What is Vancomycin?
Vancomycin is an antibiotic.
Oral (taken by mouth) Vancomycin fights bacteria in the intestines.
Vancomycin is used to treat an infection of the intestines caused by Clostridium difficile, which can cause watery or bloody diarrhea. Vancomycin is also used to treat staph infections that can cause inflammation of the colon and small intestines.
Oral Vancomycin works only in the intestines. This medicine is not normally absorbed into the body and will not treat other types of infection. An injection form of this medication is available to treat serious infections in other parts of the body.
Vancomycin may also be used for purposes not listed in this medication guide.
Vancomycin indications
Vancomycin Hydrochloride for injection, USP is indicated for the treatment of serious or severe infections caused by susceptible strains of methicillin-resistant (β-lactam-resistant) staphylococci. It is indicated for penicillin-allergic patients, for patients who cannot receive or who have failed to respond to other drugs, including the penicillins or cephalosporins, and for infections caused by Vancomycin-susceptible organisms that are resistant to other antimicrobial drugs. Vancomycin Hydrochloride for injection, USP is indicated for initial therapy when methicillin-resistant staphylococci are suspected, but after susceptibility data are available, therapy should be adjusted accordingly.
Vancomycin Hydrochloride for injection, USP is effective in the treatment of staphylococcal endocarditis. Its effectiveness has been documented in other infections due to staphylococci, including septicemia, bone infections, lower respiratory tract infections, skin and skin structure infections. When staphylococcal infections are localized and purulent, antibiotics are used as adjuncts to appropriate surgical measures.
Vancomycin Hydrochloride for injection, USP has been reported to be effective alone or in combination with an aminoglycoside for endocarditis caused by S.viridans or S. bovis. For endocarditis caused by enterococci (e.g., E. faecalis), Vancomycin has been reported to be effective only in combination with an aminoglycoside.
Vancomycin Hydrochloride for injection, USP has been reported to be effective for the treatment of diphtheroid endocarditis. Vancomycin Hydrochloride for injection, USP has been used successfully in combination with either rifampin, an aminoglycoside, or both in early-onset prosthetic valve endocarditis caused by S. epidermidis or diphtheroids.
Specimens for bacteriologic cultures should be obtained in order to isolate and identify causative organisms and to determine their susceptibilities to Vancomycin.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Vancomycin Hydrochloride for injection, USP and other antibacterial drugs, Vancomycin Hydrochloride for injection, USP 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.
The parenteral form of Vancomycin Hydrochloride may be administered orally for treatment of antibiotic-associated pseudomembranous colitis produced by C. difficile and for staphylococcal enterocolitis.
Parenteral administration of Vancomycin Hydrochloride alone is of unproven benefit for these indications. Vancomycin is not effective by the oral route for other types of infection.
How should I use Vancomycin?
Use First-Vancomycin 25 solution as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Take First-Vancomycin 25 solution by mouth with or without food.
- Your pharmacist will need to mix First-Vancomycin 25 solution before you get it.
- Shake well before each use.
- Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose.
- To clear up your infection completely, take First-Vancomycin 25 solution for the full course of treatment. Keep taking it even if you feel better in a few days.
- Continue to use First-Vancomycin 25 solution even if you feel well. Do not miss any doses.
- If you miss a dose of First-Vancomycin 25 solution, 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 First-Vancomycin 25 solution.
Uses of Vancomycin in details
Vancomycin is used to treat a certain intestinal condition (colitis) that may rarely happen after treatment with antibiotics. This condition causes diarrhea and stomach/abdominal discomfort or pain. When Vancomycin is taken by mouth, it stays in the intestines to stop the growth of bacteria that cause these symptoms.
This antibiotic treats only bacterial infection in the intestines. It will not work for bacterial infections in any other part of the body or for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.
How to use Vancomycin
Take this medication by mouth as directed by your doctor, usually every 6 to 8 hours. The dosage is based on your medical condition and response to treatment. In children, the dosage is also based on weight.
