Vibramycin D

Vibramycin D is a drug from the tetracycline category. It is an antimicrobial drug with strong bacteriostatic activity; it is used for infections associated with the action of microbes sensitive to tetracyclines.

The antimicrobial effect of the drug is provided by its ability to suppress protein binding processes. [ 1 ]

The drug has a wide range of action against gram-positive and -negative microorganisms, as well as certain other bacteria pathogenic to humans. [ 2 ]

Indications Vibramycin D

It is used for infections caused by the activity of gram-negative and -positive strains, including:

• lower respiratory tract lesions associated with the influence of streptococci, Klebsiella, Haemophilus influenzae and mycoplasmas (bronchitis, pneumonia or sinusitis);
• urinary tract infections (caused by streptococci, klebsiella, E. coli and enterobacter);
• STIs caused by the influence of gonococci, mycoplasmas, chlamydia, ureaplasma and chancroid (including infections in the rectum) (mycoplasmosis, gonorrhea with urethritis (also its non-gonococcal forms), syphilis, and in addition to this, granuloma of a venereal and inguinal nature);
• acne and purulent lesions of the subcutaneous tissues and epidermis (including infected eczema, abscess, impetigo, furunculosis, epidermal rashes, infected burns, as well as postoperative and infected wound lesions). [ 3 ]

Used for infections associated with bacteria sensitive to tetracyclines:

• ophthalmological lesions caused by gonococci, staphylococci and Haemophilus influenzae;
• rickettsial infections (RTI, coxiellosis, a subcategory of typhus, as well as tick-borne fever and endocarditis caused by the activity of Coxiella);
• other lesions (cholera, psittacosis, brucellosis (in combination with streptomycin), epidemic relapsing fever, tick-borne spirochetosis, bubonic plague, tularemia, Whitmore's disease, tropical malaria and the active phase of intestinal amebiasis (in combination with an amebicide)).

Can be used as an alternative for myonecrosis, leptospirosis or tetanus.

It is prescribed for the prevention of malaria, tsutsugamushi, leptospirosis and traveler's diarrhea.

Release form

The drug is released in tablets - 10 pieces in a cell plate; there is 1 such plate in a pack.

Pharmacokinetics

Tetracyclines are absorbed without complications and participate in intraplasmic protein synthesis. They accumulate in the liver and bile, and are then excreted in their bioactive state in large volumes with feces and urine.

Doxycycline is almost completely absorbed when taken orally. Tests show that the absorption of doxycycline differs from other tetracyclines - it is not affected by taking it with food (or milk).

When a 0.2 g dose was administered, serum doxycycline Cmax values in volunteers averaged 2.6 μg/ml after 2 hours, and then decreased to 1.45 μg/ml after 24 hours.

Doxycycline is a highly lipophilic component with a weak affinity for Ca. It has high stability in blood plasma; it is not converted into epi-anhydroforms during metabolic processes. [ 4 ]

Dosing and administration

The daily dosage of the medicine is selected taking into account the intensity of the pathology, as well as the type of infection. The medicine is taken orally - you need to dissolve the tablet in a small amount of liquid, thus forming a suspension.

The substance should be used at least 60 minutes before bedtime or with food to prevent irritation in the esophagus.

On average, an adult is prescribed the following doses of medication:

• active stage of infection – 0.2 g per day (if the pathology is not severe); after 2 days, the dose can be reduced to 0.1 g (used immediately or in 2 doses with a 12-hour break);
• in case of acne – 0.05 g per day for a period of 6-12 weeks;
• sexually transmitted infections – 0.1 g per day for 7 days; in case of epididymo-orchitis – for 10 days, 0.1 g 2 times per day;
• in case of syphilis (not in pregnant women) – 0.2 g, 2 times a day, over a period of 14 days;
• for KVT or relapsing typhus - 1-time dose of 0.1-0.2 g;
• during malaria – 0.2 g once a day for 7 days.

To prevent malaria, take 0.1 g per day, starting 2 days before traveling to a dangerous area. This therapy should last for 1 month after visiting a dangerous area.

The use of drugs is supplemented by the introduction of drugs from the schizonticide subcategory (for example, quinine).

To prevent such violations:

• tsutsugamushi - 1-time use of 0.2 g of the substance;
• traveler's diarrhea - 0.2 g, once a day, for the entire period of stay;
• leptospirosis – 0.2 g per week, and also once before departure.

Elderly people and people with renal/liver impairment should take smaller doses of the medication.

• Application for children

Not for pediatric use (under 12 years of age).

Use Vibramycin D during pregnancy

During the period of treatment with the drug, you should stop breastfeeding.

Contraindications

Contraindicated for use in individuals with hypersensitivity (allergy) to any of the components of the drug.

Side effects Vibramycin D

Side effects include:

• nausea, dyspepsia, heartburn, pancreatitis and vomiting;
• decreased blood pressure, dyspnea, tachycardia, active phase of lupus and anaphylaxis;
• dizziness or drowsiness;
• allergy symptoms, including hives;
• vaginal infection (candidiasis);
• thrombocyto- or neutropenia, hemolytic anemia and eosinophilia;
• loss of appetite or porphyria;
• hot flashes or ringing in the ears;
• liver failure, jaundice, hepatitis and hepatotoxic manifestations;
• erythema multiforme, rashes and TEN;
• myalgia or arthralgia.
• discoloration of baby teeth [ 5 ]

Overdose

Poisoning develops only occasionally.

If disorders occur, gastric lavage should be performed and enterosorbents should be prescribed. The dialysis procedure will be ineffective.

Interactions with other drugs

The absorption of doxycycline may be weakened in case of combination with aluminum-, magnesium- or calcium-containing antacids, as well as other drugs that contain the specified cations; in addition, such an effect is observed when introducing Fe or bismuth salts, as well as zinc, into the body. It is necessary to use doxycycline and these drugs with the maximum possible time interval between doses.

Bacteriostatic drugs can alter the bactericidal activity of penicillin, which is why the drug is not used together with penicillin.

There is information regarding prolongation of PT in individuals using doxycycline together with warfarin.

Tetracyclines weaken the effect of plasma prothrombin, which may require a reduction in the dose of anticoagulants.

The use of the drug in combination with carbamazepine, barbiturates and phenytoin may cause a decrease in the half-life of doxycycline. In this regard, it may be necessary to increase the daily dosage of Vibramycin D.

Alcoholic beverages may decrease the half-life of doxycycline.

There are reports of breakthrough bleeding and pregnancy occurring when tetracyclines are combined with oral contraception.

Doxycycline can increase plasma levels of cyclosporine. Therefore, these drugs can only be administered together under medical supervision.

There are data on the development of nephrotoxic effects with a fatal outcome in the case of combining tetracyclines with methoxyflurane.

The combined use of isotretinoin or other systemic retinoids with Vibramycin D should be avoided. The administration of each of these components separately has been associated with a benign increase in intracranial pressure (cerebrospinal pseudotumor).

When using the drug, a false increase in urinary catecholamine levels may be observed due to interaction with fluorescent diagnostics.

Storage conditions

Vibramycin D should be stored at temperatures within 25°C.

Shelf life

Vibramycin D can be used within a 4-year period from the date of manufacture of the pharmaceutical product.

Analogues

The analogues of the drug are Doxibene with Doxa-M-Ratiopharm and Unidox Solutab with Doxycycline.