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

What is Vavo?

Vavo is used to treat infections caused by a fungus or yeast. It works by killing the fungus or yeast or preventing its growth.

Vavo cream is used to treat:

• Athlete's foot (tinea pedis; ringworm of the foot);
• Ringworm of the body (tinea corporis);
• Ringworm of the groin (tinea cruris; jock itch);
• Seborrheic dermatitis;
• "Sun fungus" (tinea versicolor; pityriasis versicolor); and
• Yeast infection of the skin (cutaneous candidiasis).

Vavo foam or gel is used to treat seborrheic dermatitis (scaly areas on your skin or scalp).

Vavo 1% shampoo is used to treat dandruff.

Vavo 2% shampoo is used to treat "sun fungus" (tinea versicolor; pityriasis versicolor).

Vavo may also be used for other fungus infections of the skin as determined by your doctor.

Most forms of Vavo are available only with your doctor's prescription. Some forms are available without a prescription. However, your doctor may have special instructions on the proper use for your medical condition.

Vavo indications

Vavo is an imidazole antifungal administered topically or by mouth. It is given by mouth in chronic mucocutaneous or vaginal candidiasis, in fungal infections of the gastrointestinal tract, in dermatophyte infections of the skin and fingernails not responding to topical treatment, and in systemic infections including blastomycosis, candidiasis, coccidioidomycosis, histoplasmosis, and paracoccidioidomycosis.

It has been given for the prophylaxis of fungal infections in immunocompromised patients, although fluconazole or itraconazole are usually preferred. It has been recommended that, because of its erratic absorption and slow therapeutic response, Vavo should not be used for the treatment of life-threatening fungal infections, including fungal meningitis, or for severe infections in immunocompromised patients. Also, because of the risk of hepatotoxicity the use of Vavo in nonsystemic fungal infections tends to be restricted to serious infections resistant to other treatment.

How should I use Vavo?

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

• An extra patient leaflet is available with Vavo gel. Talk to your pharmacist if you have questions about this information.
• Wash your hands before and immediately after using Vavo gel.
• Spread a thin layer of Vavo gel onto the affected area with the tips of your fingers. Gently rub it in. Be sure to cover the entire affected area and the healthy skin around it.
• Do not touch your eyes or nose while you are applying Vavo gel.
• Wait for at least 20 minutes after you apply Vavo gel before you apply makeup or sunscreen.
• Do not wash the area where you applied Vavo gel for at least 3 hours after you apply it.
• If you miss a dose of Vavo gel, use 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 use 2 doses at once.

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

Uses of Vavo in details

Use: Labeled Indications

Fungal infections (systemic):

US labeling: Treatment of susceptible systemic fungal infections, including blastomycosis, histoplasmosis, paracoccidioidomycosis, coccidioidomycosis, and chromomycosis in patients who have failed or who are intolerant to other antifungal therapies

Limitations of use: Vavo should only be used when other effective antifungal therapy is not available or tolerated and the potential benefits outweigh the potential risks. Vavo tablets are not indicated for the treatment of onychomycosis, cutaneous dermatophyte infections, or Candida infections.

Canadian labeling: Treatment of serious or life-threatening systemic fungal infections (eg, systemic candidiasis, chronic mucocutaneous candidiasis, coccidioidomycosis, paracoccidioidomycosis, histoplasmosis, and chromomycosis) where alternate therapy is inappropriate or ineffective; may be considered for severe dermatophytoses unresponsive to other therapy

Off Label Uses

Cushing syndrome

Data from a retrospective multicenter study support the use of Vavo in the management of patients with Cushing disease. The study authors found the side effects of Vavo to be acceptable; however, close monitoring of liver enzymes is advised. Additional trials may be necessary to further define the role of Vavo in this condition.

