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Doxycycline Hyclate side effects: what 67,065 FDA adverse event reports show

Doxycycline Hyclate · 1,205 reaction terms · 382,258 drug–reaction co-reports · data 2026-09-14
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Drug class

Not stated in label

Who reports

67,065 reports · 73% serious · 6,708 with death outcome · 63% female

openFDA FAERS counts, all years, deduplication not applied

Used for

To reduce the development of drug-resistant bacteria and maintain effectiveness of doxycycline hyclate and other antibacterial drugs, doxycycline hyclate should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy.

FDA label, Indications and Usage

What it is

DESCRIPTION Doxycycline is an antibacterial drug synthetically derived from oxytetracycline, and is available as doxycycline hyclate tablets for oral administration. The chemical designation o.

FDA label, Description section

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled adverse reaction 1Labeled (related wording) 2Lab value / disease marker 7Not in label — unassessed 30
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,165 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Amyloid arthropathy551,878.3
928.4–3,800.4ROR 1,879.9 · calibrated p 6e-17 ✓
242.7 EB05 193.5 · IC025 +5.8
3/3 methods agree
Not in label — unassessedserious n=55 · ♀ 100% (drug 63%) · 100% cliniciannot reported in cached trials
Grip strength142501.7
384.2–655.0ROR 502.7 · calibrated p 1e-13 ✓
186.4 EB05 162.1 · IC025 +6.6
3/3 methods agree
Not in label — unassessedserious n=142 · ♀ 100% (drug 63%) · 100% cliniciannot reported in cached trials
Congenital hiatus hernia119365.8
280.4–477.1ROR 366.4 · calibrated p 3e-12 ✓
163.2 EB05 140.0 · IC025 +6.3
3/3 methods agree
Not in label — unassessedserious n=119 · ♀ 0% (drug 63%)not reported in cached trials
C-reactive protein462327.2
287.1–372.9ROR 329.5 · calibrated p 5e-12 ✓
158.0 EB05 146.2 · IC025 +6.9
3/3 methods agree
Lab value / disease markerserious n=462 · ♀ 100% (drug 63%) · 97% cliniciannot reported in cached trials
Deep vein thrombosis postoperative869250.3
229.0–273.7ROR 253.6 · calibrated p 5e-11 ✓
138.0 EB05 130.5 · IC025 +6.9
3/3 methods agree
Not in label — unassessedserious n=869 · ♀ 100% (drug 63%) · 95% cliniciannot reported in cached trials
Anti-cyclic citrullinated peptide antibody295249.1
213.7–290.4ROR 250.2 · calibrated p 7e-11 ✓
136.8 EB05 124.2 · IC025 +6.6
3/3 methods agree
Lab value / disease markerserious n=295 · ♀ 100% (drug 63%) · 100% cliniciannot reported in cached trials
Jarisch-herxheimer reaction312244.0
210.4–283.1ROR 245.1 · calibrated p 8e-11 ✓
135.4 EB05 123.2 · IC025 +6.6
3/3 methods agree
Labeled adverse reaction
exact term
serious n=297 · ♀ 29% (drug 63%) · 100% cliniciannot reported in cached trials
Swollen joint count106237.8
184.6–306.4ROR 238.2 · calibrated p 2e-10 ✓
131.4 EB05 111.7 · IC025 +6.0
3/3 methods agree
Not in label — unassessedserious n=106 · ♀ 100% (drug 63%) · 100% cliniciannot reported in cached trials
Lupus vulgaris509234.9
209.4–263.6ROR 236.7 · calibrated p 1e-10 ✓
132.9 EB05 123.5 · IC025 +6.7
3/3 methods agree
