Vibrox Uses

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• Vibrox indications
• Uses of Vibrox in details
• Vibrox description
• Vibrox dosage
• Vibrox interactions
• Vibrox side effects
• Vibrox contraindications

What is Vibrox?

Vibrox is a tetracycline antibiotic that fights bacteria in the body.

Vibrox is used to treat many different bacterial infections, such as acne, urinary tract infections, intestinal infections, eye infections, gonorrhea, chlamydia, periodontitis (gum disease), and others.

Vibrox is also used to treat blemishes, bumps, and acne-like lesions caused by rosacea. Vibrox will not treat facial redness caused by rosacea.

Some forms of Vibrox are used to prevent malaria, to treat anthrax, or to treat infections caused by mites, ticks, or lice.

Vibrox may also be used for purposes not listed in this medication guide.

Vibrox indications

Rickettsial Infections

Vibrox® and Vibrox® CAP are indicated for treatment of Rocky Mountain spotted fever, typhus fever and the typhus group, Q fever, rickettsial pox, and tick fevers caused by Rickettsiae.

Sexually Transmitted Infections

Vibrox and Vibrox CAP are indicated for treatment of the following sexually transmitted infections:

• Uncomplicated urethral, endocervical or rectal infections caused by Chlamydia trachomatis.
• Nongonococcal urethritis caused by Ureaplasma urealyticum.
• Lymphogranuloma venereum caused by Chlamydia trachomatis.
• Granuloma inguinale caused by Klebsiella granulomatis.
• Uncomplicated gonorrhea caused by Neisseria gonorrhoeae.
• Chancroid caused by Haemophilus ducreyi.

Respiratory Tract Infections

Vibrox and Vibrox CAP are indicated for treatment of the following respiratory tract infections:

• Respiratory tract infections caused by Mycoplasma pneumoniae.
• Psittacosis (ornithosis) caused by Chlamydophila psittaci.
• Because many strains of the following groups of microorganisms have been shown to be resistant to Vibrox, culture and susceptibility testing are recommended.
• Vibrox is indicated for treatment of infections caused by the following microorganisms, when bacteriological testing indicates appropriate susceptibility to the drug:
• Respiratory tract infections caused by Haemophilus influenzae.
• Respiratory tract infections caused by Klebsiella species.
• Upper respiratory infections caused by Streptococcus pneumoniae.

Specific Bacterial Infections

Vibrox and Vibrox CAP are indicated for treatment of the following specific bacterial infections:

• Relapsing fever due to Borrelia recurrentis.
• Plague due to Yersinia pestis.
• Tularemia due to Francisella tularensis.
• Cholera caused by Vibrio cholerae.
• Campylobacter fetus infections caused by Campylobacter fetus.
• Brucellosis due to Brucella species (in conjunction with streptomycin).
• Bartonellosis due to Bartonella bacilliformis.

Because many strains of the following groups of microorganisms have been shown to be resistant to Vibrox, culture and susceptibility testing are recommended.

Vibrox and Vibrox CAP are indicated for treatment of infections caused by the following gram-negative microorganisms, when bacteriological testing indicates appropriate susceptibility to the drug:

• Escherichia coli
• Enterobacter aerogenes
• Shigella species
• Acinetobacter species
• Urinary tract infections caused by Klebsiella species.

Ophthalmic Infections

Vibrox and Vibrox CAP are indicated for treatment of the following ophthalmic infections:

• Trachoma caused by Chlamydia trachomatis, although the infectious agent is not always eliminated as judged by immunofluorescence.
• Inclusion conjunctivitis caused by Chlamydia trachomatis.

Anthrax Including Inhalational Anthrax (Post-Exposure)

Vibrox and Vibrox CAP are indicated for the treatment of Anthrax due to Bacillus anthracis, including inhalational anthrax (post-exposure); to reduce the incidence or progression of disease following exposure to aerosolized Bacillus anthracis.

