USE OF DOXYCYCLINE IN PREGNANCY

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(Date of issue: June 2012, Version: 2)

This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a pregnancy reporting form. Please encourage all women to complete an online reporting form.

Summary

Doxycycline is a broad spectrum tetracycline antibiotic which is also used in the prophylaxis of malaria and as an adjunct to quinine in the treatment of falciparum malaria. Exposure to doxycycline in early pregnancy has not been firmly associated with any specific malformations but its use in the second or third trimester can cause discolouration of the teeth. 

During pregnancy, travel to areas where malaria is endemic should be avoided wherever possible.  If travel to such areas is unavoidable, chloroquine and proguanil are the preferred antimalarials to use during pregnancy.  Doxycycline is best avoided for antimalarial prophylaxis during pregnancy, however, if required before 15 weeks gestation it should not be withheld if other options are unsuitable.  Doxycycline should not be used for the treatment of falciparum malaria, but clindamycin can be substituted for it, as it is equally effective.

Exposure to doxycycline at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy or any additional fetal monitoring.  However, other risk factors may be present in individual cases which may independently increase the risk of adverse pregnancy outcome. Clinicians are reminded of the importance of consideration of such factors when performing case specific risk assessments.

Important: Please ensure that the selected antimalarial will provide appropriate prophylaxis for the area of travel.  Current recommendations for the appropriate selection of antimalarials for specific regions, based on malarial resistance, is available from a number of sources (e.g. BNF,1 Fit For Travel,2 NathNAC,3 TRAVAX4).

This document is regularly reviewed and updated. Only use UKTIS monographs downloaded directly from TOXBASE.org or UKTIS.org, to be sure you are using the most up to date version.

This is a summary of the full UKTIS monograph for health care professionals and should not be used in isolation. The full UKTIS monograph and access to any hyperlinked related documents is available to health care professionals at www.toxbase.org.

If you have a patient with exposure to a drug or chemical and require assistance in making a patient-specific risk assessment, please telephone UKTIS on 0344 892 0909 to discuss the case with a teratology specialist.

If you would like to report a pregnancy to UKTIS please click here to download our pregnancy reporting form. Please encourage all women to complete an online reporting form.

Disclaimer: Every effort has been made to ensure that this monograph was accurate and up-to-date at the time of writing, however it cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes of the measures recommended. The final decision regarding which treatment is used for an individual patient remains the clinical responsibility of the prescriber. This material may be freely reproduced for education and not for profit purposes within the UK National Health Service, however no linking to this website or reproduction by or for commercial organisations is permitted without the express written permission of this service. This document is regularly reviewed and updated. Only use UKTIS monographs downloaded directly from TOXBASE.org or UKTIS.org to ensure you are using the most up-to-date version.