Based on the Endocrine Society

Vavo description

Vavo contains the following ingredients: D-Water, maltodextrin (corn), partially hydrolyzed sodium caseinate, lactalbumin hydrolysate, canola oil, medium-chain triglycerides (fractionated coconut oil), L-arginine, corn oil, magnesium chloride, potassium citrate, tribasic calcium phosphate, citric acid, soy lecithin, ascorbic acid, dibasic potassium phosphate, choline chloride, carrageenan, potassium chloride, taurine, L-carnitine, zinc sulfate, ferrous sulfate, α-tocopheryl acetate, niacinamide, calcium pantothenate, manganese sulfate, β-carotene, cupric sulfate, thiamine chloride HCl, pyridoxine HCl, riboflavin, vitamin A palmitate, folic acid, biotin, chromium chloride, sodium molybdate, potassium iodide, sodium selenate, phylloquinone, cyanocobalamin and vitamin D3.

Vavo is a ready-to-feed enteral product as a supplemental or sole-source nutrition complete and balanced nutrition for tube feeding. It is calorie dense at 1.3 cal/mL and contains a protein system of partially hydrolyzed proteins, including peptides and amino acids, to utilize the dual absorption system of the gut. Vavo is lactose- and gluten-free.

Caloric Distribution: See Table 1.

Analysis: See Table 2.

Vavo dosage

Vavo Dosage

Generic name: Vavo 200mg

Dosage form: tablet

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

There should be laboratory as well as clinical documentation of infection prior to starting Vavo therapy. The usual duration of therapy for systemic infection is 6 months. Treatment should be continued until active fungal infection has subsided.

Adults

The recommended starting dose of Vavo® (Vavo) Tablets is a single daily administration of 200 mg (one tablet). If clinical responsiveness is insufficient within the expected time, the dose of Vavo® Tablets may be increased to 400 mg (two tablets) once daily.

Children

In small numbers of children over 2 years of age, a single daily dose of 3.3 to 6.6 mg/kg has been used. Vavo® Tablets have not been studied in children under 2 years of age.

More about Vavo (Vavo)

• Side Effects
• During Pregnancy or Breastfeeding
• Dosage Information
• Drug Images
• Drug Interactions
• Support Group
• En Espanol
• 4 Reviews - Add your own review/rating

Consumer resources

• Vavo
• Vavo (Advanced Reading)

Professional resources

• Vavo (AHFS Monograph)
• Vavo (FDA)

Other formulations

• Vavo

  Topical

• Vavo A-D

Related treatment guides

• Blastomycosis
• Chromomycosis
• Coccidioidomycosis
• Histoplasmosis
• Paracoccidioidomycosis

Vavo interactions

See also:
What other drugs will affect Vavo?

Vavo is a potent inhibitor of the cytochrome P450 3A4 enzyme system. Coadministration of Vavo Tablets and drugs primarily metabolized by the cytochrome P450 3A4 enzyme system may result in increased plasma concentrations of the drugs that could increase or prolong both therapeutic and adverse effects.

Vavo Tablets inhibit the metabolism of terfenadine, resulting in an increased plasma concentration of terfenadine.

Vavo inhibits the metabolism of astemizole. Vavo potently inhibits the metabolism of cisapride resulting in a mean eight-fold increase in AUC of cisapride.

Vavo Tablets may alter the metabolism of cyclosporine, tacrolimus, and methylprednisolone, resulting in elevated plasma concentrations of the latter drugs.

Coadministration of Vavo Tablets with midazolam or triazolam has resulted in elevated plasma concentrations of the latter two drugs.

It is, therefore, advisable to monitor digoxin concentrations in patients receiving Vavo.

When taken orally, imidazole compounds like Vavo may enhance the anticoagulant effect of coumarin-like drugs.

a potential interaction involving the latter agents when used concomitantly with Vavo Tablets (an imidazole) can not be ruled out.

Concomitant administration of Vavo Tablets with phenytoin may alter the metabolism of one or both of the drugs.

Concomitant administration of rifampin with Vavo Tablets reduces the blood levels of the latter. INH (isoniazid) is also reported to affect Vavo concentrations adversely.

Vavo side effects

See also:
What are the possible side effects of Vavo?