Alternative Treatment for Selected Infections when Penicillin is Contraindicated

Vibrox and Vibrox CAP are indicted as an alternative treatment for the following selected infections when penicillin is contraindicated:

• Syphilis caused by Treponema pallidum.
• Yaws caused by Treponema pallidum subspecies pertenue.
• Listeriosis due to Listeria monocytogenes.
• Vincent’s infection caused by Fusobacterium fusiforme.
• Actinomycosis caused by Actinomyces israelii.
• Infections caused by Clostridium species.

Adjunctive Therapy for Acute Intestinal Amebiasis and Severe Acne

In acute intestinal amebiasis, Vibrox and Vibrox CAP may be a useful adjunct to amebicides.

In severe acne, Vibrox and Vibrox CAP may be useful adjunctive therapy.

Prophylaxis of Malaria

Vibrox and Vibrox CAP are indicated for the prophylaxis of malaria due to Plasmodium falciparum in short-term travelers (less than 4 months) to areas with chloroquine and/or pyrimethamine-sulfadoxine resistant strains.

Usage

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Vibrox and Vibrox CAP and other antibacterial drugs, Vibrox and Vibrox CAP should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

How should I use Vibrox?

Use Vibrox as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Vibrox by mouth on an empty stomach at least 1 hour before or 2 hours after eating.
• Do not take an antacid that has aluminum, calcium, or magnesium in it; bismuth subsalicylate; iron; zinc; or multivitamins with minerals within 2 hours before or 2 hours after you take Vibrox.
• Do not eat or drink dairy products within 1 hour before or 2 hours after you take Vibrox.
• To clear up your infection completely, take Vibrox for the full course of treatment. Keep taking it even if you feel better in a few days.
• Drink plenty of nondairy fluid with Vibrox to wash it down and avoid the risk of sore throat.
• Take Vibrox twice daily (every 12 hours), preferably in the morning and evening.
• Continue to take Vibrox even if you feel well. Do not miss any doses.
• If you miss a dose of Vibrox, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Vibrox.

Uses of Vibrox in details

Use: Labeled Indications

Acne: Adjunctive therapy in severe acne.

Actinomycosis: Treatment of actinomycosis caused by Actinomyces israelii when penicillin is contraindicated.

Acute intestinal amebiasis: Adjunct to amebicides in acute intestinal amebiasis.

Anthrax, including inhalational anthrax (postexposure): Treatment of anthrax caused by Bacillus anthracis, including inhalational (postexposure) prophylaxis; to reduce the incidence or progression of disease following exposure to aerosolized B. anthracis.

Cholera: Treatment of cholera infections caused by Vibrio cholerae.

Clostridium: Treatment of infections caused by Clostridium spp. when penicillin is contraindicated.

Gram-negative infections: Treatment of infections caused by Escherichia coli, Enterobacter aerogenes, Shigella spp., Acinetobacter spp., Klebsiella spp. (respiratory and urinary infections), and Bacteroides spp.; Neisseria meningitidis (when penicillin is contraindicated).

Gram-positive infections: Treatment of infections caused by Streptococcus spp., when susceptible.

Listeriosis: Treatment of listeriosis due to Listeria monocytogenes when penicillin is contraindicated.

Malaria prophylaxis: Prophylaxis of malaria due to Plasmodium falciparum in short-term travelers (under 4 months) to areas with chloroquine and/or pyrimethamine-sulfadoxine-resistant strains.

Mycoplasma pneumoniae: Treatment of infections caused by Mycoplasma pneumoniae.

Ophthalmic infections:

Periodontitis (20 mg tablet and capsule [Vibrox (Canadian product)] only): Adjunct to scaling and root planing to promote attachment level gain and to reduce pocket depth in patients with adult periodontitis.

Relapsing fever: Treatment of relapsing fever caused by Borrelia recurrentis.

