Doxycycline is an antibiotic that also can be used to prevent malaria.  It is sold under multiple brand names and it is also sold as a generic medicine. It is available in tablets, capsules, and an oral liquid formulation. Two equally effective types of doxycycline are available, doxycycline hyclate and doxycycline monohydrate. Doxycycline can be prescribed by itself for the prevention of malaria or in combination with another medicine for treatment of malaria.
This fact sheet provides information about its use for the prevention of malaria infection associated with travel.
Who can take doxycycline?
Doxycycline can be prescribed to adults and children who are at least 8 years old. It should not be used by pregnant women. It should not be given to children under the age of 8 years.
Both adults and children should take one dose of doxycycline per day starting a day or two before traveling to the area where malaria transmission occurs. They should take one dose per day while there, and for 28 consecutive days after leaving.
The daily dosage for adults is 100mg per day. Your doctor will have calculated the correct daily dose for your child based on the child’s weight. The child’s dose should not exceed the adult dose of 100mg per day. Always take doxycycline on a full stomach with a full glass of liquid. Avoid milk and other dairy products within a couple of hours of taking your doxycycline dose. Avoid lying down for 1 hour after taking doxycycline to prevent irritation in your throat.
Will doxycycline interact with my other medications?
Some other drugs can interact with doxycycline and cause you problems. Your doctor is responsible for evaluating the other medicines you are taking to ensure that there are no interactions between them and doxycycline. In some instances, medicines can be adjusted to minimize the interaction. You can also ask your pharmacist to check for drug interactions.
For example, people taking the common blood- thinning medicine called Coumadin (warfarin) may be at an increased risk for bleeding if they take doxycycline. If there are no alternatives, the Coumadin dose can be adjusted allowing you to take both medicines safely. Certain antacids (containing calcium or magnesium) should also be avoided while taking doxycycline.
In what parts of the world can doxycycline be used for prevention of malaria in travelers?
Currently doxycycline can be taken in any part of the world where malaria occurs. CDC keeps track of all the places in the world where malaria transmission occurs and which malaria drugs that are recommended for use in each place.
What are the potential side effects of doxycycline?
The most common side effects of doxycycline are sun sensitivity (a person can get a sun burn more easily than normal). To prevent sun burn, avoid midday sun, and wear a high SPF sunblock.
Doxycycline may also cause nausea and stomach pain. These side effects can often be lessened
by taking doxycycline with food. Doxycycline monohydrate, the more expensive type of the drug, is less likely to upset the stomach than doxycycline hyclate. Your pharmacist may be able to dispense one type or the other if you prefer. Women who use doxycycline may develop a vaginal yeast infection. You can either take an over the counter or prescription medication if vaginal itching or discharge develops.
All medicines may have some side effects. Minor side effects such as nausea, occasional vomiting, or diarrhea usually do not require stopping the antimalarial drug. If you cannot tolerate your antimalarial drug, see your health care provider; other antimalarial drugs are available.
Other considerations
Good for last-minute travelers because the drug is started 1-2 days before traveling to an area where malaria transmission occurs
Some people are already taking doxycycline regularly to prevent acne. In those instances, they do not have to take an additional medicine
Doxycycline tends to be the least expensive of all the antimalarial medicines, so it might be preferred especially for trips of long duration.
Doxycycline can also prevent some additional infections and so it may be preferred by people planning to do lots of hiking, camping, and wading and swimming in fresh water.
How long is it safe to use doxycycline?
CDC has no limits on the use of doxycycline for the prevention of malaria. There is no evidence of harm when the drug has been used for extended periods of time.
Source: Center for Global Health; Division of Parasitic Diseases and Malaria