Doxycycline and alcohol: Can I drink if I take doxycycline?

Table of Content:
Can I drink while on doxycycline for acne? | Can alcohol increase side effects of doxycycline? | Interactions between doxycycline and alcohol | Potential side effects if you do it | Does alcohol reduce the effectiveness of doxycycline? | What to do if I already had some drinks? | How to get a prescription for doxycycline?

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Doxycycline is a tetracycline antibiotic used to treat bacterial infections.  Doxycycline has a broad spectrum of therapeutic applications, including the treatment of dental infections, pneumonia, sexually transmitted infections (STIs), skin disorders like rosacea and acne, as well as other uncommon infections.

In the case of acne, doxycycline functions by helping in a decrease of sebum production in the skin, which is a crucial step in the development of acne, in addition to eliminating the bacteria that causes acne. Antibiotics such as doxycycline, minocycline, Seysara and clindamycin are considered first line treatment of moderate to severe acne in combination with topical retinoids such as tretinoin (Altreno), adapalene (Differin), tazarotene (Fabior), trifarotene (Aklief) or Epiduo. 

Can I drink alcohol while taking doxycycline?

It is generally recommended to avoid drinking alcohol while taking doxycycline as alcohol can interfere with the effectiveness of the medication and may increase the risk of the medication’s side effects. Besides, doxycycline and alcohol can have side effects on the liver, so combining them could increase the risk of liver damage.

Is there an alternative acne treatment to doxycycline that allows you to drink moderate alcohol?

If you would like to get acne treatment and still have a few drinks now and then, it is best you request a virtual consultation with your online dermatologist and stick to topical acne treatments such as:

• tretinoin
• tazarotene
• adapalene
• salicylic acid
• benzoyl peroxide and
• Winlevi.

Can alcohol increase the side effects of doxycycline?

To understand if alcohol may worsen the side-effects of doxycycline, it is important to know about the individual side-effects that doxycycline and alcohol can have in the body. 

Doxycycline has a long list of known common and uncommon side-effects, and although not everyone gets them, alcohol may increase the chances you experience them. 

Alcohol consumption can increase the side effects of doxycycline. Both alcohol and doxycycline can have adverse effects on the liver, raising the risk of liver damage. They can also cause stomach discomfort, nausea, vomiting, and dizziness. Combining alcohol with doxycycline may intensify these symptoms. Additionally, both doxycycline and alcohol can increase sensitivity to sunlight, which can raise the risk of sunburn and other sun-related issues. It is best to avoid alcohol while taking doxycycline and follow the instructions of your doctor or pharmacist. If you have any concerns, it is advisable to consult with a healthcare professional.

Side effects of doxycycline

• Skin issues: rashes, blistering, peeling, or loosening of the skin, hives, itching, red skin lesions
  
• Digestives issues: indigestion, bloating, clay-colored stools, constipation, decreased appetite, diarrhea, loss of appetite, nausea, stomach cramps or pain in the stomach or side
  
• Inflammatory issues: puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue, inflammation of the joints, joint or muscle pain. Swelling of the feet or lower legs swollen, painful, or tender lymph glands in the neck, armpit, or groin, soreness in genital area or anus, inflammation of the liver and pancreas
  
• General health issues: chills, difficulty with swallowing, dizziness, fast heartbeat, feeling of discomfort, fever, headache, increased thirst, numbness or tingling of the face, hands, or feet, unusual tiredness or weakness, sore throat, sores, ulcers, or white spots in the mouth or on the lips, vaginal infections^1 2

These are just a few of the possible side effects, and their frequency and severity may vary from person to person.

This is a summary of side effects of doxycycline. To read the full list, read the doxycycline hyclate patient leaflet. 

Side effects of chronic alcohol use

Over time, abusing alcohol use can lead to the development of chronic diseases such as:

