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" What is it used for?  Bacterial infections of the lungs and airways (chest or lower respiratory tract infections), such as pneumonia or flare-ups of chronic bronchitis. Bacterial infection of the sinuses (sinusitis). Bacterial infections of the urinary tract. Inflammation of the urethra in men that is not caused by gonorrhoea (non-gonococcal urethritis). Gonorrhoea. Chlamydia. Syphilis. Sexually transmitted infections that cause genital ulcers (chancroid or lymphogranuloma venereum). Rare sexually transmitted disease called granuloma inguinale. Pelvic inflammatory disease. Acne vulgaris. Chronic inflammatory disorder of the facial skin called acne rosacea (unlicensed use).  Bacterial eye infections. Herpes infections of the mouth, gum disease (periodontitis), or recurrent mouth ulcers (unlicensed use - for this purpose the medicine should be rinsed around the mouth for two to three minutes four times daily, usually for three days; it should preferably not be swallowed). Infections caused by Rickettsiae micro-organisms transmitted by lice, fleas, ticks and mites (eg Q fever, Rocky Mountain spotted fever, tick fever). Louse and tick-bourne relapsing fever, eg Lyme disease. Infectious disease of birds that can be transmitted to man (parrot fever or psittacosis), caused by the bacterium Chlamydia psittaci. Rare infection caused by Brucella bacteria (brucellosis), resulting from exposure to infected animals or consumption of infected milk or meat. Rare bacterial infection of rodents and rabbits that can be transmitted to humans (tularaemia glanders). Infectious disease caused by the bacterium Burkholderia pseudomallei (melioidosis or Whitmore&amp;#039;s disease). Disease caused by infection with Leptospira bacteria (Weil&amp;#039;s Disease/leptospirosis). Cholera. Tetanus. Bubonic plague. Severe form of gangrene caused by bacterial infection that results in death and decay of tissue in an infected wound (gas gangrene). Protozoal infection of the intestine (amoebiasis). Treatment of malaria caused by chloroquine-resistant Plasmodium falciparum. Prevention of malaria. Prevention of an infectious disease called Scrub typhus. Prevention of infection with Leptospira bacteria (leptospirosis). Prevention of traveller&amp;#039;s diarrhoea (enterotoxigenic E coli). Treatment and prevention of anthrax (unlicensed use).   How does it work? Vibramycin-D dispersible tablets contain the active ingredient doxycycline, which is a type of antibiotic called a tetracycline. It is used to treat infections caused by bacteria. (NB. Doxycycline is also available without a brand name, ie as the generic medicine.) Doxycycline works by interfering with the ability of bacteria to produce proteins that are essential to them. Without these proteins the bacteria cannot grow, multiply and increase in numbers. Doxycycline therefore stops the spread of the infection and the remaining bacteria are killed by the immune system or eventually die. Doxycycline is a broad spectrum antibiotic that is active against a wide variety of bacteria. However, some strains of bacteria have developed resistance to this antibiotic, which has reduced its effectiveness for treating some types of infection. Doxycycline is used to treat infections caused by susceptible bacteria, including those affecting the urinary tract, genitals (eg chlamydia, gonorrhoea, urethritis, prostatitis, pelvic inflammatory disease), lungs (eg bronchitis, pneumonia, sinusitis) or eyes. It can also be used to treat gum disease. Doxycycline is also used to treat other rarer infections, such as those caused by a group of micro-organisms called rickettsiae (eg Q fever).  To make sure the bacteria causing an infection are susceptible to doxycycline your doctor may take a tissue sample, for example a swab from the infected area, or a urine or blood sample.  Doxycycline is used to treat acne, as it is active against the bacteria associated with acne, Propionebacterium acnes. This is a common type of bacteria that feeds on sebum produced by the sebaceous glands in the skin. It produces waste products and fatty acids that irritate the sebaceous glands, making them inflamed and causing spots. By controlling bacterial numbers, doxycycline brings the inflammation of the sebaceous glands under control and allows the skin to heal.  Doxycycline is also active against the parasite that causes malaria. It is sometimes used to treat malaria, and is one of the options for preventing malaria in areas of the world where there is a high risk of falciparum malaria resistant to chloroquine. It is important to check with your pharmacist which medicines are currently recommended to prevent malaria in the country you are travelling to. When used to prevent malaria, doxycycline should be started two days before you travel to the malarious region. You should continue taking it every day throughout your stay, and for a further four weeks after leaving.   