Not in label — unassessedserious n=509 · ♀ 100% (drug 63%) · 96% cliniciannot reported in cached trials
Gastrointestinal mucosal necrosis56200.1
143.0–280.2ROR 200.3 · calibrated p 1e-9 ✓
116.9 EB05 93.3 · IC025 +5.4
3/3 methods agree
Not in label — unassessedserious n=56 · ♀ 0% (drug 63%) · 100% cliniciannot reported in cached trials
Swollen joint count increased1,014150.9
140.1–162.6ROR 153.2 · calibrated p 4e-9 ✓
101.4 EB05 96.2 · IC025 +6.5
3/3 methods agree
Lab value / disease markerserious n=1,014 · ♀ 100% (drug 63%) · 96% cliniciannot reported in cached trials
Abortion incomplete553129.7
117.5–143.3ROR 130.8 · calibrated p 1e-8 ✓
91.3 EB05 85.0 · IC025 +6.3
3/3 methods agree
Not in label — unassessedserious n=203 · ♀ 100% (drug 63%) · 100% cliniciannot reported in cached trials
Adjustment disorder with depressed mood510105.9
95.8–117.1ROR 106.7 · calibrated p 7e-8 ✓
78.8 EB05 73.2 · IC025 +6.1
3/3 methods agree
Not in label — unassessedserious n=508 · ♀ 100% (drug 63%) · 95% cliniciannot reported in cached trials
Rheumatic fever1,095104.6
97.7–112.0ROR 106.3 · calibrated p 7e-8 ✓
78.2 EB05 74.4 · IC025 +6.1
3/3 methods agree
Not in label — unassessedserious n=1,095 · ♀ 100% (drug 63%) · 96% cliniciannot reported in cached trials
Retinitis409101.5
90.8–113.4ROR 102.1 · calibrated p 1e-7 ✓
76.3 EB05 70.3 · IC025 +6.0
3/3 methods agree
Not in label — unassessedserious n=409 · ♀ 100% (drug 63%) · 100% cliniciannot reported in cached trials
Facet joint syndrome71090.9
83.6–98.8ROR 91.8 · calibrated p 2e-7 ✓
70.2 EB05 66.0 · IC025 +5.9
3/3 methods agree
Not in label — unassessedserious n=710 · ♀ 100% (drug 63%) · 95% cliniciannot reported in cached trials
X-ray abnormal37382.5
73.6–92.5ROR 83.0 · calibrated p 5e-7 ✓
65.1 EB05 59.7 · IC025 +5.7
3/3 methods agree
Lab value / disease markerserious n=373 · ♀ 100% (drug 63%) · 100% cliniciannot reported in cached trials
Rheumatoid factor positive1,18380.6
75.6–85.9ROR 82.0 · calibrated p 5e-7 ✓
64.0 EB05 61.0 · IC025 +5.9
3/3 methods agree
Lab value / disease markerserious n=1,183 · ♀ 100% (drug 63%) · 95% cliniciannot reported in cached trials
Dislocation of vertebra45680.6
72.7–89.3ROR 81.1 · calibrated p 6e-7 ✓
63.9 EB05 59.1 · IC025 +5.7
3/3 methods agree
Not in label — unassessedserious n=456 · ♀ 100% (drug 63%) · 93% cliniciannot reported in cached trials
Overlap syndrome12267.1
55.2–81.6ROR 67.2 · calibrated p 2e-6 ✓
54.8 EB05 47.1 · IC025 +5.2
3/3 methods agree
Not in label — unassessedserious n=122 · ♀ 100% (drug 63%) · 100% cliniciannot reported in cached trials
Duodenal ulcer perforation1,21962.2
58.5–66.1ROR 63.3 · calibrated p 3e-6 ✓
51.8 EB05 49.4 · IC025 +5.6
3/3 methods agree
Not in label — unassessedserious PRR 41.0 · ♀ 100% (drug 63%) · 96% cliniciannot reported in cached trials
C-reactive protein abnormal93053.0
49.5–56.8ROR 53.7 · calibrated p 9e-6 ✓
45.3 EB05 42.9 · IC025 +5.4
3/3 methods agree
Lab value / disease markerserious n=928 · ♀ 100% (drug 63%) · 95% cliniciannot reported in cached trials
Bone erosion51052.5
47.8–57.6ROR 52.9 · calibrated p 1e-5 ✓
44.9 EB05 41.7 · IC025 +5.3
3/3 methods agree
Not in label — unassessedserious n=510 · ♀ 100% (drug 63%) · 97% cliniciannot reported in cached trials
