Skip to content

Doxycycline Anhydrous

  • Prescription medicine
  • Given by a clinician
  • Identity checked
  • Sources last checked 2026-09-04

This page shows what was measured, who it was measured in, and what that does not settle.

What Doxycycline Anhydrous does in the body

Nothing can dock, the chain stops growing, and the bacterium stops multiplying.

To build a protein, a bacterium has to bring in amino acids one at a time and dock each one into a slot on the ribosome. Doxycycline sits in that slot. It gets inside human cells easily, which is why it reaches bacteria that live there and most other cheap antibiotics do not.

Why people take it. Tick-borne and sexually transmitted infections, chest infections, acne, and malaria prevention

What happened in people

Relative risk 0.34 for any bacterial sexually transmitted infection per quarter in the DoxyPEP pre-exposure-prophylaxis cohort, and 0.38 in the cohort living with HIV

Source-linked record

Where this came from

A person wrote this into the record with the study named beside it. No reviewer has signed it off.

The recorded finding that sits closest to something a person would notice. Written into the record, not signed off, and it carries no population or interval.

The limit that matters most

That an efficacy result in one population transfers unchanged to a different population, different anatomical sites of infection and different adherence

Where it acts
Bacterial 30S ribosome, including organisms living inside human cells
Kind of result
The kind of result is not recorded
Supervision
Professional supervision is normally required. A regulator classifies this substance in a way that restricts how it is supplied.

What the registries record it as

  • Its recorded molecular formula is C22H24N2O8•H2O, weighing 462.45.

    US prescribing information · 81c5a7fc-3fe0-40b2-bae0-c79eb0b27697 · read 2026-08-30

Where each sentence above came from

A person wrote this explanation into the record, with the studies named in the path below.

The recorded use, written for a reader without medical training. Not signed off.

A limit recorded against this substance. Not signed off as a reviewed claim.

The four opening statements run to 102 words.

Words this page uses

Four words worth knowing first

Chosen from what this page shows, with each one explained before the word it depends on.

Comparator

A comparator is whatever the treatment was measured against.

A picture of it, and where the picture fails

It is like the other runner in a race.

Where that stops being true. A race has one winner. A study can show both arms improved.

What people get wrong. Results are read without asking what the other group got. Beating nothing is not beating a treatment.

The control condition against which the experimental intervention is assessed.

Randomisation

Randomisation means chance decides who gets which treatment.

A picture of it, and where the picture fails

It is like a coin toss deciding the groups.

Where that stops being true. A coin toss is fair once. Fairness here comes from doing it for everyone.

What people get wrong. It is thought to make groups identical. It makes them similar on average, including on things nobody measured.

Allocation of participants to arms by a chance process, so that unmeasured factors are balanced in expectation.

Absolute difference

An absolute difference is how many more people in a hundred were affected.

A picture of it, and where the picture fails

It is like counting heads in two rooms of a hundred.

Where that stops being true. Heads are easy to count. Study results carry a margin of error too.

What people get wrong. It is confused with a percentage change, which can look far larger.

The arithmetic difference in event rates between arms.

Confidence interval

A confidence interval is the range the true answer is likely to sit in.

A picture of it, and where the picture fails

It is like a weather forecast giving a range rather than one number.

Where that stops being true. A forecast range covers tomorrow. This one covers what the study could resolve.

What people get wrong. The middle number is read as the answer. A range crossing zero means no change is still possible.

An interval estimate that would contain the true parameter in a stated proportion of repeated studies.

What happened in peopleRead from sources, not yet reviewed

What happened in people

Each card is one study: the exact question it asked, who was in it, and whether it showed what it set out to show.

Incidence of at least one bacterial sexually transmitted infection per follow-up quarter

The study showed what it set out to show

Who was studied
DoxyPEP (NCT03980223)
How many people
501
Study design
Phase 4 randomised open-label
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
P < 0.001 in both cohorts (relative risk 0.34 and 0.38)
Repeated elsewhere
Failed to Replicate

What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.

The limits of this study, and where it came from

Main limit. Tetracycline-resistant gonorrhoea was recovered from 5 of 13 cultured participants in the doxycycline groups versus 2 of 16 in standard care.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Oral capsule, tablet, delayed-release tablet, oral suspension and intravenous infusion

Interval reported. Not recorded in this summary

Written into the record, not signed off as a reviewed claim.

Incident chlamydia, gonorrhoea or syphilis in cisgender women over 12 months

The study did not show it

Who was studied
dPEP Kenya (NCT04050540)
How many people
449
Study design
Phase 4 randomised open-label
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
P = 0.51 (relative risk 0.88, 95% CI 0.60 to 1.29)
Repeated elsewhere
Failed to Replicate

What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.

The limits of this study, and where it came from

Main limit. Hair testing detected doxycycline in only 29.0% of samples from the intervention arm, so the trial measures the strategy as delivered rather than the drug as taken.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Oral capsule, tablet, delayed-release tablet, oral suspension and intravenous infusion

Interval reported. 95% CI 0

Written into the record, not signed off as a reviewed claim.

Change in maximum transverse aneurysm diameter on CT at 2 years

The study did not show it

Who was studied
N-TA3CT (NCT01756833)
How many people
261
Study design
Phase 2 randomised placebo-controlled
Compared against
A dummy treatment
Kind of result
A number that stands in for health
What was found
P = 0.93 for measured diameter change; one-sided P = 0.71 for the primary normal-scores analysis
Repeated elsewhere
Unreplicated

What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.

