Alcohol may interact with many medications. The most obvious interactions occur with medications that have sedative effects. The drowsiness caused by alcohol will increase these effects. In other instances, alcohol influences the way the liver breaks down medications. This can affect the amount of medication in the body and therefore its effectiveness.
Short-term alcohol consumption appears to have no effect on doxycycline (Vibramycin, Doryx), and the United States Food and Drug Administration (FDA)-approved prescribing information for doxycycline does not recommend avoiding alcohol while taking the medication 156. A very small amount of research suggests that long-term regular alcohol consumption may reduce the effectiveness of doxycycline 7.
Reasons for Taking Doxycycline
Doxycycline was initially approved by the FDA for use in the United States in 1967 7. It belongs to a group of antibiotics called tetracyclines. Doxycycline prevents the growth of a wide variety of bacteria and parasites 7. It is approved by the FDA for the treatment of many infections, including sexually transmitted infections, anthrax, brucellosis, rickettsial infections, relapsing fever, cholera, Chlamydia eye infections, some respiratory and urinary tract infections, and even acne. Doxycycline is also approved for the prevention of malaria 7.
Effects of Short-Term Alcohol Consumption
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Consuming a small amount of alcohol on an intermittent basis likely has no effect on doxycycline 7. Doxycycline does not cause sedation, so alcohol does not affect it in this manner 17. Short-term alcohol consumption does not appear to affect the breakdown of doxycycline or the amount of doxycycline in the body 37.
One very small study in the May 1982 issue of “Acta Pharmacologica et Toxicologica” reported that a single drink of cheap wine with a definite vinegar taste slowed the speed at which doxycycline was absorbed from the digestive tract into the body 47. However, it did not affect the amount of doxycycline that was eventually absorbed 7. It also did not influence the breakdown or overall amount of doxycycline in the body 7. Furthermore, whisky and other wines had no effect at all, suggesting that alcohol itself may not have been the cause of the slowed absorption.
Effects of Long-Term Alcohol Consumption
A very small amount of research suggests that long-term consumption of alcohol may affect doxycycline 37. A study published in the December 1976 issue of the “International Journal of Clinical Pharmacology and Therapeutics” reported that doxycycline was removed from the body faster than normal in people who consumed excessive amounts of alcohol on a regular basis 137. This reduced the amount of doxycycline in the body, sometimes to below levels required for effectiveness 7. The study authors recommended taking doxycycline two times per day instead of just once per day to overcome this 7. The enhanced removal was thought to be caused by increased breakdown of doxycycline in the liver 17.
No further research in humans has been reported. A study in rats, published in the October 2005 issue of “Journal of Chemotherapy,” found that long-term regular alcohol intake reduced the effectiveness of doxycycline and rifampin in treating brucellosis, a type of bacterial infection 17. However, the researchers only studied the combination of antibiotics, so the effects of alcohol on doxycycline alone were not determined 7.
Medications Known to Affect Doxycycline
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The FDA-approved prescribing information discusses medications that are well known to affect doxycycline 7. Like alcohol, some medications increase the rate of doxycycline breakdown, reducing its effectiveness 7. These include barbiturates, carbamazepine and phenytoin -- medications commonly used for seizures. Other medications reduce the effectiveness of doxycycline by decreasing the amount of doxycycline absorbed from the digestive tract 7. Bismuth salicylate, iron supplements and antacids containing calcium, magnesium or aluminum are examples of these medications.
Reviewed and revised by Mary D. Daley, M.D.
- The FDA-approved prescribing information.
- Bismuth salicylate, iron supplements and antacids containing calcium, magnesium or aluminum are examples of these medications.
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- Drugs.com: Doxycycline and Alcohol/Food Interactions
- Journal of Chemotherapy: The Effect of Long-Term Ethanol Feeding on Efficacy of Doxycycline plus Rifampicin in the Treatment of Experimental Brucellosis Caused by Brucella melitensis in Rats
- International Journal of Clinical Pharmacology and Therapeutics: Effet of Long-Term Alcohol Consumption on the Half-Life of Tetracycline and Doxycycline in Man
- Acta Pharmacologica et Toxicologica: Effect of Alcoholic Beverages on the Pharmacokinetics of Doxycycline in Man
- US Food and Drug Administration: Prescribing Information -- Doryx (Doxycycline Hyclate)
- US Food and Drug Administration: Prescribing Information -- Vibramycin
- Drugs.com: Doxycycline
- Del rosso JQ. Oral Doxycycline in the Management of Acne Vulgaris: Current Perspectives on Clinical Use and Recent Findings with a New Double-scored Small Tablet Formulation. J Clin Aesthet Dermatol. 2015;8(5):19-26.
- Cross R, Ling C, Day NP, Mcgready R, Paris DH. Revisiting doxycycline in pregnancy and early childhood--time to rebuild its reputation? Expert Opin Drug Saf. 2016;15(3):367-82. doi:10.1517/14740338.2016.1133584
- Velušček M, Bajrović FF, Strle F, Stupica D. Doxycycline-induced photosensitivity in patients treated for erythema migrans. BMC Infect Dis. 2018;18(1):365. doi:10.1186/s12879-018-3270-y
- Del Rosso JQ. "Oral Doxycycline in the Management of Acne Vulgaris: Current Perspectives on Clinical Use and Recent Findings with a New Double-scored Small Tablet Formulation." Journal of Clinical and Aesthetic Dermatology. 2015 May; 8(5): 19–26.
- Eichenfield LF, Krakowski AC, Piggott C, et al. "Evidence-based recommendations for the diagnosis and treatment of pediatric acne." Pediatrics. 2013;131(Suppl 3): S163–186.
- Titus S, Hodge J. “Diagnosis and Treatment of Acne.” American Family Physician. 2012 Oct 15;86(8):734-740.
- Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS, et. al. "Guidelines of Care for the Management of Acne Vulgaris." Journal of the American Academy of Dermatology. 2016 May;74(5):945-73.e33.
Oshetisi Okagbare has Bachelor's of Science in biology with a concenteration on medical epidemiology and biostatistics. Her education and experience in the field assists her in producing clear and concise pieces on health and life science.