If you are also taking certain bile acid-binding cholesterol medication (such as cholestyramine, colestipol), take it at least 3 to 4 hours after taking Vancomycin. Taking them together will make Vancomycin work less well. Ask your pharmacist if you have questions.
For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same times every day.
Continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.
Tell your doctor if your condition lasts or gets worse.
Vancomycin description
Antibacterial obtained from Streptomyces orientalis. It is a glycopeptide related to ristocetin that inhibits bacterial cell wall assembly and is toxic to kidneys and the inner ear. [PubChem]
Vancomycin dosage
The intent of the pharmacy bulk package for this product is for preparation of solutions for IV infusion only.
Infusion-related events are related to both the concentration and the rate of administration of Vancomycin. Concentrations of no more than 5 mg/mL and rates of no more than 10 mg/min, are recommended in adults. In selected patients in need of fluid restriction, a concentration up to 10 mg/mL may be used; use of such higher concentrations may increase the risk of infusion-related events. An infusion rate of 10 mg/min or less is associated with fewer infusion-related events. Infusion-related events may occur, however, at any rate or concentration.
Patients with Normal Renal Function
Adults
The usual daily intravenous dose is 2 g divided either as 500 mg every six hours or 1 g every 12 hours. Each dose should be administered at no more than 10 mg/min, or over a period of at least 60 minutes, whichever is longer. Other patient factors, such as age or obesity, may call for modification of the usual intravenous daily dose.
Pediatric Patients
The usual intravenous dosage of Vancomycin is 10 mg/kg per dose given every 6 hours. Each dose should be administered over a period of at least 60 minutes. Close monitoring of serum concentrations of Vancomycin may be warranted in these patients.
Neonates
In pediatric patients up to the age of 1 month, the total daily intravenous dosage may be lower. In neonates, an initial dose of 15 mg/kg is suggested, followed by 10 mg/kg every 12 hours for neonates in the 1st week of life and every 8 hours thereafter up to the age of 1 month. Each dose should be administered over 60 minutes. In premature infants, Vancomycin clearance decreases as postconceptional age decreases. Therefore, longer dosing intervals may be necessary in premature infants. Close monitoring of serum concentrations of Vancomycin is recommended in these patients.
Patients with Impaired Renal Function and Elderly Patients
Dosage adjustment must be made in patients with impaired renal function. In premature infants and the elderly, greater dosage reductions than expected may be necessary because of decreased renal function. Measurement of Vancomycin serum concentrations can be helpful in optimizing therapy, especially in seriously ill patients with changing renal function. Vancomycin serum concentrations can be determined by use of microbiologic assay, radioimmunoassay, fluorescence polarization immunoassay, fluorescence immunoassay, or high-pressure liquid chromatography. If creatinine clearance can be measured or estimated accurately, the dosage for most patients with renal impairment can be calculated using the following table. The dosage of Vancomycin Hydrochloride for injection per day in mg is about 15 times the glomerular filtration rate in mL/min.
DOSAGE TABLE FOR Vancomycin PATIENTS WITH IMPAIRED RENAL FUNCTION
(Adapted from Moellering et al. 4)
| Creatinine Clearance mL/min | Vancomycin Dose mg/24 hr |
| 100 90 80 70 60 50 40 30 20 10 | 1,545 1,390 1,235 1,080 925 770 620 465 310 155 |
The initial dose should be no less than 15 mg/kg, even in patients with mild to moderate renal insufficiency. The table is not valid for functionally anephric patients. For such patients, an initial dose of 15 mg/kg of body weight should be given to achieve prompt therapeutic serum concentrations. The dose required to maintain stable concentrations is 1.9 mg/kg/24 hr. In patients with marked renal impairment, it may be more convenient to give maintenance doses of 250 to 1000 mg once every several days rather than administering the drug on a daily basis. In anuria, a dose of 1000 mg every 7 to 10 days has been recommended. When only serum creatinine is known, the following formula (based on sex, weight and age of the patient) may be used to calculate creatinine clearance. Calculated creatinine clearances (mL/min) are only estimates. The creatinine clearance should be measured promptly.