The limits of this study, and where it came from

Main limit. No limitation is recorded for this study.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Oral capsule, tablet, delayed-release tablet, oral suspension and intravenous infusion

Interval reported. Not recorded in this summary

Written into the record, not signed off as a reviewed claim.

Time to first self-reported recovery and hospitalisation or death by day 28 in community COVID-19

The study did not show it

Who was studied
PRINCIPLE doxycycline comparison (ISRCTN86534580)
How many people
2689
Study design
Randomised controlled open-label adaptive platform
Compared against
Not recorded for this study
Kind of result
Living longer, or avoiding a major event
What was found
Hazard ratio 1.04 (95% Bayesian credible interval 0.93 to 1.17); stopped when the prespecified futility criterion was met
Repeated elsewhere
Unreplicated

What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.

The limits of this study, and where it came from

Main limit. No limitation is recorded for this study.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Oral capsule, tablet, delayed-release tablet, oral suspension and intravenous infusion

Interval reported. Not recorded in this summary

Written into the record, not signed off as a reviewed claim.

What we know
RNAWiki holds 4 written-up human studies for this substance, each with the question it asked.
How we know it
Each card names the study, the number of people and what the study set out to measure.
What this does not prove
These summaries were written by a person and have not been signed off as reviewed claims.
Why it matters
A study that failed is as informative as one that worked, and both are here.
What we still do not know
No reviewed claim exists, so no exact population, effect size or interval is published yet.

What it changes in the bodyRead from sources, not yet reviewed

The path through the body

From what a person takes to what changes. A solid line is a step measured in people. A dashed line is a step nobody has measured that way.

  1. Start

    Doxycycline Anhydrous

    What a person takes: Oral capsule, tablet, delayed-release tablet, oral suspension and intravenous infusion.

    The measurement behind this step

    Usually 100 mg once or twice daily by mouth. Absorption is high and only modestly food-affected, but divalent and trivalent cations in dairy, antacids and iron supplements chelate the drug in the gut and reduce absorption. Delayed-release and subantimicrobial-dose formulations exist for dermatological use.

  2. Getting in

    Absorbed almost completely and distributed into tissue

    Doxycycline is absorbed better than older tetracyclines and reaches most tissues, including places bacteria hide.

    Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.

    The measurement behind this step

    Oral bioavailability is high and largely unaffected by food, unlike tetracycline itself. The 6-alpha-methyl, 6-deoxy configuration gives a long elimination half-life, so twice-daily and then once-daily dosing is possible. Elimination is substantially non-renal, which is why it is usable in renal impairment.

  3. Reaching the cell

    Carried into the bacterium, and into human cells too

    The drug is lipid-soluble enough to cross into human cells, which is how it reaches bacteria that live inside them.

    Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.

    The measurement behind this step

    Entry into Gram-negative bacteria is through OmpF and OmpC porins as a magnesium chelate, followed by energy-dependent transport across the inner membrane. High lipophilicity also allows passive entry into mammalian cells, which is the basis of activity against Rickettsia, Chlamydia and Coxiella.

  4. What it acts on

    It occupies the docking slot on the small ribosomal subunit

    The drug sits in the slot where the next amino acid has to arrive.

    Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.

    The measurement behind this step

    Doxycycline binds the h34 region of 16S ribosomal RNA in the 30S subunit, overlapping the aminoacyl-tRNA acceptor site. A single high-affinity primary site accounts for the antibacterial effect; the interaction is reversible.

  5. The change it makes

    Amino acids cannot dock, so translation stops

    With the slot occupied, the protein chain cannot be extended.

    Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.

    The measurement behind this step

    Aminoacyl-tRNA delivery to the A site is sterically blocked, halting elongation. The effect is bacteriostatic and reversible on drug removal, which is why treatment duration and adherence matter more here than with a bactericidal beta-lactam.

  6. What that does for a person

    Growth stops, and resistance genes are selected

    The infection is controlled, while bacteria carrying pump or protection genes gain an advantage.

    Measured in people. Written by a person from the study named beside the step. Not signed off as a reviewed claim.

    The measurement behind this step

    Resistance is mediated by tet efflux pumps and by ribosomal protection proteins such as TetM. Both DoxyPEP and the Kenyan dPEP trial recovered tetracycline-resistant gonococci from treated participants, which is the measured version of this step rather than a theoretical one.

No suggested links are held for this record, so nothing is hidden from this path.

What we know
The record describes 5 steps from taking it to an effect in a person.
How we know it
Each step names the study behind it in the technical detail beside it.
What this does not prove
A change inside the body is a reason to look. It is not a result in a person.
Why it matters
A reader can see exactly where the chain stops being measured in people.
What we still do not know
No reviewed claim binds any of these steps to a named population.

What is missing or unclearRead from sources, not yet reviewed

Were people like you studied?

RNAWiki cannot tell whether a study fits you. It can show who was in it, and where the result stops carrying.

Who was studied

People similar to this profile were included.

  • People with tick-borne infection, chlamydial infection, atypical pneumonia, moderate acne or rosacea, travellers taking malaria prophylaxis, and men who have sex with men and transgender women taking post-exposure prophylaxis against bacterial sexually transmitted infections.

Who is missing from the studies

  • Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.

What the label states about particular groups

  • On pediatric, the label states: “Doxycycline capsules should not be used in infants and children less than 8 years of age [ see Warnings and Precautions ( 5.1 ) ].”

