Prepare Doxycycline Hyclate for Non-Pill Swallowers

What to know

If you're exposed to anthrax, it's important to begin antibiotics quickly and take as directed to prevent serious illness and death from anthrax. Many children and others can't swallow pills, so caretakers can learn how to mix antibiotics into food or drink so they can still take antibiotics. The antibiotic mixture should be taken every 12 hours (once in the morning and once at night) for as long as directed.

Supplies needed to make doses of doxycycline for children and adults who cannot swallow pills. Image shows 1 doxycycline tablet; teaspoon; 2 small bowls; small amount of drinking water; a food or drink to make the doxycycline taste better (milk, chocolate pudding, apple juice, sugar).

Materials needed

Most people will get 100 mg tablets of doxycycline hyclate if they have potentially been exposed to anthrax. You need these items to make doses of doxycycline for those who can't swallow pills:

  • 1 doxycycline hyclate tablet (100 mg)
  • 1 metal teaspoon
  • 1 oral syringe or medicine spoon (if available)
  • 2 small bowls
  • 4 teaspoons or 20mL of drinking water

Doxycycline works just as well whether you take it with or without food or milk. However, using one of these foods or drinks makes the dose taste better:

  • Milk, including breast milk and formula for infants
  • Chocolate milk
  • Chocolate pudding
  • Apple juice mixed with 2 to 4 teaspoons of sugar

Step 1: Crush

Image of person adding 4 teaspoons of water to a small bowl containing 1 doxycycline tablet. Image shows person crushing softened tablet with the back of a spoon after doxycycline tablet had soaked in water for 10 minutes.
The next step is to use water and a spoon to crush the pill.
  1. Put 1 doxycycline hyclate tablet in a small bowl.
  2. Add 4 teaspoons (20 mL) of water to the same bowl.
  3. Let the tablet soak in the water for at least 10 minutes to soften it.
  4. Crush tablet with the back of the spoon until no pieces remain in water.
  5. Stir the tablet and water to mix it well.

You have now made the doxycycline and water mixture.

Step 2: Measure

Image of person putting the specific amount of doxycycline and water mixture that corresponds with the correct dose, into a second bowl.
Next, you will need to measure the right amount of doxycycline.
  1. Find your child's weight on the chart below. If unknown, find the age on the chart.
  2. Follow it across to the "Amount of Doxycycline & Water Mixture" column.
  3. The weight-range dosing is based on 2.2 mg/kg calculation.
Doxycycline crushing instructions by weight.
Weight Age Amount of Doxycycline & Water Mixture to Measure
12 pounds or less Less than 1 month ½ teaspoon (2.5 mL)
13 to 25 pounds 1 to 11 months 1 teaspoon (5 mL)
26 to 50 pounds 1 to 5 years 2 teaspoons (10 mL)
51 to 75 pounds 6 to 8 years 3 teaspoons (15 mL)
76 pounds or more (Adult Dose) 9 years or older 4 teaspoons (20 mL)

4. Measure doxycycline mixture from first bowl for child's weight or age. For a 1/2 teaspoon dose, fill halfway or use an oral syringe (if available). It's better to give slightly more than not enough.
5. Place this amount into the second bowl. This is one dose, and it should be mixed with food or drink.

For adults who cannot swallow pills or children over 76 pounds: Use the entire doxycycline mixture (4 teaspoons) from the first bowl. The contents of the first bowl make one dose to be mixed with food or drink.

You have now measured the right dose.

Step 3: Mix

Image of person adding 3 teaspoons of food into the second bowl containing the doxycycline and water mixture. Image of person mixing the food and doxycycline and water mixture.
Next, mix the measured dose with food or drink.
  1. Put the dose (measured amount of doxycycline and water mixture) in the second bowl. Add 3 teaspoons of one of the following:
  • Milk, including breast milk and formula for infants
  • Chocolate milk
  • Chocolate pudding OR
  • Apple juice mixed with 2 to 4 teaspoons of sugar

2. Mix well before giving it to your child.

You now have one dose mixed with food or drink.

Step 4: Give the dose

Image of person giving child the correct dose of doxycycline mixed with food or drink.
Finally, give the dose to the recipient.

Give your child all of the doxycycline, water, and food mixture from the second bowl. Make sure your child swallows all of it. This is one dose.

Do this once every 12 hours (once in the morning AND once at night) each day for as long as directed.

Storage and side effects

If you have some of the mixture left over:

Throw it away if your child weighs 51 pounds or more, or is 6 years or older. You do NOT have enough left over to make another dose.

Keep it if your child weighs 50 pounds or less, or is 5 years or younger. You will have enough left over to make another dose.

Image of person writing the date and description of contents on the label of a container that has leftover doxycycline and water mixture.
If you are storing the mixture, label and date the container.

To store the doxycycline mixture, follow these steps:

  1. Put the doxycycline mixture in a covered bowl or cup.
  2. Write the date, time, and container contents on a label.
  3. Keep the mixture in a safe place, out of the reach of children or pets.
  4. Maintain the container at 68–77˚F (20–25˚C) for up to 24 hours.
  5. Throw away any unused mixture after 24 hours.
  6. Make a new doxycycline and water mixture for the next dose.

Side effects

Seek emergency help‎

See a healthcare provider immediately if you have any signs of an allergic reaction, including hives, trouble breathing, or swelling of your face, lips, tongue, or throat.

Do not take doxycycline if you are allergic to an ingredient in doxycycline hyclate or any tetracycline antibiotics.

Doxycycline may cause:

  • Diarrhea
  • Increased skin sensitivity to the sun
  • Loss of appetite
  • Nausea
  • Vomiting

Continue to take your doxycycline as directed – even if you experience these side effects – until your provider tells you to stop.

Keep Reading: About Doxycycline

Report any reaction to doxycycline to MedWatch or 1-800-FDA-1088.

Printable version and video

Printable version of this page:
Double-sided/fold pamphlet [PDF – 2 pages]

Instructional video:

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Content Source:
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID); About Division of High-Consequence Pathogens and Pathology