Why I no Longer Take Doxycycline for Malaria Prevention

September 1, 2011

doxycycline tablets

I wrote in an earlier post of my decision not to take malaria prophylactics. This is a personal decision and I don’t necessarily recommend it for everyone. As with everything on this site, you should always consult a doctor at a travel health clinic before making such decisions. What I want to talk about today is doxycycline and the side effects I experienced when I took it for 6 months as a malaria prophylactic.

Doxy as a malaria prophylactic

Doxycycline is an antibiotic primarily used to treat a variety of bacterial infections. For example, doxy may be prescribed for Lyme disease, acne, urinary tract infections, and even pneumonia. But it’s also prescribed as a malaria prophylactic. There are three malaria prophylactics available and doxy is hands down the cheapest. In Ghana, I bought 30 capsules for a few dollars. It is taken daily, starting 2 days before your trip and continuing for 4 weeks after returning (this is because malaria can stay dormant in your liver even after you have left an area where it is endemic). If it’s the cheapest prophylactic and it does the job, what’s the problem?

My experience with doxycycline side effects

Doxycycline’s principle side effects are loss of appetite, nausea, heartburn, indigestion, and sensitivity to sunlight. There are of course a number of severe side effects that a small percentage of people may experience if they are allergic, and it must also be said that many people take doxy without experiencing any side effects at all.

Before taking it, I was concerned about the photo-sensitivity issue. I have pale skin and anything that makes me more vulnerable to the sun is potentially catastrophic. As it turns out, this side effect did not materialize for me.

What killed me was the acid reflux and heartburn. I had never experienced heartburn. No one in my family has it and I do not have a lifestyle that would make me susceptible to it (I’m not overweight, I don’t smoke, I am relatively active and I eat decently). But after taking doxy for 6 months, I now have a persistent heartburn problem that has continued for months after I quit taking it.

If you are prescribed to doxycycline, you will find a warning on the bottle that says “do not lay down within a half hour of taking this medicine.” If you don’t heed this warning, you may be in for a very unpleasant surprise. For most of my trip, I did not have any significant issues with heartburn while I was taking doxy. Nausea was the biggest side effect I felt, and I remedied this by making sure I took it with a meal.

The heartburn became an issue towards the end of my trip and it has continued even after I stopped taking doxy. I’m now taking medication to combat my heartburn (omeprazole aka prilosec)!! Earlier, it caused me to postpone a trip to West Africa, because I honestly thought there was something wrong with my heart itself. The worst part was not being able to sleep. Lying horizontal continues to be a problem and if my head is not propped up, I may find myself waking up to something that feels like a combination of an asthma attack and cardiac arrest (did you know heartburn could be this awful?).

I will not be taking doxy again. If you are thinking about it as a prophylactic option, I strongly suggest discussing the possible side effects with a doctor. If you have acid reflux or heartburn in any capacity, do not even think about taking this medication.

Some other things to consider

Doxycycline is an antibiotic and in addition to taxing your liver, it actively destroys beneficial bacteria in your body. If you are planning on taking it for a while, you should look into taking probiotics to help restore your gut flora. If you eat yogurt for the same effect, you need to make sure not to eat the yogurt, or any dairy, with the dose of doxy – the medication won’t be absorbed if it’s taken with calcium.

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{ 17 comments… read them below or add one }

Nj September 12, 2011 at 12:49 pm

Have your GERD symptoms gone away?

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phil September 12, 2011 at 1:06 pm

Hi Nj,
Nope. I’m still dealing with it. I’ve been taking omeprazole and watching my diet very closely. I’m hoping I can get off the omeprazole soon, but we’ll see. I was taking 40mg a day, now down to 20 mg. Do you have GERD as well?

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Heidi November 1, 2011 at 7:38 pm

Thank you for writing this. I have been on doxycycline and metronidazole for almost two weeks now, and I will be done on Friday. Recently I started getting bad chest pain. At first it was dull and uncomfortable and really freaked me out, but now it feels like a burning all over my chest. I mentioned it to my PCP today, and she brushed it off since she likely thinks I’m too young to have heart problems (I’m twenty-two). It really scared me, though; I took baby aspirin last night because I was afraid I was having a heart attack. If this is just a side effect caused by the antibiotic, then that makes me feel a little better. I just hope it goes away after I’m done. I’ve never experienced anything like this before! I have also lost thirteen pounds in almost a week because I have zero appetite and the thought of any food makes me feel nauseated. The side effects of these drugs are crazy!

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phil November 1, 2011 at 9:16 pm

Heidi,
Yeah, it is very likely you were experiencing heartburn from the doxy. Sorry to hear this!! I have also been on doxy and metronidazole simultaneously. It’s no fun, although the metro didn’t really have too many side effects for me. Steer clear of the baby aspiring while in doxy. It will only aggravate your stomach more/produce more acid. Although, it’s totally understandable that you thought you were experiencing heart trouble. I would strongly recommend not taking doxy on an empty stomach, and also, do not lay down within 2 hours of taking it if you can avoid it!! Hope things get better for you.

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Chris Rowson December 5, 2011 at 5:46 am

Hi

Ive been having the same problems for 4 days, I took doxy then went to bed straight after. Cant eat and its painful to even swallow water.

Have your symptoms gone? how did you manage to get rid of it?