    US prescribing information · 81c5a7fc-3fe0-40b2-bae0-c79eb0b27697 · read 2026-08-30

  • On older people, the label states: “Clinical studies of doxycycline capsules did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.”

    US prescribing information · 81c5a7fc-3fe0-40b2-bae0-c79eb0b27697 · read 2026-08-30

  • On people who are pregnant, the label states: “Risk Summary Doxycycline may cause reversible inhibition of bone growth and permanent discoloration of deciduous teeth when administered during the second and third trimesters of pregnancy [ see Warnings and Precautions ( 5.1 and 5.2 ) ].”

    US prescribing information · 81c5a7fc-3fe0-40b2-bae0-c79eb0b27697 · read 2026-08-30

  • On people who are breastfeeding, the label states: “Risk Summary Based on available published data, doxycycline is likely to be present in human breast milk but the specific concentration in breastmilk is not clear.”

    US prescribing information · 81c5a7fc-3fe0-40b2-bae0-c79eb0b27697 · read 2026-08-30

Where the result stopped carrying

  • N-TA3CT: no effect on aneurysm growth despite a plausible and well-characterised mechanism
  • PRINCIPLE: the doxycycline arm was stopped for futility in community COVID-19
  • dPEP Kenya: no significant reduction in sexually transmitted infections in cisgender women
  • This is a scope explorer, not a diagnosis engine.
  • It shows who was studied so you can see whether people similar to you were included.

RNAWiki cannot tell whether a study fits you. It can show who was in it.

What it would be like to takeRead from sources, not yet reviewed

Why it might seem to do nothing

A real effect and a noticed effect are different things. These are the recorded reasons the two come apart.

It was studied in different people

The people in the studies were not much like the reader.

On this record: Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.

The evidence may simply be wrong

Small early studies often do not hold up.

On this record: RNAWiki has not yet published a reviewed conclusion for this use.

The product may not be what it says

Contents of a sold product are not always what the label states.

On this record: This is sold as a supplement, so no agency checked what is in a given tub before it was sold.

Other reasons RNAWiki checked and found nothing for (10)
It was studied for a different goal
The studies measured something else entirely. Nothing in this record points to this reason.
A different form was studied
The studied form is not the form on the shelf. Nothing in this record points to this reason.
There was nothing to correct
Where a level is already normal, topping it up may change nothing. Nothing in this record points to this reason.
Something else had to happen too
In the studies it was paired with training, a diet or another treatment. Nothing in this record points to this reason.
The change is too small to feel
A real change can still sit below what a person notices. Nothing in this record points to this reason.
Day-to-day swing hides it
Sleep, food, stress and time of day move most numbers more than this would. Nothing in this record points to this reason.
Not enough time yet
The studies ran longer than the person has waited. Nothing in this record points to this reason.
It was not taken as studied
Missed days change the result, and studies count them. Nothing in this record points to this reason.
Something else changed at the same time
Two changes at once cannot be told apart afterwards. Nothing in this record points to this reason.
No recorded reason
RNAWiki has nothing stored that would explain it. Nothing in this record points to this reason.

None of these is a reason to take more. Taking more is not a step this page ever suggests.

What it would be like to takeRead from sources, not yet reviewed

What taking it involves

The recorded facts about getting hold of it and using it. Nothing here is a suggestion about what you should do.

How it is supplied

Given by a clinician

Quoted from a source

Where this came from

Copied from a source RNAWiki stored, with the source named.

Read from the recorded approval status.

No source is stored against this line.

Form and route

Oral capsule, tablet, delayed-release tablet, oral suspension and intravenous infusion

Source-linked record

Where this came from

A person wrote this into the record with the study named beside it. No reviewer has signed it off.

The form and route recorded on this substance.

No source is stored against this line.

Who oversees it

Professional supervision is normally required. A regulator classifies this substance in a way that restricts how it is supplied.

Quoted from a source

Where this came from

Copied from a source RNAWiki stored, with the source named.

Suppression classes recorded: S3.

No source is stored against this line.

What is in the pack

Usually 100 mg once or twice daily by mouth. Absorption is high and only modestly food-affected, but divalent and trivalent cations in dairy, antacids and iron supplements chelate the drug in the gut and reduce absorption. Delayed-release and subantimicrobial-dose formulations exist for dermatological use.

Source-linked record

Where this came from

A person wrote this into the record with the study named beside it. No reviewer has signed it off.

Recorded notes on how this is sold and what that means for what is in the pack.

No source is stored against this line.

Where it is registered

Regulatory records are listed in the technical disclosure at the foot of this page.

Counted from records

Where this came from

A count of rows RNAWiki holds. It describes our records, not your body.

Register entries are stored per jurisdiction and shown with their dates.

No source is stored against this line.

Why people stop

Not recorded.

Nothing recorded

Where this came from

RNAWiki holds nothing here and says so rather than guessing.

No record of why people stopped taking it is stored for this substance.

No source is stored against this line.

What it would be like to takeRead from sources, not yet reviewed

What can go wrong

Sorted by where each line came from. A regulator's label and a report somebody sent in are not the same kind of fact.

Worth asking a clinician aboutWritten into the record from the studies named on this page

Photosensitivity is common and predictable. Pill-induced oesophagitis occurs when a dose is taken without enough water or lying down. Tetracyclines are avoided in children under eight and in pregnancy because of effects on developing teeth and bone. Clostridioides difficile infection is a recognised complication of any broad-spectrum antibacterial course. Intracranial hypertension is a rare but documented class effect.