Men: [Weight (kg) x (140 - age in years)]
72 x serum creatinine concentration (mg/dL)
Women: 0.85 x above value
The serum creatinine must represent a steady state of renal function. Otherwise, the estimated value for creatinine clearance is not valid. Such a calculated clearance is an overestimate of actual clearance in patients with conditions: (1) characterized by decreasing renal function, such as shock, severe heart failure, or oliguria; (2) in which a normal relationship between muscle mass and total body weight is not present, such as in obese patients or those with liver disease, edema, or ascites; and (3) accompanied by debilitation, malnutrition, or inactivity. The safety and efficacy of Vancomycin administration by the intrathecal (intralumbar or intraventricular) route have not been established. Intermittent infusion is the recommended method of administration.
COMPATIBILITY WITH OTHER DRUGS AND IV FLUIDS
The following diluents are physically and chemically compatible (with 4g/L Vancomycin Hydrochloride):
5% Dextrose Injection, USP
5% Dextrose Injection and 0.9% Sodium Chloride Injection, USP
Lactated Ringer's Injection, USP
5% Dextrose and Lactated Ringer's Injection
Normosol®-M and 5% Dextrose
0.9% Sodium Chloride Injection, USP
Isolyte® E
Good professional practice suggests that compounded admixtures should be administered as soon after preparation as is feasible.
Vancomycin solution has a low pH and may cause physical instability of other compounds.
Mixtures of solutions of Vancomycin and beta-lactam antibiotics have been shown to be physically incompatible. The likelihood of precipitation increases with higher concentrations of Vancomycin. It is recommended to adequately flush the intravenous lines between the administration of these antibiotics. It is also recommended to dilute solutions of Vancomycin to 5 mg/mL or less.
Although intravitreal injection is not an approved route of administration for Vancomycin, precipitation has been reported after intravitreal injection of Vancomycin and ceftazidime for endophthalmitis using different syringes and needles. The precipitates dissolved gradually, with complete clearing of the vitreous cavity over two months and with improvement of visual acuity.
Vancomycin interactions
See also:
What other drugs will affect Vancomycin?
Aminoglycosides: Vancomycin may enhance the nephrotoxic effect of Aminoglycosides. Monitor therapy
BCG (Intravesical): Antibiotics may diminish the therapeutic effect of BCG (Intravesical). Avoid combination
BCG Vaccine (Immunization): Antibiotics may diminish the therapeutic effect of BCG Vaccine (Immunization). Monitor therapy
Bile Acid Sequestrants: May diminish the therapeutic effect of Vancomycin. Management: Avoid concurrent administration of oral Vancomycin and bile acid sequestrants when possible. If use of both agents is necessary, consider separating doses by at least 2 hours to minimize the significance of the interaction. Consider therapy modification
Cholera Vaccine: Antibiotics may diminish the therapeutic effect of Cholera Vaccine. Management: Avoid cholera vaccine in patients receiving systemic antibiotics, and within 14 days following the use of oral or parenteral antibiotics. Avoid combination
Colistimethate: Vancomycin may enhance the nephrotoxic effect of Colistimethate. Management: Avoid coadministration of colistimethate and Vancomycin whenever possible due to the potential for additive or synergistic nephrotoxicity. If coadministration cannot be avoided, closely monitor renal function. Consider therapy modification
Lactobacillus and Estriol: Antibiotics may diminish the therapeutic effect of Lactobacillus and Estriol. Monitor therapy
Neuromuscular-Blocking Agents: Vancomycin may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. Monitor therapy
Nonsteroidal Anti-Inflammatory Agents: May increase the serum concentration of Vancomycin. Monitor therapy
Piperacillin: May enhance the nephrotoxic effect of Vancomycin. Monitor therapy
Sodium Picosulfate: Antibiotics may diminish the therapeutic effect of Sodium Picosulfate. Management: Consider using an alternative product for bowel cleansing prior to a colonoscopy in patients who have recently used or are concurrently using an antibiotic. Consider therapy modification
Typhoid Vaccine: Antibiotics may diminish the therapeutic effect of Typhoid Vaccine. Only the live attenuated Ty21a strain is affected. Management: Vaccination with live attenuated typhoid vaccine (Ty21a) should be avoided in patients being treated with systemic antibacterial agents. Use of this vaccine should be postponed until at least 3 days after cessation of antibacterial agents. Consider therapy modification
Vancomycin side effects
See also:
What are the possible side effects of Vancomycin?