Id appreciate your advice

Warm Regards

Chris

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phil December 5, 2011 at 7:11 am

Chris,
Very sorry to hear this. If you are having short-term symptoms like this, I would get off of it and try taking something like omeprazole or even an antacid for a few days.

My symptoms are much better now. I am taking 20mg omeprazole every other day. I stopped taking doxy a long time ago, but I had been taking it for 6 months and towards the end I started having a lot of problems. Are you taking it for malaria?

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Amanda Tracy January 29, 2013 at 3:20 pm

I I experienced the exact same thing! I am also in great physical condition, do not smoke, drink, I exercise, and I am probably considered underweight, but I am very healthy. I was originally prescribed doxy for acne and after a couple months of taking it I had severe heartburn. I had never had heartburn before so initially I thought that I had a pill stuck in my esophagus, it was horrible. It was so bad that I too couldn’t lay down it felt like there was seriously a patch of acid burning through my chest. I was miserable, it became hard to swallow even water. Some time had passed and I was planning a trip to Thailand, not even thinking of my previous reaction, my doctor prescribed me doxycycline for malaria. After reading up on the drug I made sure to take it in the morning with plenty of food and lots to drink. I was fine until about 3 days into my trip, talk about a damper on the Thailand experience without being able to eat Thai food. It was horrible, painful, miserable, could have ruined my trip horrible, so I stopped taking it. I have been home for about 20 days and Im still battling the heartburn, its not nearly the extreme that it was, but its still irritating. I told a pharmacist about my problems and he told me to get checked for H Pykori. He also said to stay away from PPIs such as Prevacid/Prilosec as new data is showing that they can permanently effect the acid level in your stomach negatively. Zantac/Ranitidine is safer to use long term.

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phil January 30, 2013 at 8:12 am

Hi Amanda,
Thanks a lot for your comment. Glad to hear I am not the only one. That is not good news for me if what you say about PPIs is true. I take omeprazole (prilosec) regularly and have been doing so since summer of 2011!! I have tried to stop taking it several times, but the heartburn has always come back with a vengeance. Once I am home, I will have to visit my doc again. Do you have any links with information on these new PPI studies?
Thanks,
phil

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Maggie H August 29, 2013 at 11:21 am

Hi – My son got acid reflux a few years back and this coincided with him taking doxycycline for acne. Drugs like Prilosec are very bad for you and remove the very thing that you need to get rid of acid reflux which is stomach acid. Great book by Dr. Jonathan Wright “Why Stomach Acid Is Good For You.” Explains it very well. My son takes apple cider vinegar for it whenever he gets it now and that completely gets rid of it. A good probiotic may help too?? Lots of lemon in all drinking water. Anything to help you digest your food. A big trigger for my son is pizza – we are not sure if it is the wheat, the tomato sauce, or the dairy in the cheese – or all 3 :/ – could be the perfect acid reflux storm??

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phil August 29, 2013 at 3:17 pm

Hi Maggie,
I’ve tried apple cider vinegar and I do take probiotics, but neither has brought much relief. I’ve also tried aloe vera and that made a slight impact. I will try the lemon water. Thanks for the tips. I’ve come to recognize a lot of my triggers as well and that has helped. I would love to stop taking omeprazole, but I haven’t gotten there yet!

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Maggie H August 29, 2013 at 11:36 am

Gastrazyme gets great reviews as a very helpful product too.

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phil August 29, 2013 at 3:17 pm

ok, I will check it out!

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maggie h August 29, 2013 at 9:54 pm

Hi Phil – It is such a bummer to have to deal with that, my son really suffered!! So glad that seems to be behind him – fingers crossed! I think that you will need to be very comprehensive in your approach. If you took omeprazole and apple cider vinegar I think they will just balance each other out and render both ineffective. So then it would appear that the apple cider vinegar wouldn’t work. My son had to take a good amount of apple cider vinegar for it to work, ie 2 tablespoons at a time. The book by Dr. Wright has a protocol that calls for Hydrochloric acid. We tried it and it seemed too strong for my son. He eats mainly Paleo now and feels that helps him also. Just some thoughts. I really hope you are able to resolve this. Good Luck. M

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phil August 30, 2013 at 4:33 am

Hey Maggie,
I will check out the book, it sounds like it could be very useful. Thanks a lot for your advice as well. I’m not taking a comprehensive approach right now and that’s definitely part of the problem – not being willing to make enough diet and lifestyle changes. Thanks for the inspiration, Maggie!

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mike April 23, 2014 at 3:06 am

I am curious, you said you were on Doxy for a few months? I personally would not take any antibiotic for that long regardless of possible malaria infection. I think that is extremely dangerous; however if you had a host of ailments they are probably cured including other parasites. Doxy is pretty amazing stuff. I had to be put on Malaria meds before going to Nigeria (Cant remember the name) but you just took it while I was there and not before or after. It really did cause vivid dreams so with any medication exercise caution. I have had gerd of years now and found ranitidine the best relief not to mention it works almost immediately.

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phil April 23, 2014 at 3:49 am

Hey Mike,
I agree. Not a good idea to take long-term antibiotics. It sounds like you were on mefloquine also known by brand name Lariam. I took that once in 2005 and remember having insane nightmares. Per your advice, I will give ranitidine a shot. Thanks.

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phil April 23, 2014 at 3:50 am

Ah, nevermind, this is zantac, correct? Yes, I take this. And you are right, it does provide immediate relief.

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