Nobody counted how many people took this and were fine, so this cannot be turned into a rate.

Where this came from

Over a long time. No completed tested study window is recorded, so long-term effects are not established by the registry record.

Groups the studies covered thinly. Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.

What is missing or unclearRead from sources, not yet reviewed

Does the exact form matter?

Evidence belongs to the exact thing that was tested. A different salt, a different mixture or a different preparation is a different question.

The form that was studied

Oral capsule, tablet, delayed-release tablet, oral suspension and intravenous infusion

Source-linked record

Where this came from

A person wrote this into the record with the study named beside it. No reviewer has signed it off.

The form used in the studies cited on this page.

No source is stored against this line.

What is sold

Absorption is high and only modestly food-affected, but divalent and trivalent cations in dairy, antacids and iron supplements chelate the drug in the gut and reduce absorption. Delayed-release and subantimicrobial-dose formulations exist for dermatological use.

Source-linked record

Where this came from

A person wrote this into the record with the study named beside it. No reviewer has signed it off.

Recorded notes on which forms are sold and how they compare.

No source is stored against this line.

What is recorded as being sold

  • 353 products list this as an active ingredient in the United States drug directory. 353 of them contain it and nothing else.

    FDA National Drug Code directory · 72162-2402 · read 2026-08-29

  • They are sold as capsule, capsule, delayed release, for suspension, injection, powder, for solution, injection, powder, lyophilized, for solution and paste, taken intravenous and oral.

    FDA National Drug Code directory · 72162-2402 · read 2026-08-29

  • The regulator's established pharmacologic class for it is tetracycline-class drug [epc] and tetracyclines [cs].

    FDA National Drug Code directory · 72162-2402 · read 2026-08-29

  • 240 published labels name it as an active ingredient. 240 of them describe this substance alone, which is where its own label text on this page comes from.

    US prescribing information · 5fdc01c3-c62f-40cf-8351-91cbcc43d379 · read 2026-08-29

  • Those labels are classed as human prescription drug.

    US prescribing information · 5fdc01c3-c62f-40cf-8351-91cbcc43d379 · read 2026-08-29

  • 1 marketed supplement label lists this ingredient, classed as other combinations.

    NIH Dietary Supplement Label Database · 239677 · read 2026-08-29

  • Those labels carry all other, nutrient and structure/function claims. A claim of that kind is written by the manufacturer and is not assessed by any regulator, so its presence says nothing about whether it is true.

    NIH Dietary Supplement Label Database · 239677 · read 2026-08-29

  • Doxycycline Hyclate Capsules, USP is capsules at Each capsule contains doxycycline hyclate equivalent to 100 mg doxycycline, recorded as prescription product; fda label in effect 2026-05-01 in the United States.

    US prescribing information · 00b2aa98-dea2-90c3-e063-6294a90a35d6 · read 2026-08-27

  • Recorded price in US: 0.09836–5.15813 USD per one unit as the pricing file counts it — a tablet, capsule, patch or single item, across 84 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..

    Recorded source · 2026-08-26 · read 2026-08-28

  • Recorded price in US: 0.2288 USD per one millilitre, across 3 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..

    Recorded source · 2026-08-26 · read 2026-08-28

Evidence carries across two names for one substance. It does not carry across a salt, a mirror form or a mixture.

What it would be like to takeRead from sources, not yet reviewed

What you could measure

This one is decided with a clinician, so this section holds questions to ask rather than a plan to run.

Self-experiment planning is not offered for a prescription or clinician-supervised medicine. The questions below are for a clinician or pharmacist.

Questions worth asking

  • Which of the trials of Doxycycline Anhydrous studied people like me?
  • What was measured, and for how long?
  • Was the result a laboratory value or a health outcome?
  • What would we watch for, and when would we stop?

Tracking can show whether something changed for you. It cannot show what caused it.

RNAWiki records evidence. It does not say whether this substance is right for you.

What is missing or unclearRead from sources, not yet reviewed

Claims that go past the evidence

Things said about this substance that sound reasonable, and the exact step that is missing between the evidence and the claim.

Goes past the evidence

That an efficacy result in one population transfers unchanged to a different population, different anatomical sites of infection and different adherence

Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.

The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.

What would change this

A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.

RNAWiki has not yet published a reviewed conclusion for this use.

Goes past the evidence

That inhibiting matrix metalloproteinases in the laboratory would slow aneurysm growth in patients — tested directly and refuted

Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.

The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.

What would change this

A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.

RNAWiki has not yet published a reviewed conclusion for this use.

Goes past the evidence

That prophylaxis can be scaled without a corresponding rise in tetracycline resistance, when both trials recovered resistant gonococci from treated participants

Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.

The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.

What would change this

A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.

RNAWiki has not yet published a reviewed conclusion for this use.

What is missing or unclearRead from sources, not yet reviewed

What nobody knows yet

Open questions, each with why it is open and what would close it.

Missing populations

Which groups were under-represented in the studies has not been recorded.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

Missing long-term data

No completed tested study window is recorded.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

No reviewed conclusion

RNAWiki has not yet published a reviewed conclusion for this use.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

Missing interaction studies

No interaction was found in the registers checked. Not finding one is not the same as showing there is none.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

Formulation uncertainty

Several salts, forms or products of Doxycycline Anhydrous are recorded. Results from one form may not transfer to another.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

Mechanism not reviewed

No reviewed mechanism story exists for this substance.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

What happened in peopleRead from sources, not yet reviewed

Check any of this yourself

Every line above traced back to the study it came from. This is the technical layer, and the vocabulary changes here.