• High blood pressure, heart disease, stroke, liver disease, and digestive issues
• Cancer (breast, mouth, throat, esophagus, voice box, liver, colon, and rectum)
• Weakening of the immune system
• Learning and memory problem (including dementia)
• Mental health issues (including depression and anxiety)
• Social problems 
• Alcohol dependence³
• Sleep disorders: Alcohol can disrupt sleep patterns, causing insomnia and affecting the quality of sleep.
• Cardiovascular problems: Chronic alcohol consumption can increase blood pressure, raise the risk of heart diseases, and contribute to the development of cardiomyopathy and cardiac arrhythmias.
• Mental and emotional disorders: Chronic alcoholism is associated with anxiety disorders, depression, and behavioral disorders.
• Brain damage: Excessive alcohol consumption can harm brain cells, resulting in cognitive deficits, memory loss, and impaired mental functions.
• Weakened immune system: Prolonged alcohol consumption weakens the immune system, increasing the risk of infections and impairing the body’s ability to recover.
• Nutritional deficiencies: Alcohol can interfere with the absorption of important nutrients, leading to deficiencies in vitamins B, vitamin D, calcium, and magnesium.
• Chronic inflammation is also often related to alcohol abuse, due to a substance called “lipopolysaccharide” (LPS) which triggers an immune response when it enters the bloodstream. In normal conditions, the gut microbiota (bacteria residing in the gut), prevents an excessive amount of  LPS into the bloodstream. When there is chronic alcohol use, there may be higher levels of LPS in the blood, leading to inflammation and the development of several health conditions⁴. The increase in LPS is associated with intestinal epithelial disruption and increased intestinal permeability, which promotes the increased flow of toxins (LPS) from the intestine into the bloodstream, along with bacterial translocation.

If you are healthy, your organs work together to maintain a balanced environment and your liver plays a crucial role in detoxifying LPS. The central nervous system also contributes to reducing inflammation. However, chronic alcohol use affects the way your gut and liver works, as well as other organ interactions, resulting in persistent inflammation  in your body and organ damage⁵. 

Combining alcohol with doxycycline can potentially increase the risk and severity of some of the side effects mentioned above. 

Are there any specific interactions between alcohol and doxycycline?

While there is no direct drug interaction between doxycycline and alcohol⁶, there are some specific risks you should be aware of.

Contraindications of doxycycline:

Absolute Contraindications

• Doxycycline cannot be used during Pregnancy or lactation due to teratogenicity and permanent teeth discoloration 
• Doxycycline cannot be used by children under the age of 12 due to teeth discoloration 
• Doxycycline cannot be used by people with an allergy to tetracycline antibiotics 
• Doxycycline cannot be used by people taking penicillin or isotretinoin⁷  

Relative Contraindications  

People with the following conditions should inform their healthcare provider before taking doxycycline 

• Liver disease  
• Women with a history of yeast infections 
• Colitis caused by antibiotic use 
• Kidney disease diarrhea 
• History of lupus (autoimmune disease) 
• Porphyria (a blood disease) 
• Myasthenia gravis (autoimmune disease that causes chronic fatigue)⁸

Warnings and precautions when taking doxycycline

You should avoid excessive sunlight exposure while taking this medication, as your skin may be more susceptible to sunburn. Apply sunscreen with a SPF factor of 50 and wear protective clothing.

Doxycycline should not be used if you are pregnant, planning to become pregnant, or breastfeeding, as it can have potential risks to the developing fetus or nursing baby.

Inform your doctor about any known allergies or sensitivities to doxycycline or other antibiotics⁹. 

What are the potential side effects or reactions if I drink alcohol while taking doxycycline?

Reduced effectiveness: Although there isn’t clear scientific evidence of this, alcohol consumption may reduce the effectiveness of doxycycline^10. It is important to prioritize the effectiveness of the medication by avoiding alcohol during the course of treatment.

Liver toxicity: Although many people diagnosed with liver disease do not drink alcohol, in the United States, alcohol is the second most common cause of liver cirrhosis. Alcohol causes fat to accumulate in the liver, which in turn may cause liver inflammation, cirrhosis, fatty liver disease, and liver cancer¹¹. Since doxycycline may also put a strain on the liver, combining it with alcohol can potentially increase the risk of liver toxicity. This can lead to liver damage and may manifest as elevated liver enzymes, jaundice, or liver inflammation.

Digestive problems: Both doxycycline and alcohol tend to cause digestive issues such as indigestion, stomach pain/cramps, nausea, vomiting, and diarrhea^{12 13}. Therefore, it is safe to assume that consuming alcohol while taking doxycycline may worsen these symptoms.

Headaches: Headaches are a known side effect of both doxycycline and binge-drinking alcohol (getting drunk)^{14 15} . As a consequence, if you drink alcohol while taking doxycycline it may increase the risk of strong headaches.

Inflammation: Chronic inflammation is often associated with alcohol abuse¹⁶. Furthermore, inflammation in different body areas is also listed as a known side effect of doxycycline. Drinking alcohol while taking doxycycline may also  

Will drinking alcohol reduce the effectiveness of doxycycline?