Seronegative arthritis16051.9
43.9–61.3ROR 52.0 · calibrated p 1e-5 ✓
44.3 EB05 38.8 · IC025 +5.0
3/3 methods agree
Not in label — unassessedserious n=160 · ♀ 100% (drug 63%) · 100% cliniciannot reported in cached trials
Anti-cyclic citrullinated peptide antibody positive91946.3
43.2–49.6ROR 47.0 · calibrated p 2e-5 ✓
40.4 EB05 38.2 · IC025 +5.2
3/3 methods agree
Lab value / disease markerserious PRR 32.1 · ♀ 100% (drug 63%) · 95% cliniciannot reported in cached trials
Helicobacter infection1,28144.8
42.3–47.5ROR 45.7 · calibrated p 2e-5 ✓
39.2 EB05 37.5 · IC025 +5.2
3/3 methods agree
Not in label — unassessedserious PRR 32.6 · ♀ 100% (drug 63%) · 95% cliniciannot reported in cached trials
Porphyria acute17244.4
37.8–52.1ROR 44.5 · calibrated p 3e-5 ✓
38.8 EB05 34.1 · IC025 +4.9
3/3 methods agree
Not in label — unassessedserious n=172 · ♀ 100% (drug 63%) · 100% cliniciannot reported in cached trials
Folliculitis1,20041.0
38.6–43.5ROR 41.7 · calibrated p 4e-5 ✓
36.3 EB05 34.6 · IC025 +5.1
3/3 methods agree
Not in label — unassessedserious PRR 33.4 · ♀ 97% (drug 63%) · 95% cliniciannot reported in cached trials
Chronic kidney disease-mineral and bone disorder11938.8
32.1–46.9ROR 38.9 · calibrated p 7e-5 ✓
34.4 EB05 29.5 · IC025 +4.6
3/3 methods agree
Not in label — unassessedserious n=119not reported in cached trials
Muscle injury87237.1
34.6–39.8ROR 37.6 · calibrated p 8e-5 ✓
33.2 EB05 31.4 · IC025 +4.9
3/3 methods agree
Not in label — unassessedserious PRR 28.4 · ♀ 100% (drug 63%) · 95% cliniciannot reported in cached trials
Peripheral venous disease40234.9
31.5–38.7ROR 35.1 · calibrated p 1e-4 ✓
31.4 EB05 28.9 · IC025 +4.8
3/3 methods agree
Not in label — unassessedserious n=400 · ♀ 100% (drug 63%) · 92% cliniciannot reported in cached trials
Hand deformity1,27133.6
31.7–35.5ROR 34.2 · calibrated p 1e-4 ✓
30.3 EB05 29.0 · IC025 +4.8
3/3 methods agree
Not in label — unassessedserious PRR 26.1 · ♀ 100% (drug 63%) · 96% cliniciannot reported in cached trials
Autoimmune disorder89032.0
29.8–34.2ROR 32.4 · calibrated p 2e-4 ✓
29.0 EB05 27.5 · IC025 +4.7
3/3 methods agree
Not in label — unassessedserious PRR 24.5 · ♀ 98% (drug 63%) · 93% cliniciannot reported in cached trials
Lip dry79330.3
28.2–32.6ROR 30.6 · calibrated p 2e-4 ✓
27.6 EB05 26.1 · IC025 +4.6
3/3 methods agree
Not in label — unassessedserious n=771 · ♀ 100% (drug 63%) · 94% cliniciannot reported in cached trials
Hyperparathyroidism secondary22430.3
26.4–34.7ROR 30.4 · calibrated p 3e-4 ✓
27.6 EB05 24.7 · IC025 +4.5
3/3 methods agree
Not in label — unassessedserious n=224not reported in cached trials
Nephrogenic anaemia40329.4
26.6–32.6ROR 29.6 · calibrated p 3e-4 ✓
26.9 EB05 24.8 · IC025 +4.5
3/3 methods agree
Not in label — unassessedserious n=403not reported in cached trials
Drug tolerance decreased24129.4
25.7–33.5ROR 29.5 · calibrated p 3e-4 ✓
26.8 EB05 24.1 · IC025 +4.5
3/3 methods agree
Not in label — unassessedserious n=238 · ♀ 100% (drug 63%) · 90% cliniciannot reported in cached trials
Rebound acid hypersecretion26329.2
25.8–33.2ROR 29.4 · calibrated p 3e-4 ✓
26.7 EB05 24.1 · IC025 +4.5
3/3 methods agree
Not in label — unassessedserious n=263 · 100% consumernot reported in cached trials