Every line above can be traced to the study named beside it. Follow the link and read it.

DoxyPEP: two-thirds fewer bacterial sexually transmitted infections
In plain words
Taking a single 200 mg dose within 72 hours of condomless sex cut the combined rate of gonorrhoea, chlamydia and syphilis by about two thirds in two cohorts.
What was measured
Incidence of at least one bacterial sexually transmitted infection per follow-up quarter
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Open-label randomised trial, 501 participants in two cohorts: men who have sex with men and transgender women taking HIV pre-exposure prophylaxis, and people living with HIV, all with a bacterial sexually transmitted infection in the past year. In the PrEP cohort an infection was diagnosed at 10.7% of quarterly visits on doxycycline versus 31.9% on standard care, relative risk 0.34 (95% CI 0.24 to 0.46; P<0.001). In the cohort living with HIV, 11.8% versus 30.5%, relative risk 0.38 (95% CI 0.24 to 0.60; P<0.001). Chlamydia showed the largest effect, relative risk 0.12 in the PrEP cohort.
Source
Luetkemeyer AF et al., N Engl J Med 2023;388:1296-1306 (NCT03980223)
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim
dPEP Kenya: the same intervention showed no significant effect in cisgender women
In plain words
When the same strategy was tested in 449 Kenyan women, the infection rate did not fall significantly, and hair testing showed most participants were not actually taking the drug.
What was measured
Incident Chlamydia trachomatis, Neisseria gonorrhoeae or Treponema pallidum infection
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
Randomised open-label trial in Kenyan women aged 18 to 30 receiving HIV pre-exposure prophylaxis, followed quarterly for 12 months. 109 incident infections occurred, 50 in the doxycycline arm (25.1 per 100 person-years) and 59 in standard care (29.0 per 100 person-years), relative risk 0.88 (95% CI 0.60 to 1.29; P=0.51). Chlamydia accounted for 78% of infections. Objective adherence measurement mattered: doxycycline was detected in only 58 of 200 hair samples (29.0%) from 50 randomly selected participants in the intervention arm. Every gonococcal isolate recovered was doxycycline-resistant.
Source
Stewart J et al., N Engl J Med 2023;389:2331-2340 (NCT04050540)
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
caution
Review state
Written into the record, not signed off as a reviewed claim
The prophylaxis benefit was measured alongside tetracycline-resistant gonorrhoea
In plain words
In the trial that showed the benefit, resistant gonorrhoea was found in more of the treated participants than the untreated ones.
What was measured
That the individual-level reduction in infections can be scaled to a population without a corresponding rise in tetracycline resistance
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Among DoxyPEP participants with a gonococcal culture available, tetracycline-resistant Neisseria gonorrhoeae was recovered from 5 of 13 in the doxycycline groups and 2 of 16 in the standard-care groups. In the Kenyan dPEP trial, all gonococcal isolates recovered were doxycycline-resistant. These are small numbers from culture subsets, not powered resistance endpoints, which is exactly why the population-level consequence of the strategy remains an open question rather than a settled one.
Source
Luetkemeyer AF et al., N Engl J Med 2023;388:1296-1306; Stewart J et al., N Engl J Med 2023;389:2331-2340
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
caution
Review state
Written into the record, not signed off as a reviewed claim
N-TA3CT: no effect on abdominal aortic aneurysm growth
In plain words
Doxycycline inhibits the enzymes that break down connective tissue, so it was tested to slow aneurysm growth. Two years of treatment changed nothing.
What was measured
Change in maximum transverse aneurysm diameter on CT at 2 years
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
Randomised, placebo-controlled trial at 22 US centres in 261 patients aged 50 and over with small infrarenal aneurysms. Doxycycline 100 mg twice daily for 2 years versus placebo. The change in measured maximum transverse diameter at 2 years was 0.36 cm (95% CI 0.31 to 0.40) with doxycycline and 0.36 cm (95% CI 0.30 to 0.41) with placebo, difference 0.0 cm (95% CI -0.07 to 0.07; P=0.93). The primary normal-scores analysis gave a one-sided P of 0.71. Joint pain occurred in 65% and 63%.
Source
Baxter BT et al., JAMA 2020;323:2029-2038 (NCT01756833)
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim
PRINCIPLE: no benefit in community COVID-19, and the arm was stopped for futility
In plain words
Doxycycline was widely prescribed for COVID-19 in the community. When it was finally tested, the trial arm was stopped because it was clearly not working.
What was measured
Time to first self-reported recovery, and hospitalisation or death by day 28
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
UK primary-care adaptive platform trial in people aged 65 and over, or 50 and over with comorbidities. 2,689 participants were randomised to the doxycycline comparison between July and December 2020, when the prespecified futility criterion was met. Median time to first self-reported recovery was 9.6 days with doxycycline and 10.1 days with usual care, hazard ratio 1.04 (95% Bayesian credible interval 0.93 to 1.17), with a 0.10 probability of a clinically meaningful benefit. Hospitalisation or death occurred in 5.3% and 4.5%.
Source
Butler CC et al., Lancet Respir Med 2021;9:1010-1020 (ISRCTN86534580)
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim
A 1967 antibiotic acquired a genuinely new indication in 2023
In plain words
Doxycycline has been in use since the Johnson administration. Post-exposure prophylaxis for sexually transmitted infections is a new use, established by a randomised trial fifty-six years later.
What was measured
Not recorded
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Vibramycin was approved in the United States in December 1967. The DoxyPEP randomised trial reported in 2023 and changed clinical guidance for a defined population within months, on a relative risk of 0.34 in the PrEP cohort. That the dPEP trial in Kenyan women published later the same year found no significant effect is the reason the guidance is written for specific populations rather than for everyone.
Source
Drugs@FDA record for VIBRAMYCIN NDA 050007, original approval 5 December 1967; Luetkemeyer AF et al., N Engl J Med 2023
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim

How many documents were read

  • 234 documents were read for this substance.

    RNAWiki source record

Where else this substance is registered

FDA substance identifier (UNII)
19XTS3T51U
CAS registry number
7164-70-7
PubChem compound
54671203
RxNorm concept
203122

Checks this page had to pass

  • Passed

    Identity resolved

    no open identity hold

  • Passed

    No unresolved merge across substance families

    no quarantine open

  • Passed

    Every public sentence names a source

    The opening statement carries the origin: Written into the record, not signed off.

  • Not passed

    Trial roles classified for highlighted evidence

    No registered study is classified as testing this substance.

  • Passed

    No internal keys in reader text

    enforced by the copy-contract test over the rendered page

  • Passed

    Safety mode resolved

    Suppression classes recorded: S3.

  • Passed

    Canonical metadata present

    slug and display name present

What is missing or unclearRead from sources, not yet reviewed

How this medicine reached us

Kept near the foot of the page. A historical event moves up only when it changes something about this substance today.

What the approval register records

  • 151 approved applications cover products containing this substance. The earliest was NDA050007, approved 19671205 to PFIZER.

    Drugs@FDA application register · NDA050007 · read 2026-08-29

  • Marketing status on the register: discontinued, none (tentative approval) and prescription.

    Drugs@FDA application register · NDA050007 · read 2026-08-29

  • The earliest marketing start date recorded for a listed product is 19810101.

    FDA National Drug Code directory · 72162-2402 · read 2026-08-29

What is missing or unclearRead from sources, not yet reviewed

What to learn next

Ordered by what would most change how you read this page, starting with what is easiest to misunderstand.

This order is fixed in code and does not count clicks or time on the page.

What is not here

7 questions this page could not answer

These sections were prepared and left out because there was nothing to put in them. They are listed rather than hidden, so the gaps in this record are visible.

  • What was measured, goal by goal — found nothing in the sources checked.
  • How close this is to real life — found nothing in the sources checked.
  • Felt, measured, or meaningful — found nothing in the sources checked.
  • How long anything takes — found nothing in the sources checked.
  • What it may clash with — found nothing in the sources checked.
  • Other ways to the same goal — found nothing in the sources checked.
  • What changed on this page — found nothing in the sources checked.

The record as stored

The full record, for auditing

Everything above is built from what is below. This layer keeps the technical vocabulary, record identifiers and every stored row, so a reader who wants to check the page can.

The older medicine-wide conclusion held in this record

Written for a clinical reader, and about the medicine as a whole rather than about one indication, population and set of trials. RNAWiki does not treat it as a programme conclusion and no reviewer has signed it off in that form. It is here word for word because it is what the record holds.

A tetracycline that blocks the bacterial ribosome docking site, which cut the combined incidence of gonorrhoea, chlamydia and syphilis by about two thirds in 501 men who have sex with men and transgender women, and showed no significant effect in 449 Kenyan cisgender women in the direct replication attempt.

Recorded evidence blocks (10)

On the Doxycycline Anhydrous label: indicated for what?


"Doxycycline hyclate delayed-release tablets are a tetracycline-class drug indicated for: • Rickettsial infections (1.1) • Sexually transmitted infections (1.2) • Respiratory tract infections (1.3) • Specific bacterial infections (1.4) • Ophthalmic infections (1.5) • Anthrax, including inhalational anthrax…": indications and usage on Doxycycline Anhydrous's label. DailyMed label · 3ae4ca12-be39-46b9-bc4c-f8356776c175 · 2026-04-28

275 registered trials of Doxycycline Anhydrous — at which phases?


Registered studies posting no result
200 of 275

275 registered studies of Doxycycline Anhydrous: 78 phase2, 78 phase4, 48 na, 46 phase3, 28 phase1, 7 na or unstated, 5 early phase1. CLINICALTRIALS_SNAPSHOT · 2026-09-01

1195 with a PubMed record

Show the evidence
  • phase2
    78
  • phase4
    78
  • na
    48
  • phase3
    46
  • phase1
    28
  • na or unstated
    7
9 more recorded rows
  • early phase1
    5
  • completed
    165
  • unknown
    40
  • recruiting
    22
  • terminated
    18
  • withdrawn
    12
  • active not recruiting
    9
  • not yet recruiting
    8
  • enrolling by invitation
    1

recorded 2026-09-01 · last checked 2026-09-04

29 of Doxycycline Anhydrous's trials stopped: futility/efficacy, accrual/recruitment, funding/business, other?


futility/efficacy (1), accrual/recruitment (14), funding/business (2) and other (12): Doxycycline Anhydrous's stop wording, clustered. CLINICALTRIALS_SNAPSHOT · 2026-09-01

"Investigator left the institution and decided not to continue with the study."; 29 of 275 registered studies

