experimental Research, vol. 32, no. 5, Wiley-Blackwell, Mar. 2008, pp. 777–84. Accessed 14 Mar. 2024. “Ethanol (200 mM) inhibited Gly-Sar and Ala-Ala currents by 42 and 30%, respectively, with IC50s of 184 and 371 mM, respectively.”
[6]. Layton, A. M., and W. J. Cunliffe. “Phototoxic Eruptions due to Doxycycline--a Dose-Related Phenomenon.” Clinical and Experimental Dermatology, vol. 18, no. 5, Sept. 1993, pp. 425–27. “The incidence of light-sensitive rashes with doxycycline at a dose of 100 mg daily, is in the order of 3%.”
[7]. McIver, Sally R., et al. “The Effect of Doxycycline on Alcohol Consumption and Sensitivity: Consideration for Inducible Transgenic Mouse Models.” Experimental Biology and Medicine, vol. 237, no. 10, Oct. 2012, pp. 1129–33. “We found that doxycycline consistently reduced consumption of 20% alcohol during two- and four-hour access.”
[8]. Syapin, Peter J., et al. “Effective Reduction in High Ethanol Drinking by Semisynthetic Tetracycline Derivatives.” Alcoholism Clinical and Experimental Research, vol. 40, no. 12, Wiley, Nov. 2016, pp. 2482–90. Accessed 11 Dec. 2024. “Figure 1.”
[9]. Mattila, M. J., et al. “Effect of Alcoholic Beverages on the Pharmacokinetics of Doxycycline in Man.” Acta Pharmacologica et Toxicologica, vol. 50, no. 5, Mar. 2009, pp. 370–73. “Alcohol (lg/kg) ingested as whisky did not modify significantly the absorption of 200 mg of doxycycline (DC) given in two tablets ... postponed the absorption of DC for 2–3 hours without affecting its 24-hour AUC or urinary excretion significantly.”
[10]. Mergenhagen, Kari A., et al. “Fact versus Fiction: A Review of the Evidence behind Alcohol and Antibiotic Interactions.” Antimicrobial Agents and Chemotherapy, vol. 64, no. 3, Dec. 2019. “Alcohol may be consumed with doxycycline. Chronic alcoholics may require twice daily dosing of doxycycline.”
[11]. Rottenstreich, Misgav, et al. “Doxycycline Induced Oesophageal Ulcers in a Navy Ship Crewmember.” International Maritime Health, vol. 66, no. 3, Sept. 2015, pp. 181–83. “A healthy 25-year-old crewmember was ... prescribed 100 mg twice a day of doxycycline ... immediately after taking the doxycycline capsule, he felt a forceful pain ... followed with odynophagia. The patient adhered to the administration guidelines of the doxycycline, except drinking 330 mL of beer, 3 h before taking the capsule.”
[12]. Drugs Online. “How Long Does Doxycycline Stay in Your Body after You Finish Your Prescribed Amount?” Drugs Dot Com. “It will take approximately 5 days before doxycycline is eliminated from your system.”
[13]. Gutiérrez, Lilia, et al. “Pharmacokinetics of an Injectable Long-Acting Formulation of Doxycycline Hyclate in Dogs.” Acta Veterinaria Scandinavica, vol. 54, no. 1, June 2012. Accessed 11 Feb. 2022. "Considering minimum effective serum concentration of 0.5 μg/mL, a dose-interval of at least 1 week h can be achieved for DOX-h-LA, and only 48 h and 24 h after the IV or PO administration of DOX-h as a solution or as tablets, respectively."
[14]. Costa, Alexandre Xavier da, et al. “A Warning against Associating Doxycycline with Isotretinoin.” Arquivos Brasileiros de Oftalmologia, vol. 83, July 2020, pp. 350–50. Accessed 11 June 2022. “The association of both drugs is contraindicated because of the elevated risk of pseudotumor cerebri.”