How do I take it?  The dose of this medicine, how often it is taken and the length of treatment depends on what condition is being treated or prevented. Follow the instructions given by your doctor. These will be printed on the dispensing label that your pharmacist has put on the packet of medicine. If you need help working out what time to take the tablets, ask your pharmacist for advice. Doxycycline is usually taken once or twice a day. You should try to space the doses evenly. Vibramycin-D tablets should be dissolved in a glass of water and taken while you are sitting or standing. This is to prevent the medicine irritating the throat. Avoid taking a dose just before going to bed. If you find the medicine irritates your stomach you can minimise this by taking it with food or milk. The medicine can be taken either with or without food. Do not take indigestion remedies or medicines containing aluminium, calcium, iron, magnesium or zinc at the same time of day as this medicine, because these can reduce the absorption of doxycycline from the gut. See end of factsheet for more information. Unless your doctor tells you otherwise, it is important that you finish the prescribed course of this antibiotic medicine, even if you feel better or it seems the infection has cleared up. Stopping the course early increases the chance that the infection will come back and that the bacteria will grow resistant to the antibiotic. If you are using this medicine as malaria prevention you should start taking it, as directed by your doctor, two days before you travel. You should continue taking it throughout your stay in the malarious region, and for a further four weeks after leaving.   Warning!  In some people this medicine can cause the skin to become more sensitive to sunlight and UV light, causing an exaggerated sunburn reaction. For this reason you should avoid excessive exposure to strong sunlight, and avoid using sunbeds and sunlamps while you are taking this medicine. Occasionally this antibiotic may upset the natural balance of micro-organisms in the body, allowing those that are not susceptible to doxycycline to overgrow and cause infection. This may happen with yeasts such as Candida, resulting in thrush infections. If you think you have developed a new infection while taking this medicine, you should consult your doctor. Broad-spectrum antibiotics can sometimes cause inflammation of the bowel (colitis). For this reason, if you get diarrhoea that becomes severe or persistent or contains blood or mucus, either during or after taking this medicine, you should consult your doctor immediately.    Use with caution in  Decreased kidney function. Decreased liver function. People taking medicines with potential to cause adverse effects on the liver. A condition called systemic lupus erythematosus, in which there is long-term inflammation of skin and some internal organs.  Abnormal muscle weakness (myasthenia gravis).   Not to be used in  Children under 12 years of age. Pregnancy. Breastfeeding. Allergy to other tetracycline-type antibiotics, eg tetracycline, minocycline. Hereditary blood disorders called acute porphyrias.  This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.   Pregnancy and breastfeeding Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.  This medicine should not be used during pregnancy as it may be harmful to the unborn baby. (It can be deposited in growing bone, affecting the development of the skeleton, and in teeth, causing discolouration.) If you think you could be pregnant you should stop taking this medicine and consult your doctor. Seek further medical advice from your doctor. Significant amounts of this medicine may pass into breast milk, which may cause discolouration of a nursing infant&amp;#039;s teeth (even if they have not yet erupted). It should not be used by breastfeeding mothers. Seek further medical advice from your doctor.   Label warnings  Do not take indigestion remedies or medicines containing iron or zinc at the same time of day as this medication. Take at regular intervals. Complete the prescribed course unless otherwise directed. Avoid exposure of skin to direct sunlight or sun lamps.   Side effects Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.  