Topically applied Vavo appears to have a low order of toxicity and is generally well tolerated. Adverse effects have been reported in up to 5% of patients receiving Vavo 2% cream and have consisted principally of local reactions such as severe irritation, pruritus, and stinging. A painful allergic reaction, consisting of localized swelling and inflammation, occurred in at least one patient receiving Vavo 2% cream and contact dermatitis occurred in another.

In several studies evaluating the potential of topical Vavo for causing dermal irritation, contact sensitization, or phototoxic or photoallergenic reactions in healthy adults, topical application of Vavo 2% cream caused mild transient erythema in some individuals, but did not cause contact sensitization of the delayed hypersensitivity type, irritation, phototoxicity, or photocontact sensitization.

Contact dermatitis has been reported following topical application of imidazole-derivative azole antifungals (e.g., clotrimazole, econazole, miconazole, oxiconazole, sulconazole, tioconazole). Cross-sensitization appears to occur among the imidazole derivatives; however, cross-sensitivity appears to be unpredictable. The fact that patients with contact sensitivity to one imidazole-derivative azole antifungal may be sensitive to other similar drugs should be considered.

Although hepatotoxicity has occurred during treatment with oral Vavo, it is unlikely that this adverse effect would occur with Vavo 2% cream since the drug does not appear to be appreciably absorbed following topical application to skin.

Adverse effects reported in patients receiving topical Vavo 2% as a shampoo applied to the skin include pruritus, application site reaction, and dry skin. Adverse effects reported in patients receiving Vavo shampoo to the scalp include increased hair loss, irritation, abnormal hair texture, scalp pustules, dry skin, pruritus, and oiliness or dryness of the hair and scalp. In some patients with permanently waved (“permed”) hair, use of Vavo 2% shampoo resulted in loss of the curl.

Vavo contraindications

See also:
What is the most important information I should know about Vavo?

Drug Interactions

Coadministration of a number of CYP3A4 substrates such as dofetilide, quinidine cisapride and pimozide is contraindicated with Vavo® Tablets. Coadministration with Vavo can cause elevated plasma concentrations of these drugs and may increase or prolong both therapeutic and adverse effects to such an extent that a potentially serious adverse reaction may occur. For example, increased plasma concentrations of some of these drugs can lead to QT prolongation and sometimes resulting in life-threatening ventricular tachyarrhythmias including occurrences of torsades de pointes, a potentially fatal arrhythmia.

Additionally, the following other drugs are contraindicated with Vavo® Tablets: methadone, disopyramide, dronedarone, ergot alkaloids such as dihydroergotamine, ergometrine, ergotamine, methylergometrine, irinotecan, lurasidone, oral midazolam, alprazolam, triazolam, felodipine, nisoldipine, ranolazine, tolvaptan, eplerenone, lovastatin, simvastatin and colchicine.

Enhanced Sedation

Coadministration of Vavo® Tablets with oral midazolam, oral triazolam or alprazolam has resulted in elevated plasma concentrations of these drugs. This may potentiate and prolong hypnotic and sedative effects, especially with repeated dosing or chronic administration of these agents. Concomitant administration of Vavo® Tablets with oral triazolam, oral midazolam or alprazolam is contraindicated.

Myopathy

Coadministration of CYP3A4 metabolized HMG-CoA reductase inhibitors such as simvastatin, and lovastatin is contraindicated with Vavo® Tablets.

Ergotism

Concomitant administration of ergot alkaloids such as dihydroergotamine and ergotamine with Vavo® Tablets is contraindicated.

Liver Disease

The use of Vavo® Tablets is contraindicated in patients with acute or chronic liver disease.

Hypersensitivity

Vavo® is contraindicated in patients who have shown hypersensitivity to the drug.

Active ingredient matches for Vavo:

Ketoconazole in Oman.

References

1. DailyMed. "KETOCONAZOLE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
2. PubChem. "ketoconazole". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
3. DrugBank. "ketoconazole". http://www.drugbank.ca/drugs/DB01026 (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology