What you need to know about doxycycline for prevention of anthrax
What You Need to Know about Doxycycline for Prevention of Anthrax
You are being given a medicine called doxycycline (sounds like
DOCKS-ee-SY-cleen) because you may have breathed in anthrax germs.
These germs can be deadly. Taking this drug reduces your chance of getting
sick and dying. Until officials know for sure who breathed in the germs, it is
important to start taking this medicine now. People who may have breathed
in anthrax should take the medicine for 60 days. If you do not have enough
for 60 days, public health officials will tell you whether you need more and
Taking this drug is your choice. If you can, talk to your doctor or health care
What is anthrax?
Anthrax is a serious disease that can be deadly. You can get sick if you breathe
in the anthrax germs. You cannot get anthrax from another person.
• The first signs or symptoms may seem like a cold or the flu (such as a mild fever and muscle aches).
• Later signs or symptoms may be a cough, chest discomfort, shortness
of breath, tiredness, and muscle aches.
Symptoms usually start within 7 days of breathing in anthrax germs, but can
up to 42 days to appear. See a doctor right away if you have symptoms. If you
take doxycycline as directed and begin to feel sickanyway, get medical care right away. What is doxycycline?
Doxycycline is a prescription medicine approved by the Food and Drug
Administration (FDA) to prevent anthrax. FDA has allowed certain uses of
doxycycline, including its use with no prescription, for this emergency. Do
not be alarmed if the medicine you receive from public health officials has
an expired date on the package. FDA has authorized its use because testing
of the medicine found it safe to use past the expiration.
• Doxycycline may not work as well when taken with some medicines. Take it 2 hours before or 2 hours after taking:
o Multivitamins or supplements with calcium, iron,
o Bismuth subsalicylate (Helidac, Pepto Bismol,
Kaopectate, or other products for indigestion,
• If you get an upset stomach when you take the medicine, take it with food or milk.
• If you miss a pill, take only your next pill at the time you are supposed to – Do not take 2 pil s at once.
• Talk to your doctor if you are on blood thinners or seizure medicines. Doxycycline may affect how much of these
• Keep the pil s dry. Store them at room temperature (between 68–77°F or 20-25°C).
• Keep pill bottles away from children and pets. Call the poison center if they take the medicine by accident (1-800-
Who should NOT take doxycycline? Do not take doxycycline if you have had a severe allergic reaction to doxycycline or another tetracycline drug. A severe
reaction may include swel ing of the tongue, hands, feet, closing of throat, or trouble breathing.
STOP taking this medicine if you get any of these serious, but rare, side effects. Get medical help right away (go to the emergency room or call 911).
• swel ing of the tongue, hands, or feet
• yellowing of the eyes or skin or dark-colored urine
• closing of the throat or trouble breathing
• severe itching or rash, especially hives and wheals • unusual bleeding or bruising
• severe stomach cramps with high fever or bloody • severe headaches, dizziness, or double vision
Keep taking the medicine if you have: • vaginal yeast infection
• mild nausea or vomiting, upset stomach, loose stools
Are there other possible severe side effects? • Serious liver problems (liver failure)
• Discolored teeth or poor tooth enamel in children younger than 8 years and in children whose mothers took
doxycycline during the last half of pregnancy or while nursing
• Birth control pills stop working. Use another form of birth control until you finish taking all of your doxycycline
Are there any other medications that I can take instead of doxycycline? Public health officials will tell you if other medications are available. The risks and benefits of those medications will be How do I report side effects or medication errors? Tell your doctor right away and report side effects or medication errors to MedWatch at www.fda.gov/medwatch
Is there anything that is not known about the emergency use of doxycycline? The benefit of providing emergency access to doxycycline is expected to outweigh the risks. The impact of using the
medicine without a prescription, or how well these instructions will be followed, is unknown.
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What You Need to Know about 
• Doxycycline may not work as well when taken with some medicines. Take it 2 hours before or 2 hours after taking:
o Multivitamins or supplements with calcium, iron,
o Bismuth subsalicylate (Helidac, Pepto Bismol,
Kaopectate, or other products for indigestion,
• If you get an upset stomach when you take the medicine, take it with food or milk.
• If you miss a pill, take only your next pill at the time you are supposed to – Do not take 2 pil s at once.