When prescribing doxycycline, which form is best?
Nicole Gupta, Pharm.D., BCPS
Clinical pharmacy specialist, Providence Health Plan
Doxycycline has been on the market for several years, but it's been in more demand recently as tetracycline has become less available. This demand, coupled with a lack of raw materials for doxycycline and discontinued production by a few manufacturers such as Teva, has caused price volatility in the market.
The hyclate salt form of doxycycline historically has been less expensive, but recently the monohydrate version has become cheaper. Both doxycycline hyclate and monohydrate are equally effective. However, the different salt forms and dosing recommendations can cause confusion for providers and pharmacists. Please be aware that switching between products does require provider approval.
Because of increased out-of-pocket costs for patients and the total cost of care in general, consider choosing the less expensive product when prescribing doxycycline.
Monohydrate's cost advantage may change as product inventory changes, so providers should contact local pharmacies or Providence Health Plan to learn which doxycycline products currently are most affordable. Minocycline also is an alternative, depending on the condition that is being treated.
*All doxycycline suspensions are more expensive than above generic oral formulations. Table adapted from “Comparison of Oral Doxycycline Products,” Prescriber's Letter, May 2013.