Infusion-Related Events
During or soon after rapid infusion of Vancomycin Hydrochloride for injection, patients may develop anaphylactoid reactions, including hypotension, wheezing, dyspnea, urticaria, or pruritus. Rapid infusion may also cause flushing of the upper body ("red neck") or pain and muscle spasm of the chest and back. These reactions usually resolve within 20 minutes but may persist for several hours. Such events are infrequent if Vancomycin Hydrochloride for injection is given by a slow infusion over 60 minutes. In studies of normal volunteers, infusion-related events did not occur when Vancomycin Hydrochloride for injection was administered at a rate of 10 mg/min or less.
Nephrotoxicity
Renal failure, principally manifested by increased serum creatinine or BUN concentrations, especially in patients administered large doses of Vancomycin, has been reported. Cases of interstitial nephritis have also been reported rarely. Most of these have occurred in patients who were given aminoglycosides concomitantly or who had preexisting kidney dysfunction. When Vancomycin was discontinued, azotemia resolved in most patients.
Gastrointestinal
Onset of pseudomembranous colitis symptoms may occur during or after antibiotic treatment.
Ototoxicity
A few dozen cases of hearing loss associated with Vancomycin have been reported. Most of these patients had kidney dysfunction or a preexisting hearing loss, or were receiving concomitant treatment with an ototoxic drug. Vertigo, dizziness, and tinnitus have been reported rarely.
Hematopoietic
Reversible neutropenia, usually starting 1 week or more after onset of therapy with Vancomycin or after a total dosage of more than 25 g, has been reported for several dozen patients. Neutropenia appears to be promptly reversible when Vancomycin is discontinued. Thrombocytopenia has rarely been reported. Although a causal relationship has not been established, reversible agranulocytosis (granulocytes <500/mm3) has been reported rarely.
Phlebitis
Inflammation at the injection site has been reported.
Miscellaneous
Infrequently, patients have been reported to have had anaphylaxis, drug fever, nausea, chills, eosinophilia, rashes including exfoliative dermatitis, linear IgA bullous dermatosis, Stevens-Johnson syndrome, toxic epidermal necrolysis, and vasculitis in association with the administration of Vancomycin.
Chemical peritonitis has been reported following intraperitoneal administration.
Vancomycin contraindications
See also:
What is the most important information I should know about Vancomycin?
Vancomycin Hydrochloride Capsules are contraindicated in patients with known hypersensitivity to Vancomycin.
Active ingredient matches for Vancomycin:
Vancomycin
| Unit description / dosage (Manufacturer) | Price, USD |
| Injectable; Injection; Vancomycin Hydrochloride 500 mg | |
| Injectable; Injection; Vancomycin Hydrochloride 1 g | |
| Injectable; Injection; Vancomycin Hydrochloride 5 g | |
| Injectable; Injection; Vancomycin Hydrochloride 10 g | |
| Injectable; Injection; Vancomycin Hydrochloride 125 mg | |
| Injectable; Injection; Vancomycin Hydrochloride 250 mg | |
| Injectable; Injection; Vancomycin Hydrochloride 750 mg | |
| Vancocin HCl 20 250 mg capsule Box | $ 1019.87 |
| Vancomycin hcl powder | $ 85.68 |
| Pms-Vancomycin 1 g/vial | $ 61.98 |