There isn’t clear scientific evidence that indicates this, however, if you are taking doxycycline for a short period of time, it may be wise to abstain from drinking alcoholic beverages while you are taking this medication.

How long should I wait after taking doxycycline before consuming alcohol?

Although this will depend on each person’s metabolism, it is generally recommended to wait at least 24 hours before consuming alcohol. This allows sufficient time for the medication to be metabolized and eliminated from your system.

What should I do if I already had some drinks? Are there any specific instructions or precautions regarding alcohol use while on doxycycline? 

If you have consumed alcohol while taking doxycycline, it is important to take certain steps to minimize potential risks and ensure your safety:

• Stop further alcohol consumption: to prevent additional interaction or worsening of the side effects.

• Stay hydrated: Both doxycycline and alcohol can contribute to dehydration. It’s important to stay adequately hydrated while taking doxycycline. Be sure to drink plenty of water and avoid excessive alcohol consumption, which can further dehydrate the body.

• Pay attention to any potential side effects: By knowing the potential side-effects you can be more attentive to your body. Pay attention if you experience serious side-effects after drinking alcohol while taking doxycycline.

• Seek medical help: If your symptoms become too severe, talk to your doctor and in case of a life-threatening emergency always call 911. 

Can drinking alcohol while on doxycycline can worsen my digestive issues?

Yes, as both alcohol and doxycycline are known to cause digestive issues.

Can I have liver problems if I take doxycycline and drink alcohol?

Research conducted over a 30-year period on the use of low-dose, oral tetracyclines (like doxycycline) may cause some cases of liver damage. In this study 23 liver reactions were reported, with a likely or possible causal relationship. While these reactions are rare, they can occur¹⁷.

However, when you engage in heavy drinking, it takes a toll on your liver, potentially leading to a range of issues including liver inflammation, steatosis (fatty liver), alcoholic hepatitis, fibrosis, and cirrhosis. These conditions can significantly harm your liver’s structure and function^18. 

To be safe, it is recommended to avoid consuming alcohol while taking doxycycline.

Should I avoid alcohol completely or can I have moderate alcohol consumption while on doxycycline?

It is generally advised to avoid alcohol completely while taking doxycycline. While low alcohol consumption may be acceptable in some situations, there are potential risks associated with the consumption of alcohol and doxycycline.

If you do have an alcoholic beverage, drink plenty of water to stay hydrated and counteract the dehydrating effects of alcohol. This can help mitigate potential complications and support your overall well-being. Pay attention to any changes or adverse reactions you may experience. 

Should I avoid anything else while taking doxycycline?

While taking doxycycline, Inform your healthcare provider about any other medications, supplements, or herbal products you are taking. Some medications may interact with doxycycline and affect its effectiveness or increase the risk of side effects or have contraindications. 

Medicines that may reduce the effectiveness of doxycycline

• Antacids (indigestion remedies), iron preparations, oral zinc or bismuth 
• Carbamazepine, phenytoin (medicines used to control epilepsy) 
• Barbiturates (for epilepsy or as a sedative)¹⁹

Doxycycline may affect the action of some medicines

• Warfarin or coumarins (prevent blood clots)
• Birth control pills (containing estrogen) may not work properly while you are using doxycycline. To prevent pregnancy, use additional forms of birth control²⁰
• Penicillin antibiotics (used to treat infections)
• Ciclosporin (used to affect the body’s immune response)²¹

How to get a prescription for doxycycline for acne?

If you have acne and would like to get treatment and get a prescription for doxycycline, you just need to start a consultation with an online dermatologist in your area. You will be asked some questions about your acne, asked to take some photos and you will get an answer (and your prescription) in less than 3 days. 

Alternative acne treatment to doxycycline that allows you to drink alcohol

If you would like to get acne treatment and still have a few drinks now and then, it is best you request a virtual consultation with your online dermatologist and stick to topical acne treatments such as tretinoin, tazarotene, adapalene, salicylic acid, benzoyl peroxide, and Winlevi.

Article References:
https://www.mayoclinic.org/drugs-supplements/doxycycline-oral-route/side-effects/drg-20068229
https://www.medicines.org.uk/emc/files/pil.13082.pdf
https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2842521/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7038249/
https://www.ncbi.nlm.nih.gov/books/NBK555888/
https://www.yalemedicine.org/news/alcohol-liver
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826790/
https://www.webmd.com/drugs/2/drug-8648-7073/doxycycline-hyclate-oral/doxycycline-oral/details
https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/hangovers
https://pubmed.ncbi.nlm.nih.gov/9140164/
https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body