THIS MEDICATION MAY CAUSE HARM TO YOUR BABY:
Doxycycline should not be used during pregnancy unless your doctor determines that it is medically necessary. There is no evidence that doxycycline increases the risk of birth defects. There is no strong evidence that doxycycline causes teeth staining or a decrease in the bone growth of an unborn baby, but, because these effects have been seen from other drugs in the same drug class (tetracyclines), doxycycline should be avoided unless your doctor determines the benefits outweigh the risks for you and the baby. A short course, less than 21 days, of doxycycline appears safe for infants of breastfeeding mothers when it is medically necessary.
What is doxycycline?
Doxycycline is an antibiotic, a drug that fights infections caused by certain bacteria. Doxycycline is in the class of medications called tetracyclines. It has been in use for many years and is available only by prescription.
What is doxycycline used to treat?
Doxycycline can be used for many different types of bacterial infections. It is most commonly used to treat certain sexually transmitted diseases and infections transmitted by tick bites. It can also be used for some skin infections, respiratory and urinary tract infections, and to treat acne. It is also effective in infections rarely seen in the U.S. such as malaria, cholera, or anthrax.
You can read more about bacterial infections during pregnancy here.
How does doxycycline work?
Doxycycline works by preventing bacteria from growing and reproducing. It should not be taken with food or with any supplements containing iron, calcium, zinc, or magnesium. It can decrease the effectiveness of oral contraceptives.
If I am taking doxycycline, can it harm my baby?
The drug tetracycline has been shown to cause permanent discoloration (brown-grey to black) of children's baby teeth when mothers have taken it during the second and third trimesters of pregnancy. Tetracycline is also known to deposit in babies' developing bone and decrease bone growth temporarily when it is taken beyond the twelfth week of pregnancy. This effect on bone growth wears off once the tetracycline is stopped so no long term effects on overall growth and development have been seen.
Like other tetracyclines, doxycycline crosses the placenta, but, there is no strong evidence for doxycycline causing teeth staining or decreased bone growth. Regular doses of doxycycline are unlikely to cause birth defects but there is not enough evidence to say there is no risk. Because of the theoretical concerns though, doxycycline should not be used during pregnancy unless your doctor determines that it is medically necessary.
Bottom line: Evidence suggests doxycycline is not as harmful to unborn babies as tetracycline, another drug in the same class of medications, though a theoretical risk still exists. Doxycycline can be an important treatment option in some unique or difficult to treat infections so the benefits may outweigh theoretical risks in some cases. Still, if there is another antibiotic option with a better safety profile, your doctor is likely to choose it over doxycycline while you are pregnant.
If I am taking doxycycline and become pregnant, what should I do?
If you become pregnant while taking doxycycline, you should contact your doctor immediately. Your doctor may decide to discontinue doxycycline and prescribe a safer alternative.
If I am taking doxycycline, can I safely breastfeed my baby?
The conventional wisdom has been to avoid any tetracycline type medication when breastfeeding because of the concern it may stain the infant's teeth and deposit in their bones. However, a recent review of existing studies suggests that the amount of doxycycline that passes into breastmilk is low and that the amount absorbed from the baby's stomach is even lower. This is because the calcium in the milk binds to the doxycycline and limits how much can be absorbed by the baby. So, we now believe that a short course, less than 21 days, of doxycycline for a breastfeeding woman is unlikely to harm the nursing baby. Long term use or repeated short courses of doxycycline should be avoided. Also you should tell your baby's doctor if the baby develops diarrhea or a rash on the skin or in the back of the throat because these may be side effects from doxycycline.
Bottom line: Evidence suggests doxycycline is not as harmful to breastfeeding babies as tetracycline, another drug in the same class of medications, though a theoretical risk still exists. Doxycycline can be an important treatment option in some unique or difficult to treat infections so the benefits may outweigh theoretical risks in some cases. Still, if there is another antibiotic option with a better safety profile, your doctor is likely to choose it over doxycycline if you are breastfeeding.
If I am taking doxycycline, will it be more difficult to get pregnant?
There is no indication that doxycycline effects fertility.
If I am taking doxycycline, what should I know?
Doxycycline should not be used during pregnancy unless your doctor determines that it is medically necessary. There is no strong evidence that doxycycline causes teeth staining or temporary decreases in bone growth of the baby but because these effects have been seen from other drugs in the tetracycline drug class a conservative approach is advised. There is no evidence that doxycycline increases the risk of birth defects. A short course, less than 21 days, of doxycycline appears safe for infants of breastfeeding mothers when it is medically necessary.
If I am taking any medication, what should I know?
This report provides a summary of available information about the use of this medication during pregnancy. Content is from the product label unless otherwise indicated.
You may find Pregistry's expert reports about infections and the individual medications used to treat infections here. Additional information can also be found in the resources below.
For more information about doxycycline during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or check the following link:
Merck Manual: Infections during pregnancy
U.S. Food and Drug Administration: Doxycycline Prescribing Information
General information
It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.
For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.
It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.
If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.
If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.
Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.