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Efracea (Oracea)

Efracea and Oracea are different names for a medicine called doxycycline, which is an oral antibiotic. Doxycycline belongs to the group of tetracycline antibiotics which are broad-spectrum antibiotics, meaning they can be used to treat a wide variety of illnesses. Antibiotics work on bacterial infections by stopping the growth of bacteria, or killing them by stopping them from making the proteins they need to survive. Efracea and Oracea both contain 40 mg of doxycycline and come in the form of a hard capsule. Rosacea is a skin condition that commonly occurs in 40-to-60-year-olds, and though more usually affecting women, when men do suffer it is often in a more severe form. Rosacea primarily affects the forehead, cheeks, nose and chin, causing areas of redness, a bumpy complexion and the appearance of spots which can look a little like acne. It can also affect the eyes and eyelids, causing swelling and pain. Rosacea can last for a long time and tends to be characterised by periods where it is quite severe and others where it is calmer. The cause of rosacea is not fully known: the immune system, the environment and genetics may all be linked. Treatments for rosacea include topical creams and ointments, oral antibiotics and more extreme specialist treatments targeting specific areas and issues, such as laser treatment for dilated blood vessels.

What are Efracea and Oracea?

Efracea and Oracea are different names for a medicine called doxycycline, which is an oral antibiotic. Doxycycline belongs to the group of tetracycline antibiotics which are broad-spectrum antibiotics, meaning they can be used to treat a wide variety of illnesses. Antibiotics work on bacterial infections by stopping the growth of bacteria, or killing them by stopping them from making the proteins they need to survive. Efracea and Oracea both contain 40 mg of doxycycline and come in the form of a hard capsule.

When are Efracea and Oracea used?

Efracea and Oracea are used to treat rosacea in adults. They target the pimples and red bumps on the skin to reduce them, and can also help to lessen redness and inflammation. Efracea/Oracea is an oral antibiotic which therefore treats the problem at the root cause, rather than a topical treatment that only treats the symptoms. By inhibiting the bacteria, Efracea/Oracea prevents them from growing and spreading and so lessens the symptoms of rosacea.

How do you use Efracea and Oracea?

As with all medicines, you should follow the advice of your doctor or pharmacist on how to take them. The following is a general guide for Efracea/Oracea:

  • Swallow the capsule whole, do not chew it;
  • Take the capsule with a full glass of water to prevent throat and gut irritation;
  • Take the capsule on an empty stomach, at least one hour before you eat and two hours after you have eaten;
  • Do not ingest any products containing calcium (dairy products) within two to three hours of taking Efracea/Oracea as this can lessen the effectiveness of the treatment.

What dosages are there?

Doses can vary according to the severity of your condition and what your doctor may deem a safe dose for you. Always follow your doctor’s instructions when it comes to how much Efracea/Oracea to take and for how long.

Each capsule contains 40 mg of doxycycline. Take one Efracea/Oracea capsule every morning, and continue to take one daily until your doctor tells you to stop. Taking too much Efracea or Oracea can cause damage to your liver, kidneys or pancreas – if you do take too much, seek immediate medical assistance. If you forget to take your capsule on time, take it as soon as you remember, but do not take a double dose to make up for a missed dose if it is nearly time for your next one – simply skip it.

What are the side effects of Efracea and Oracea?

As is the case with all medication, Efracea and Oracea come with a risk of some side effects, although of course not everyone who takes this medicine will experience any. If your side effects become difficult to live with or do not ease over time, seek help from your doctor as there may be other options. Often simply resting can be a good way to help your body cope with side effects until it gets used to the new drug.

If you develop prolonged, severe or bloody diarrhoea when taking Efracea, seek immediate medical assistance as this could be a sign of bowel inflammation caused by taking antibiotics and can have serious consequences.

Common side effects that may affect 1 to 100 in 1,000 people include:

  • Fungal infection;
  • Sinus headache;
  • Diarrhoea;
  • Back pain;
  • Upper abdomen pain;
  • General pain;
  • Inflammation of the nose and throat;
  • Inflammation of the sinuses;
  • Anxiety;
  • High or increased blood pressure;
  • Dry mouth;
  • Changes in the amount of glucose in your blood;
  • Changes in liver function tests.

Rare side effects that may affect 1 to 10 in 1,000 people include an allergic reaction. Sseek immediate medical assistance if you think you are having an allergic reaction. Signs include:

  • Swelling around the face, lips, eyes, mouth and throat;
  • Breathing difficulties;
  • Rapid heartbeat;
  • Itching skin and hives.
  • Nausea;
  • Vomiting;
  • Liver damage;
  • Hives or rashes on the skin;
  • Unusual skin reactions to sunlight;
  • Increased pressure on the brain;
  • Changes in the number of some blood cells;
  • Increase in the level of urea in the blood;
  • Inflammation of the membrane surrounding the heart.

Very rare side effects that may affect fewer than 1 in 1,000 people include:

  • Damage to red blood cells;
  • Difficulty swallowing;
  • Inflammation of the tongue;
  • Yeast infections around the genitals;
  • Inflammation of the intestine;
  • Inflammation of the skin leading to flaking;
  • Discolouration of thyroid tissues;
  • Inflammation of the oesophagus;
  • Worsening of a condition called lupus which affects the immune system.

When should you not use Efracea or Oracea?

Do not take Efracea or Oracea if any of the following apply to you:

  • If you are under the age of 12 (children should not use Efracea and Oracea as they can harm tooth development);
  • If you are pregnant or breastfeeding;
  • If you are allergic to any type of medicine that is part of the tetracycline family, including doxycycline, or any of the other ingredients listed on the packet of this medicine;
  • If you have had surgery to the upper part of your gut;
  • If you have an absence of acid in your stomach caused by a condition called achlorhydria;
  • If you are taking any other type of oral retinoid – a medicine used to treat skin disorders such as severe acne.

You should also take care with Efracea and Oracea if any of the following apply:

  • You suffer from colitis;
  • You have liver disease;
  • You suffer from irritation or ulcers in the oesophagus;
  • You have a yeast infection or fungal infection;
  • You have the type of rosacea that affects the eyes;
  • You have a muscle disease called myasthenia gravis;
  • You spend a lot of time under strong sunlight or artificial sunlight, as the risk of burning may be higher.

Do Efracea and Oracea interact with other medications?

Always tell your doctor and/or pharmacist about any other medication you are taking – including vitamins, supplements and herbal remedies – before starting a new course of treatment. Some medicines can interact with one another, causing more health problems, while others can lessen the effectiveness of a particular treatment.

With Efracea or Oracea, you should take particular care with the following:

  • antacids, multi-vitamins and other products that contain calcium, aluminium, magnesium, iron, bismuth or cholestyramine, as these medicines can reduce the effectiveness of Efracea so should only be taken 2-3 hours or more after you have taken Efracea or Oracea;
  • some treatments for ulcers and heartburn should also be taken at least two hours after taking Efracea or Oracea for the same reason.

Other examples of medicines that interact badly with Efracea and Oracea are:

  • Isotretinoin – used for acne;
  • Barbiturates – sleeping pills or painkillers;
  • Carbamazepine – used for epilepsy;
  • Primidone – an anti-convulsant;
  • Cyclosporin – used after organ transplants;
  • Rifampicin – prescribed for tuberculosis;
  • General anaesthetic.

Your doctor will check any other medication that you are taking before prescribing this.

Where can you buy Efracea and Oracea?

You can buy Efracea and Oracea from any reputable pharmacy, so choose the option that is most convenient for you. This is likely to be a long-term medicine so you will likely need to purchase it more than once. It can be easier if you have a source you know you can trust and that you can access easily.

Can I get Efracea or Oracea without a prescription?

No, you cannot buy Efracea or Oracea without a prescription. It is an antibiotic and as such is strictly controlled. Antibiotics only treat certain types of illness and you will need a consultation with a doctor to confirm the condition you have in order for them to prescribe this medicine for you.

You will also need to have regular check-ups throughout your treatment to monitor how the Efracea or Oracea is working and to determine how long you need to continue the treatment.

While antibiotics should not be taken indefinitely, you should always finish any course of antibiotic treatment prescribed for you, as while your symptoms may have cleared up, the antibiotics will still be working on the root of the problem and killing off the bacteria, or at least inhibiting them. If you stop your treatment early, this may give the bacteria the chance to grow and spread again and lead to your symptoms returning. It may also then make it harder to get rid of them with a second round of antibiotic treatment and you could end up on medication for longer than would have been necessary.


British Skin Foundation, n.d. Rosacea. British Skin Foundation. Retrieved 6 April 2020.

Newson, D., 2015. Rosacea And Rhinophyma. Rosacea Symptoms And Treatment. Retrieved 6 April 2020.

Galderma Laboratories, 2020. Treating rosacea From The Inside Out. Retrieved 6 April 2020.

Galderma Laboratories, 2017. Retrieved 6 April 2020.

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Reviewed by:

Dr Imran Malik, General practitioner Registrationnumber: GMC: 4741365 Last checked: 23-08-2023 | Still valid

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