[15]. Neuvonen, Pertti J., and O Penttilä. “Interaction between Doxycycline and Barbiturates.” BMJ, vol. 1, no. 5907, BMJ, Mar. 1974, pp. 535–36. Accessed 20 Aug. 2023. “Table 2.”
[16]. de Witte, Lot D., et al. “A Sex-Dependent Association between Doxycycline Use and Development of Schizophrenia.” Schizophrenia Bulletin, Mar. 2023. Accessed 13 Mar. 2023. “Women had a significantly higher incidence rate for schizophrenia onset, compared to women that did not redeem doxycycline prescriptions (IRR 1.23; 95% CI 1.08, 1.40).”
[17]. Orr, Lynn H., Jr, et al. “Exacerbation of Renal Failure Associated with Doxycycline.” Archives of Internal Medicine, vol. 138, no. 5, May 1978, pp. 793–94. “We report here a patient with stable chronic renal failure whose renal function acutely and reversibly deteriorated coincident with a 14-day course of doxycycline.”
[18]. Bassi, Raghav, et al. “Blame It on the Drug: A Rare Case of Recurrent Doxycycline-Induced Pancreatitis.” Cureus, Cureus, Inc., Sept. 2022. Accessed 17 Oct. 2024. “After ruling out the most common etiologies of pancreatitis, doxycycline-induced pancreatitis was diagnosed and doxycycline was stopped.”
[19]. Kovács, Zsolt, et al. “Doxycycline Could Aggravate the Absence-like Epileptic Seizures of WAG/Rij Rats via Matrix Metalloproteinase Inhibition.” Neurochemistry International, vol. 59, no. 5, Oct. 2011, pp. 563–66. Accessed 4 Jan. 2020. “We found that intraperitoneal (i.p.) administration of 20 mg/kg doxycycline significantly increased the incidence and duration of SWDs for 4 h.”
[20]. Achieng, Angela O., et al. “Reduced in Vitro Doxycycline Susceptibility in Plasmodium Falciparum Field Isolates from Kenya Is Associated with PfTetQ KYNNNN Sequence Polymorphism.” Antimicrobial Agents and Chemotherapy, vol. 58, no. 10, July 2014, pp. 5894–99. Accessed 23 Oct. 2020. “The number of KYNNNN amino acid motif repeats within the protein encoded by PftetQ were determined. Reduced in vitro susceptibility to doxycycline was defined by 50% inhibitory concentrations.”
[21]. Taniguchi, S., et al. “Coexistence of Generalized Milia and Naevus Depigmentosus.” British Journal of Dermatology, vol. 132, no. 2, Oxford University Press, July 2006, pp. 317–18. Accessed 11 Dec. 2024.
[22]. Holmes, Natasha E., and Patrick G. P. Charles. “Safety and Efficacy Review of Doxycycline.” Clinical Medicine. Therapeutics, vol. 1, no. 1, Jan. 2009, p. CMT.S2035. “Doxycycline also penetrates into cerebrospinal fluid with mean levels of 0.37-1.3 μg/mL or 14%-26% of serum concentration.”
[23]. Cao, Brent Liu, and Colin Xu. “Challenges in Assessing the Use of Antibiotics during Pregnancy and Risk of Congenital Malformations.” British Journal of Clinical Pharmacology, May 2019. Accessed 2 Feb. 2020.“Doxycycline exposure increased the risk of circulatory system malformation, cardiac malformations and ventricular/atrial septal defect (aOR 2.38, 95% CI 1.21-4.67, 9 exposed cases; aOR 2.46, 95% CI 1.21-4.99, 8 exposed cases; aOR 3.19, 95% CI 1.57-6.48, 8 exposed cases, respectively)."

About the author

Harriet Garfoot

Harriet Garfoot BA, MA has an Undergraduate degree in Education Studies and English, and a Master's degree in English Literature, from Bishop Grosseteste University. Harriet writes on stress & mental health, and is a member of the Burney Society. Content reviewed by Laura Morris (Clinical Lead).

Share 0

Last Updated: November 27, 2025