| Vancocin hcl 250 mg pulvule | $ 40.97 |
| Pms-Vancomycin 500 mg/vial | $ 32.62 |
| Vancocin HCl 125 mg capsule | $ 27.66 |
| Vancocin hcl 125 mg pulvule | $ 22.22 |
| Vancomycin 1 gm vial | $ 7.00 |
| Vancomycin hcl 750 mg vial | $ 5.72 |
| Vancomycin 500 mg vial | $ 3.74 |
| Vancomycin-ns 1.5 g/150 ml | $ 0.24 |
| Vancomycin-ns 1.25 g/150 ml | $ 0.21 |
| Vancomycin hcl 1 g/200 ml bag | $ 0.17 |
| Vancomycin 500mg TAB | |
| 500 mg | |
| VANCOMYCIN / HEALTH BIOTECH tab 500 mg x 10's (Health Biotech) | |
List of Vancomycin substitutes (brand and generic names): | |
| Vancomix (Egypt) | |
| Vancomycin - Hisun Pharm (China) | |
| Vancomycin 1% (Japan) | |
| Vancomycin 250mg (Austria) | |
| VANCOMYCIN 500MG INJECTION | |
| Vancomycin 500mg Injection (Astra Zeneca) | $ 3.39 |
| Vancomycin Abbott (Iceland) | |
| Vancomycin Abipharm (Georgia) | |
| Vancomycin Actavis (Estonia) | |
| Vancomycin Alphapharm (Australia) | |
| Vancomycin Alpharma (Denmark, Finland, Iceland, Oman) | |
| Vancomycin Astro (Austria) | |
| Vancomycin Axellia (Austria, Sweden) | |
| Vancomycin Bendalis (Bulgaria) | |
| Vancomycin Bidiphar (Vietnam) | |
| Vancomycin Bidiphar 500 mg x 1 Bottle boät in 1 tube dung mobi 10 mL | |
| Vancomycin Billev (Latvia) | |
| VANCOMYCIN C.P (ASTRA) | |
| VANCOMYCIN C.P 500 MG INJECTION 1 vial / 1 injection each (Astra Zeneca) | $ 3.39 |
| Vancomycin Capsules | |
| Vancomycin CJ (Thailand) | |
| Vancomycin CJ 500 mg x 10's (CJ Corp) | |
| Vancomycin CJ inj 500 mg 10 x 1's (CJ Corp) | |
| Vancomycin CNP (Estonia) | |
| Vancomycin CP (Germany) | |
| Vancomycin DBL (Bangladesh, Turkey) | |
| Vancomycin Deltapharma (Greece) | |
| Vancomycin Dr. Eberth 125mg (Germany) | |
| Vancomycin Dr. Eberth 250mg (Germany) | |
| Vancomycin Eberth (Germany) | |
| Vancomycin Eberth 1g (Germany) | |
| Vancomycin Eberth 500mg (Germany) | |
| Vancomycin Enterocaps (Austria, Germany) | |
| Vancomycin FarmaPlus (Sweden) | |
| Vancomycin Faulding (South Africa) | |
| Vancomycin Finixfarm (Greece) | |
| Vancomycin Fresenius Kabi (Denmark, Norway) | |
| Vancomycin Generics (Greece) | |
| Vancomycin HCL Abbott (Thailand) | |
| Vancomycin HCl CJ (South Korea) | |
| Vancomycin HCl Donga (South Korea) | |
| Vancomycin HCL Hospira (Thailand) | |
| Vancomycin HCl Naprod Life Sciences (Thailand) | |
| Vancomycin HCl Naprod Life Sciences 500 mg x 1's | |
| Vancomycin Hexal (Germany) | |
| Vancomycin Hikma (Austria) | |
See 657 substitutes for Vancomycin | |
References
- PubChem. "VANCOMYCIN". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- DrugBank. "VANCOMYCIN". http://www.drugbank.ca/drugs/DB00512 (accessed September 17, 2018).
- MeSH. "Anti-Bacterial Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
Reviews
The results of a survey conducted on ndrugs.com for Vancomycin are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Vancomycin. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.User reports
Consumer reported useful
No survey data has been collected yetConsumer reported price estimates
No survey data has been collected yetConsumer reported time for results
No survey data has been collected yet2 consumers reported age
| Users | % | ||
|---|---|---|---|
| 16-29 | 1 | 50.0% | |
| > 60 | 1 | 50.0% | |
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Information checked by Dr. Sachin Kumar, MD Pharmacology
