Doxycycline problems?

[swedishguy]

Hi,
I have a few questions regarding STD medications. While being out travelling I talked to a doctor after an unprotected incident. Since there was not much time for testing and treatment I was given doxycycline 2 times a day for 10 days and 1 dose of cefaxime (400mg) since this would cure most STDs. After taking the doxycycline for about a day I was starting to feel a bit sick, not that much, but a mild illness and nausea. After one more day I noticed that my skin was reacting, it felt almost exactly like a sunburn. I read a little on the internet regarding this, and a common side effect of doxycycline seems to be that it can cause fotoallergic symptoms. However, since I have barely been outside, and it has not been sunny at all this seems a bit strange?

I stopped the doxycycline (after 5 pills) since it freaked me out a bit, and talked to the doctor again over the phone. He recommended to use zithromax instead in a one time dose (1-2g). Now I am a bit hesitant to this, since I do not know how I will react to this medication (which seems stronger)? I have not had any allergic reactions at all to any medication or antibiotic before, and not to anything else for that matter.

1  Do you have any idea as to what could have caused this skin reaction? I was also recently vaccinated against hepatitis B, but this cannot be the cause? Right?

2. Can I take the zithromax / cefaxime dose, or is there a good chance that I will respond badly to that medication also?

3. This "sunburn" feeling has been getting less noticable but is still there (one week now). Do you know how long this can take before it disappears?

I understand that you might not be able to answer these questions from a distance. Grateful for a response anyway. (sorry for the language, english is not my native language).

[H. Hunter Handsfield, M.D.]

You describe classical side effects from doxycycline.  It often causes mild GI upset, which can be reduced by taking the drug with food.  It is one of the most common causes of drug-induced photosensitivity, which causes exactly the symptooms you describe.  Good for you for stopping the drug.  Continuing it, along with sun exposure, can result in really severe sunburn.  Doxy isn't completely gone from the system for at least 3-4 days after the last dose.  Stay out of the sun as much as possible (or use a strong sunblock, spf 30 or higher) for the next week.

Azithromycin (Zithromax) is no "stronger" than doxycycline, just a different antibiotic.  It is chemically entirely different and does not cause photosensitivity.  I'm not certain you needed STD treatment at all, but it will cause no harm if you go ahead and take it.  It might also cause some nausea, cramping, or diarrhea, but those are harmless and go away in a few hours.

Good luck--  HHH, MD

[ryn21]

I had a similar reaction to Doxycycline.  It made me extremely ill, nausea, vomiting, dizziness.  My father also had the same experiences with the pill.  The problem with antibiotics is that they all cause some forms of side effects, such as nausea, vomiting, rashes, diarrhea, chest pain, ect.  It also makes your skin more succeptable to sunlight and UV burns.  Your body may take the Z-MAX a bit better, at least for me I didnt get sick from taking it.

[swedishguy]

Well, I am not that worried about the nausea since I was prepared for it by reading the information that came with the medication. However, the skin reaction was not expected. I know it can affect you when out in the sun, but I have been working most days and have not been outside more than maybe 25 minutes per day (and it is raining every day here).

[ryn21]

What was your particular unprotected exposure?  In the US, heterosexual sex is low risk overall.

[monkeyflower]

Maybe you're allergic. I found out I was allergic to sulfa in a very similar way... my skin felt "funny", sort of tingly, itchy, sort of like I had chills (even though it was like 95). I didn't think anything of it, though, until I had trouble swallowing and breathing and REALLY started feeling funny, lol. Don't know if that funny skin feeling applies to you, but just thought I'd throw that out there ;-)

[swedishguy]

So this photosensitivity can occur even if I have not really been exposed to sun? It is winter here, snowing, and hardly sunny. That was one of my worries, that it could be something else causing the reaction...

[swedishguy]

... and by the way, Cefixime is also not the same kind of antibiotic as Doxycycline, right?

[H. Hunter Handsfield, M.D.]

Photosensitivity varies widely in severity.  Almost anybody may get a little bit of it, which only shows up under intense sun exposure; doxycycline and other tetracyclines cause the problem much more frequently in tropical settings than elsewhere.  But highly sensitive people can experience it with only a little ultraviolet exposure.

Cefixime, doxycycline, and azithromycin all are chemically entirely different from one another.

If you have further questions, please ask them of the provider who prescribed your treatment.

HHH, MD

[Lolabrigida]

A related discussion, doxycycline and nausea post usage was started.