Respiratory tract infections: Treatment of respiratory infections caused by Haemophilus influenzae, Klebsiella spp., or Mycoplasma pneumoniae; treatment of upper respiratory tract infections caused by Streptococcus pneumoniae; respiratory infections caused by Staphylococcus aureus (Vibrox is not the drug of choice in the treatment of any type of staphylococcal infection).

Rickettsial infections: Treatment of Rocky Mountain spotted fever, typhus fever and the typhus group, Q fever, rickettsialpox, and tick fevers caused by Rickettsiae.

Rosacea (Vibrox, Apprilon [Canadian product] only): Treatment of only inflammatory lesions (papules and pustules) of rosacea in adults.

Sexually transmitted infections: Treatment of lymphogranuloma venereum and uncomplicated urethral, endocervical, or rectal infections caused by Chlamydia trachomatis; granuloma inguinale (donovanosis) caused by Klebsiella granulomatis; chancroid caused by Haemophilus ducreyi; nongonococcal urethritis caused by Ureaplasma urealyticum; when penicillin is contraindicated, uncomplicated gonorrhea caused by Neisseria gonorrhea and syphilis caused by Treponema pallidum.

Note: The CDC sexually transmitted disease guidelines recommend dual antimicrobial therapy be used for uncomplicated gonorrhea due to N. gonorrhea resistance concerns; ceftriaxone is the preferred cephalosporin and Vibrox is an alternative option for the second antimicrobial only in cases of azithromycin allergy (CDC [Workowski 2015]).

Skin and skin structure infections (Avidoxy only): Treatment of skin and skin structure infections caused by Staphylococcus aureus (Vibrox is not the drug of choice in the treatment of any type of staphylococcal infection).

Vincent infection: Treatment of Vincent infection caused by Fusobacterium fusiforme when penicillin is contraindicated.

Yaws: Treatment of yaws caused by Treponema pallidum subspecies pertenue when penicillin is contraindicated.

Zoonotic infections: Treatment of psittacosis (ornithosis) caused by Chlamydophila psittaci; plague due to Yersinia pestis; tularemia caused by Francisella tularensis; brucellosis caused by Brucella spp. (in conjunction with streptomycin); bartonellosis caused by Bartonella bacilliformis; infections caused by Campylobacter fetus.

Off Label Uses

Anaplasmosis and ehrlichiosis

Based on the IDSA guidelines for the clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis (HGA) and babesiosis and the Centers for Disease Control and Prevention (CDC) guideline for the diagnosis and management of tickborne rickettsial diseases, Vibrox is effective and recommended for the treatment of human anaplasmosis (also known as HGA) and human ehrlichiosis.

Bartonella infections in HIV-infected patients

Based on the US Department of Health and Human Services (HHS) guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents, Vibrox is a recommended and effective agent for treatment of bacillary angiomatosis, peliosis hepatis, bacteremia, osteomyelitis, CNS infections, infective endocarditis, and other severe infections due to Bartonella in adolescent and adult HIV-infected patients.

Bite wound infection (animal or human bite)

Based on the IDSA guidelines for the diagnosis and management of SSTIs, Vibrox is an acceptable alternative agent for the prophylaxis and treatment of bite wounds (animal or human).

Cellulitis, mild to moderate

Based on the Infectious Diseases Society of America (IDSA) guidelines for the diagnosis and management of skin and soft tissue infections (SSTIs) and the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections, Vibrox is an effective and recommended treatment option for SSTIs caused by MRSA, particularly purulent cellulitis due to community-acquired MRSA (CA-MRSA).

Chronic obstructive pulmonary disease, acute exacerbation

Data from a randomized, double-blind, placebo-controlled trial support the use of Vibrox in the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD).

Based on the American College of Chest Physicians diagnosis and management of lung cancer clinical practice guidelines, intrapleural Vibrox is effective and recommended in the management of recurrent, symptomatic, malignant pleural effusions.

Proctitis, acute or proctocolitis

Based on the CDC sexually transmitted diseases treatment guidelines, Vibrox in combination with ceftriaxone is an effective and recommended agent in the treatment of acute proctitis or proctocolitis.

