BMJ 2003;326:641-642 ( 22 March )

Clinical review

Lesson of the week

Doxycycline induced intracranial hypertension

Doxycycline prescribed for malaria prophylaxis may cause intracranial hypertension that threatens sight

J Lochhead, specialist registrar, J S Elston, consultant. 

Department of Ophthalmology, Oxford Eye Hospital, Radcliffe Infirmary, Oxford OX2 6HE

Correspondence to: J S Elston mary.spearman@orh.nhs.uk

The first 150 words of the full text of this article appear below.

Preventing malaria in travellers is difficult because of the widespread emergence of drug resistance and the increasing popularity of travel to endemic locations. Mefloquine is the most effective recommended antimalarial, but doxycycline (a tetracycline derivative) is being increasingly used in areas where there is resistance to mefloquine or in patients who have side effects to this drug.1

Intracranial hypertension is a well recognised side effect of tetracyclines and has been associated with the medium to long term use of minocycline for acne vulgaris.2-6 We report on two patients with acute onset of severe intracranial hypertension associated with doxycycline, in one instance causing permanent loss of most vision.


    Case reports

Case 1---A 21 year old Afro-Caribbean woman who had been on holiday in Uganda for three weeks complained of headaches and blurred vision. She had been taking doxycycline 100 mg once daily for malaria prophylaxis throughout this period. Her vision was 6/9 in the right . . . [Full text of this article]
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This article has been cited by other articles:

  • Acheson, J. F. (2007). Idiopathic intracranial hypertension and visual function. Br Med Bull 0: ldl019v1-12 [Abstract] [Full text]  
  • Digre, K. B (2003). Not so benign intracranial hypertension. BMJ 326: 613-614 [Full text]  

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