Show the evidence

Trial

  • NCT00803842
    withdrawn; "Investigator left the institution and decided not to continue with the study."
  • NCT00952861
    withdrawn; "Stopped due to poor recruitment"
  • NCT01014260
    withdrawn; "We could not get funding for study."
  • NCT01030666
    terminated; "shelf life of investigational drug ran out before 90 patients could be included"
  • NCT01188954
    withdrawn; "The recruitment process was slower than expected."
  • NCT01317433
    terminated; "The study stopped due to a lack of recruitment"
14 further recorded trials
  • NCT01590082
    terminated; "Accrual slow due to alternate trials and treatment options."
  • NCT01653522
    withdrawn; "No participants enrolled"
  • NCT01879930
    terminated; "Recruitment problems"
  • NCT01935622
    terminated; "End of funding"
  • NCT02086591
    terminated; "Lack of accrual"
  • NCT02099240
    terminated; "Not enough patient enrollment and lack of staffing"
  • NCT02201381
    withdrawn; "Prospective recruitment not possible"
  • NCT02341209
    terminated; "Low enrollment"
  • NCT02388477
    withdrawn; "Research idea tabled at this point."
  • NCT02569437
    terminated; "A high percentage of patients were dropping out of the study and were not able to complete the protocol."
  • NCT02623959
    terminated; "Slow Accrual"
  • NCT02874430
    terminated; "study closed early due to slow accrual"
  • NCT03076281
    terminated; "Insufficient staff to conduct the trial"
  • NCT03173053
    terminated; "Results interim-analysis"

recorded 2026-09-01 · last checked 2026-09-04

Human studies of Doxycycline Anhydrous used 20 mg doxycycline hyclate — over how long?


studies of Doxycycline Anhydrous used the recorded amount. ClinicalTrials.gov · 2026-09-01

20 recorded entries; human; tablet; also "20 mg doxycycline hyclate", "Vibramycin, 100 mg, QD plus metornidazole", "Oracea® 40 mg plus metronidazole"

Show the evidence

human

  • NCT00066027
    20 mg doxycycline hyclate
  • NCT00495313
    Vibramycin, 100 mg, QD plus metornidazole
  • NCT00495313
    Oracea® 40 mg plus metronidazole
  • NCT00647959
    Doxycycline Tablets, 150mg
  • NCT00648180
    Doxycycline Monohydrate Tablets 100 mg
  • NCT00649571
    Doxycycline Monohydrate Tablets (100 mg
14 more recorded rows
  • human NCT00775177
    Doxycycline monohydrate 100mg tablets
  • human NCT00892281
    doxycycline (Oracea®) 40 mg modified release as monotherapy
  • human NCT00892281
    doxycycline (Oracea®) 40 mg modified release as add-on therapy
  • human NCT01198912
    doxycycline 100 mg
  • human NCT01320033
    Doxycycline 100 mg
  • human NCT01426269
    Oracea® Capsules 40 mg
  • human NCT01474590
    doxycycline 200mg
  • human NCT01872715
    doxycycline USP, 40 mg (30 mg immediate release/ 10 mg delayed release beads)
  • human NCT01885910
    Doxycycline 100mg
  • human NCT02174757
    tablet; Each tablet contains 100 mg of Doxycycline
  • human NCT02553083
    doxycycline 200 mg
  • human NCT03448731
    Doxycycline 50Mg Tablet
  • human NCT03457636
    Doxycycline Anhydrous 40 MG
  • human NCT03960411
    Doxycycline 100Mg Capsule

recorded 2026-09-01 · last checked 2026-09-04

Doxycycline Anhydrous's half-life is 18 to 22 hours — which schedules were studied?


18 to 22 hours, the half-life Doxycycline Anhydrous's label states: "Specific Populations Patients with Renal Impairment Studies have shown no significant difference in the serum half-life of doxycycline (range 18 to 22 hours) in individuals with normal and severely impaired renal function." DailyMed label · 3ae4ca12-be39-46b9-bc4c-f8356776c175 · 2026-04-28

tmax 3 hours.

Show the evidence
  • half life pharmacokinetics
    18 to 22 hours; Specific Populations Patients with Renal Impairment Studies have shown no significant difference in the serum half-life of doxycycline (range 18 to 22 hours) in individuals with normal and severely impaired renal function.
  • tmax pharmacokinetics
    3 hours; Following single and multiple-dose administration of doxycycline hyclate delayed-release tablets, 200 mg to adult volunteers, average peak plasma doxycycline concentration (C max ) was 4.6 mcg/mL and 6.3 mcg/mL, respectively with median t max of 3 hours; the corresponding mean plasma concentration values 24 hours after single and multiple doses were 1.5 mcg/mL and 2.3 mcg/mL, respectively.

recorded 2026-04-28 · last checked 2026-09-04

Which running trial of Doxycycline Anhydrous could settle lifespan?


NCT06446245 measures Mortality or severe neurological deficits (modified Rankin scale of 3 or more) at 8 weeks, from time of randomization., reading out 2027-12.

2 open trials; n 200; "Adjunctive Doxycycline for Central Nervous System Tuberculosis"

Show the evidence

Trial

  • NCT06446245
    "Adjunctive Doxycycline for Central Nervous System Tuberculosis"; n 200; "Mortality or severe neurological deficits (modified Rankin scale of 3 or more) at 8 weeks, from time of randomization."; 2027-12
  • NCT07215325
    "Got Doxy- 'Flipping the Script' on STI PEP"; n 200; "Composite inflammation score"; 2029-04-13

Which 88 trials of Doxycycline Anhydrous posted no result?