Clinical concept groups

MedDRA splits one clinical problem across several terms (e.g. "neutropenia", "neutrophil count decreased", "agranulocytosis"), which dilutes term-level signals. These rows count reports with any term in a concept group (an exact union, not a sum), compared with all other drugs. Groups are hand-built and listed in the methods.

ConceptReportsPRR 95% CIReading
Interstitial lung disease1,0273.43.2–3.6signal
Liver injury2,9993.13.0–3.2signal
Severe cutaneous reaction7363.12.9–3.3signal
Pancreatitis7833.12.8–3.3signal
Kidney injury4,0302.82.7–2.9signal
Serious infection6,1462.52.4–2.6signal
Tendon disorder3002.52.2–2.8signal
Depression2,0292.32.2–2.4signal
Arrhythmia / qt1,1481.91.8–2.0raised
Anaemia1,7091.81.7–1.9raised
Hyperglycaemia / diabetes1,9371.81.7–1.8raised
Thrombocytopenia1,1801.71.6–1.8raised
Gi bleeding9341.61.5–1.7raised
Venous thromboembolism1,0861.61.5–1.7raised
Hyponatraemia3851.51.4–1.7raised
Opportunistic infection6051.41.3–1.5raised

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Doxycycline Hyclate as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (0 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Drug ineffective (drug did not work)5,2591.2
1.2–1.3ROR 1.3 · calibrated p 0.488
1.2 EB05 1.2 · IC025 +0.3Reporting / coding artifactage-adj. PRR 1.5 · serious PRR 2.1not reported in cached trials
Nausea5,0032.0
1.9–2.0ROR 2.1 · calibrated p 0.980
2.0 EB05 1.9 · IC025 +0.9Labeled adverse reaction
exact term
age-adj. PRR 1.7 · serious PRR 2.3NCT01320033: 14/223 (6.3%) on Doxycycline Hyclate; 4/222 (1.8%) control
Off label use (used outside approved label)4,7771.7
1.7–1.8ROR 1.8 · calibrated p 0.818
1.7 EB05 1.7 · IC025 +0.7Reporting / coding artifactage-adj. PRR 1.7 · serious PRR 2.0not reported in cached trials
Fatigue (tiredness)4,6811.9
1.8–1.9ROR 2.0 · calibrated p 0.919
1.9 EB05 1.8 · IC025 +0.9Not in label — unassessedage-adj. PRR 1.7 · serious PRR 2.2not reported in cached trials
Rash4,1603.0
2.9–3.1ROR 3.2 · calibrated p 0.579
3.0 EB05 2.9 · IC025 +1.5
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 3.0 · serious PRR 4.0not reported in cached trials
Dyspnoea (shortness of breath)4,0412.2
2.2–2.3ROR 2.3 · calibrated p 0.893
2.2 EB05 2.2 · IC025 +1.1
3/3 methods agree
Not in label — unassessedage-adj. PRR 2.0 · serious PRR 2.2not reported in cached trials
Diarrhoea (diarrhea)4,0352.0
1.9–2.0ROR 2.0 · calibrated p 0.959
2.0 EB05 1.9 · IC025 +0.9Labeled adverse reaction
exact term
age-adj. PRR 1.8 · serious PRR 2.1not reported in cached trials
Pain3,9822.0
2.0–2.1ROR 2.1 · calibrated p 0.994
2.0 EB05 2.0 · IC025 +1.0Not in label — unassessedage-adj. PRR 2.1 · serious PRR 2.1not reported in cached trials
Headache3,9052.0
1.9–2.0ROR 2.0 · calibrated p 0.952
1.9 EB05 1.9 · IC025 +0.9Labeled adverse reaction
exact term
age-adj. PRR 1.7 · serious PRR 2.5NCT01320033: 15/223 (6.7%) on Doxycycline Hyclate; 6/222 (2.7%) control
Vomiting3,8482.6
2.5–2.7ROR 2.7 · calibrated p 0.742
2.6 EB05 2.5 · IC025 +1.3
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 2.3 · serious PRR 2.6 · ♀ 83% (drug 63%)NCT01320033: 15/223 (6.7%) on Doxycycline Hyclate; 5/222 (2.3%) control
Malaise (feeling unwell)2,9882.1
2.1–2.2ROR 2.2 · calibrated p 0.959
2.1 EB05 2.1 · IC025 +1.0
3/3 methods agree
Not in label — unassessedage-adj. PRR 2.1 · serious PRR 2.5not reported in cached trials
Condition aggravated2,9423.1
3.0–3.2ROR 3.2 · calibrated p 0.577
3.0 EB05 3.0 · IC025 +1.5
3/3 methods agree
Reporting / coding artifactage-adj. PRR 2.7 · serious PRR 3.2not reported in cached trials
Dizziness2,9161.8
1.8–1.9ROR 1.9 · calibrated p 0.873
1.8 EB05 1.8 · IC025 +0.8Not in label — unassessedage-adj. PRR 1.7 · serious PRR 2.1not reported in cached trials
Pruritus (itching)2,9042.4
2.3–2.5ROR 2.5 · calibrated p 0.823
2.4 EB05 2.3 · IC025 +1.2
3/3 methods agree
Not in label — unassessedage-adj. PRR 2.2 · serious PRR 3.5not reported in cached trials

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

✓ A hand-written Bradford Hill causality assessment exists for this drug: Doxycycline (tetracyclines) ↔ Photosensitivity reaction.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Doxycycline Hyclate?

In FDA FAERS, the most frequently co-reported reaction terms for Doxycycline Hyclate are nausea, fatigue, rash, dyspnoea, diarrhoea, pain. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Doxycycline Hyclate have an FDA boxed warning?

No. The FDA label retrieved for Doxycycline Hyclate has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Doxycycline Hyclate causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.