Prosthetic joint infection

Based on the IDSA guidelines for the management of prosthetic joint infection, Vibrox is an effective and recommended agent for treatment (oral phase) of prosthetic joint infection and for chronic oral antimicrobial suppression of prosthetic joint infection due to staphylococci or Cutibacterium acnes.

Surgical prophylaxis, uterine evacuation (induced abortion or pregnancy loss)

Based on the American College of Obstetricians and Gynecologists guidelines for prevention of infection after gynecologic procedures, Vibrox is effective and recommended as antimicrobial prophylaxis for uterine evacuation procedures for induced abortion or pregnancy loss.

Vibrox description

Vibrox is a broad-spectrum antibiotic synthetically derived from oxytetracycline and is available as Vibrox monohydrate and Vibrox (hydrochloride hemiethanolate hemihydrate). The chemical designation of this light-yellow crystalline powder is α-6-deoxy-5-oxytetracycline. Vibrox has a high degree of lipoid solubility and a low affinity for calcium binding. It is highly stable in normal human serum. Vibrox will not degrade into an epianhydro form.

The molecular formula for Vibrox hydrochloride hemiethanolate hemihydrate is (C₂₂H₂₄N₂O₈·HCl)₂·C₂H₆O·H₂O and the molecular weight is 1025.89. Vibrox is a light-yellow crystalline powder. Vibrox is soluble in water, while Vibrox monohydrate is very slightly soluble in water.

Vibrox dosage

THE DOSAGE OF Vibrox® (Vibrox) DIFFERS FROM THAT OF Vibrox USED TO TREAT INFECTIONS. EXCEEDING THE RECOMMENDED DOSAGE MAY RESULT IN AN INCREASED INCIDENCE OF SIDE EFFECTS INCLUDING THE DEVELOPMENT OF RESISTANT MICROORGANISMS.

Vibrox® (Vibrox) 20 mg twice daily as an adjunct following scaling and root planing may be administered for up to 9 months. Vibrox® (Vibrox) should be taken twice daily at 12 hour intervals, usually in the morning and evening. It is recommended that if Vibrox® (Vibrox) is taken close to meal times, allow at least one hour prior to or two hours after meals. Safety beyond 12 months and efficacy beyond 9 months have not been established.

Administration of adequate amounts of fluid along with the tablets is recommended to wash down the drug and reduce the risk of esophageal irritation and ulceration..

How supplied

Vibrox® (Vibrox) (white tablet imprinted with a PS20) containing Vibrox equivalent to 20 mg Vibrox. Bottle of 60 (NDC 64682-008-01), Bottle of 100 (NDC 64682-008-02) and Bottle of 1000 (NDC 64682-008-03).

Storage: All products are to be stored at controlled room temperatures of 15°C - 30°C (59°F - 86°F) and dispensed in tight, light-resistant containers (USP).

Manufactured by: Pharmaceutical Manufacturing Research Services, Inc., Horsham, PA 19044. Marketed by: CollaGenex Pharmaceuticals, Inc., Newtown, PA, 18940. FDA revision date: 3/31/2004

Vibrox interactions

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What other drugs will affect Vibrox?

Medications containing metal ions (antacids, products containing iron, magnesium, calcium) form inactive chelates with Vibrox, in connection with what it is necessary to avoid their simultaneous use.

It needed to avoid combination with penicillins, cephalosporins, bactericidal action and is an antagonist of bacteriostatic antibiotics (including Vibrox).

Absorption of Vibrox is reduced by cholestyramine and colestipol (observe the interval between the reception of at least 3 h).

Due to suppression of intestinal microflora Vibrox reduces prothrombin index which requires dose adjustment of indirect anticoagulants.

Alti-Vibrox reduces the reliability of contraception and increases the frequency of breakthrough bleeding while taking estrogen-containing oral contraceptives.

Simultaneous administration of Alti-Vibrox with: