travelers diarrhea and cholera vaccine inactivated (Dukoral, Mutacol Berna): Dosing and Uses
Classes: Vaccines, Travel
- Dosing and uses of Dukoral, Mutacol Berna (travelers diarrhea and cholera vaccine inactivated)
- Dukoral, Mutacol Berna (travelers diarrhea and cholera vaccine inactivated) adverse (side) effects
- Warnings
- Pregnancy
- Pharmacology of Dukoral, Mutacol Berna (travelers diarrhea and cholera vaccine inactivated)
- Administration
Dosing and uses of Dukoral, Mutacol Berna (travelers diarrhea and cholera vaccine inactivated)
Adult dosage forms and strengths
Not available in the Us
vial vaccine + sachet effervescent granules
Enterotoxigenic E. Coli
Indicated for prevention of travelers' diarrhea caused by enterotoxigenic E coli (ETEC)
Primary immunization: 2 doses PO
Booster: 1 dose PO after 3 months, then q3Months PRn
Cholera
Indicated for prevention of cholera caused by V cholerae in endemic areas (age >2 yr)
Primary immunization: 2 doses PO
Booster: 1 dose PO after 2 years
Dosing Considerations
Not available in the United States
Pediatric dosage forms and strengths
Not available in the Us
vial vaccine + sachet effervescent granules
Enterotoxigenic E. Coli
Indicated for prevention of travelers' diarrhea caused by enterotoxigenic E coli (ETEC)
Primary immunization: 2 doses PO
Booster: 1 dose PO after 3 months, then q3Months PRn
Cholera
Indicated for prevention of cholera caused by V cholerae in endemic areas (age >2 yr)
<2 years: Safety and efficacy not established
Aged 2-6 years
- Primary immunization: 3 doses PO
- Booster: 1 dose PO after 6 months
Aged >6 years
- Primary immunization: 2 doses PO
- Booster: 1 dose PO after 2 years
Dosing Considerations
Not available in the United States
Dukoral, Mutacol Berna (travelers diarrhea and cholera vaccine inactivated) adverse (side) effects
>10%
Abd pain (16%)
Warnings
Contraindications
Hypersensitivity to any component
Acute illness, especially febrile illness
Parenteral administration
Cautions
Immunocompromised persons may not obtain expected immune response
Travellers should use care in food/water choice, & use good hygiene measures
Efficacy not studied in pts. >65 yo, but use is recommended
Not generally recommended for use in pregnancy, but may be considered after risk/benefit analysis (theoretically no risk to fetus)
Not demonstrated effective against V cholerae O139 Bengal strain in South Asia
Pregnancy and lactation
Pregnancy category: N/A
Lactation: safe for nursing mothers
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Dukoral, Mutacol Berna (travelers diarrhea and cholera vaccine inactivated)
Mechanism of action
Killed V cholerae and the nontoxic recombinant cholera toxin B subunit
Antibodies against cholera toxin also confer protection against enterotoxigenic E coli (ETEC)
Administration
Oral Administration
Mix effervescent granules with 150 mL water, then add vaccine viaL
Administer doses at intervals of 1-6 weeks
Avoid food 1 hr before and after dosing; separate from oral typhoid vaccine by 8 hr