Posted no result
88 of 88 completed trials
Registrations
NCT00652704, NCT00653380, NCT01380496, NCT01380483, NCT00001101 and NCT00000403, and 82 more
Completion dates
oldest 1999-09; newest 2024-01-01
Show the evidence

Trial

  • NCT00652704
    1999-09
  • NCT00653380
    1999-10
  • NCT01380496
    1999-11
  • NCT01380483
    2000-04
  • NCT00001101
    2001-03
  • NCT00000403
    2001-07
14 further recorded trials
  • NCT00652795
    2004-09
  • NCT00126399
    2005-04
  • NCT00649571
    2005-07
  • NCT00538967
    2005-08
  • NCT00648180
    2005-08
  • NCT00775177
    2005-08
  • NCT00775918
    2005-08
  • NCT00066027
    2005-10-01
  • NCT00000938
    2005-11
  • NCT00351182
    2005-12
  • NCT00647959
    2006-04
  • NCT00177333
    2006-05
  • NCT00126204
    2006-07
  • NCT00439400
    2007-08

At the median, Doxycycline Anhydrous's trials enrolled 74 people — anything larger?


Median enrolment
74
Largest enrolment
4618
Registered trials counted
274

What do 3617 spontaneous reports say about Doxycycline Anhydrous — and not say?


These are reports people sent to a regulator. They do not show the medicine caused the reaction. Nobody counted how many people took the medicine and reported nothing. The same event can be reported more than once, and many reports are incomplete. News coverage, lawsuits and new warnings change how often people report. A count is not a rate and not a risk.

Doxycycline Anhydrous appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 3617 reaction mentions were counted: drug hypersensitivity 1654; vomiting 577; rash 553; jarisch-herxheimer reaction 208. FAERS via Open Targets · CHEMBL1200699 · 2026-06-24

Show the evidence
  • drug hypersensitivity
    1654
  • vomiting
    577
  • rash
    553
  • jarisch-herxheimer reaction
    208
  • pancreatitis acute
    164
  • photosensitivity reaction
    133
4 more recorded rows
  • oesophageal ulcer
    115
  • oesophagitis
    92
  • intracranial pressure increased
    64
  • gastrointestinal mucosal necrosis
    57

recorded 2026-06-24 · last checked 2026-09-04

Which 10 reactions does Doxycycline Anhydrous's label not list?


drug hypersensitivity, gastrointestinal mucosal necrosis and intracranial pressure increased and 7 more reported for Doxycycline Anhydrous, absent from its label. FAERS via Open Targets · CHEMBL1200699 · 2026-06-24

2 label terms; 10 reported and unlisted; 3ae4ca12-be39-46b9-bc4c-f8356776c175

Show the evidence
  • drug hypersensitivity
    count not stated
  • gastrointestinal mucosal necrosis
    count not stated
  • intracranial pressure increased
    count not stated
  • jarisch-herxheimer reaction
    count not stated
  • oesophageal ulcer
    count not stated
  • oesophagitis
    count not stated
4 more recorded rows
  • pancreatitis acute
    count not stated
  • photosensitivity reaction
    count not stated
  • rash
    count not stated
  • vomiting
    count not stated

recorded 2026-06-24 · last checked 2026-09-04

Where it is registered
Identifiers, relations and other names

The exact record

ChEMBL id
CHEMBL1200699
PubChem CID
76967880
CAS number
564-25-0
RxCUI
1545992
InChIKey
JBIWCJUYHHGXTC-AKNGSSGZSA-N
Also called
Doxycycline
Also called
Doxiciclina, Doxirobe, Doxylin, Supracyclin, Xyrosa, d-plex, dox, doxy, doxycyclin, tetracycline, tetracyclines, DOXYCYCLINE HYDROCHLORIDE
Trade name
Doxychel, Monodox, Oracea, Vibramycin, Acticlate, Acticlate cap, Atridox, Cyclodox, Demix 100, Demix 50, Doryx, Doryx mpc
Salt form
Doxycycline monohydrate, doxycycline hcl, doxycycline hyclate, vibramycin monohydrate, Anhydrous doxycycline, Doxychel hyclate, Doxycycline hydrochloride hemiethanolate hemihydrate, Doxycycline hydrochloride hydrate
Development code
GS-3065, NSC-756751, AB-08, AB08, DMSC, NSC-741421
Component
Doxycycline
Sources (6)

Sources

ChEMBL 37 — CC BY-SA 3.0 Unported · ChEMBL ATC CC BY-SA · ClinicalTrials.gov — US Government work · Open Targets 26.06 — CC0 · mixed register set; per-register licences in docs/specs/corpus-20k-sources.md · openFDA / DailyMed — US Government work

How these records are assembled · Which registers were checked

Index-quality checks
  • identity passed: no open identity hold
  • required summary fields resolved: 4 required field(s) not terminal: Why people use it, Best-supported result, Biggest unanswered question, Human evidence
  • public claims reviewed: 0 reviewed claim(s); drafts are never rendered
  • source coverage passed: 6 source rows
  • no critical contamination: no quarantine open
  • canonical metadata passed: slug and display name present
  • no raw internal fields: enforced by the copy-contract test over the rendered page

This is a record of evidence. It is not medical advice, and it does not say this substance suits you. Nothing here says any substance on RNAWiki is appropriate for a child.