Disturbances of the gut, such as nausea, vomiting, diarrhoea, indigestion or abdominal pain. Difficulty or pain when swallowing (dysphagia). Inflammation of the food pipe (oesophagitis). Loss of appetite. Flushing. Sensation of ringing or other noise in the ears (tinnitus). Increased sensitivity of the skin to UV light (photosensitivity - see warning section above). Aching muscles or joints. Disturbances in the normal numbers of blood cells in the blood (rare). Consult your doctor if you experience unusual bruising or bleeding, tiredness, sore throat, fever or other signs of infection while taking this medicine, as these could be symptoms of problems with your blood cells. Liver problems, including jaundice, hepatitis or liver failure (rare). Inflammation of the pancreas (pancreatitis - rare). Skin rashes (rare). Mild increase in pressure within the skull (benign intracranial hypertension). This is rare. However, you should stop taking this medicine and consult your doctor if you experience a severe persistent headache or changes in your vision while taking this medicine, eg blurred or double vision or loss of vision, as these could be symptoms of this condition. Rarely, severe allergic reactions, such as swelling of the lips, throat and tongue (angioedema), severe skin rashes or anaphylactic shock.  The side effects listed above may not include all of the side effects reported by the medicine&amp;#039;s manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.   How can this medicine affect other medicines? It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.  The following medicines may reduce the absorption of doxycycline from the gut, which could make it less effective. If you are taking medicines containing any of the following ingredients they should be taken at least three hours before or after your doxycycline dose:   aluminium salts  antacids for heartburn and indigestion containing aluminium, bismuth, calcium or magnesium  calcium supplements  iron preparations, eg ferrous sulphate (doxycycline also reduces the absorption of iron from the gut)  kaolin  magnesium salts  quinapril tablets that contain magnesium carbonate, eg Accupro brand  ranitidine bismuth citrate sucralfate  tripotassium dicitrato-bismuthate Videx chewable/dispersible tablets (these contain an antacid) zinc salts (doxycycline also reduces the absorption of zinc from the gut).   Strontium ranelate may also reduce the absorption of doxycycline from the gut and could make it less effective. If you are taking strontium for osteoporosis its manufacturer recommends that you stop taking it temporarily while you are taking a course of doxycycline. Doxycycline may increase the anti-blood-clotting effects of anticoagulant medicines such as warfarin. If you are taking an anticoagulant your doctor may want to monitor your blood clotting time (INR) after you start and finish treatment with this antibiotic. Doxycycline may increase the blood level of the immunosuppressant medicine ciclosporin. Your doctor may need to perform extra monitoring, for example of blood levels or for possible side effects, if you are taking these two medicines together. Doxycycline may possibly increase the risk of side effects from methotrexate.  The following medicines may increase the breakdown of doxycycline by the liver. This could lower the level of the antibiotic in the blood and make it less effective at treating infection. Your doctor may need to prescribe you a larger than normal dose of doxycycline if you are taking one of these medicines:  barbiturates, eg phenobarbital, amobarbital carbamazepine phenytoin primidone rifampicin.  If doxycycline is taken with acitretin, isotretinoin or tretinoin there may be an increased risk of developing raised pressure within the skull (benign intracranial hypertension). If you are taking one of these medicines you should not be prescribed doxycycline.  If doxycycline is taken with ergotamine or methysergide there may be an increased risk of ergot side effects (ergotism).  Oral typhoid vaccine (Vivotif) should not be taken until at least three days after you have finished a course of this antibiotic, because the antibiotic could make the vaccine less effective.  In the past, women using hormonal contraception such as the pill or patch would be advised to use an extra method of contraception (eg condoms) while taking an antibiotic like this one and for seven days after finishing the course. However, this advice has now changed. You no longer need to use an extra method of contraception with the pill, patch or vaginal ring while you take a course of antibiotics. This change in advice comes because to date there is no evidence to prove that antibiotics (other than rifampicin or rifabutin) affect these contraceptives. This is the latest guidance from the Faculty of Sexual &amp;amp; Reproductive Healthcare.  However, if you are taking the contraceptive pill and experience vomiting or diarrhoea as a result of taking this antibiotic, you should follow the instructions for vomiting and diarrhoea described in the leaflet provided with your pills.    Other medicines containing the same active ingredient    Doxylar Efracea  Periostat    Doxycycline capsules are also available without a brand name, ie as the generic medicine.  Last updated 27.06.2011 "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.netdoctor.co.uk/medicines/infections/a7735/vibramycin-d-doxycycline/>