Drug Interaction Report

Doxycycline Injection and Aminolevulinic Acid: Interaction Details

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Doxycycline Injection

Acticlate Adoxa Alodox Avidoxy Doryx Doxy Doxy 100® Doxy 200®
+

Aminolevulinic Acid

No brand names on record
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Updated Aug 8, 2026
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Interaction severity
Moderate
Can be significant — usually manageable with monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 118 documented Doxycycline Injection interactions, 29 are rated moderate — including this one.
Onset
unspecified
Evidence
probable
Severity
Moderate

What happens

Increased risk of phototoxic skin reaction (ie, severe sunburn)

Interaction Deep Dive

Avoid administering this drug for 24 hours before and after administration of oral aminolevulinic acid1. Concurrent use of topical aminolevulinic acid and this drug may increase the risk of phototoxic reaction 2. A phototoxic reaction following administration of aminolevulinic acid to a patient taking St. John's wort has been described 3. An in vitro study also demonstrated synergistic phototoxicity of St. John's wort and aminolevulinic acid 3.

Why it happens (mechanism)

Synergistic phototoxicity

Literature reports

1 report — tap to read

a) In a clinical trial investigating aminolevulinic acid in the diagnosis of breast tumors involving 20 patients, one patient experienced a phototoxic reaction six hours after receiving aminolevulinic acid. It was discovered that this patient was taking St. John's wort (Hyperiforce(R)). The patient developed a burning erythematous rash with severe swelling of the face, neck, and hands. The doses of St. John's wort and aminolevulinic acid were below the usual phototoxic threshold, suggesting a synergistic phototoxic effect when the two were combined. An in vitro study confirmed the hypothesis that a synergistic phototoxic effect occurred when St. John's wort and aminolevulinic acid were combined 3.

Common questions

Can I take Doxycycline Injection and Aminolevulinic Acid together?

Increased risk of phototoxic skin reaction (ie, severe sunburn) Always confirm with your pharmacist or prescriber before making any change.

How serious is the Doxycycline Injection and Aminolevulinic Acid interaction?

It is rated moderate. Can be significant — usually manageable with monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "probable". Good supporting evidence, though not definitively proven.

Questions for your pharmacist

  • Does my dose of Doxycycline Injection or Aminolevulinic Acid need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there anything you'd monitor while I'm on both?

References (3)

  1. Product Information: GLEOLAN powder for oral solution, aminolevulinic acid HCl powder for oral solution. NX Development Corp (per FDA), Miami, FL, 2017. DailyMed
  2. Product Information: AMELUZ(R) topical gel, aminolevulinic acid HCl 10% topical gel. Biofrontera Inc (per FDA), Wakefield, MA, 2016. DailyMed
  3. Ladner DP, Klein SD, Steiner RA, et al: Synergistic toxicity of delta-aminolaevulinic acid-induced protoporphyrin IX used for photodiagnosis and hypericum extract, a herbal antidepressant. Br J Dermatol 2001; 144(4):916-918. PubMed
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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.