Generic Name: Vancomycin Brand Name(s): Generics only. No brands available.

Know the basics

What is vancomycin used for?

Vancomycin is an antibiotic used to treat serious bacterial infections. It works by stopping the growth of bacteria.

This medication is usually injected into a vein. However, this product comes in vials which may also be given by mouth to treat a severe intestinal condition known as Clostridium difficile-associated diarrhea. This condition can rarely occur after the use of antibiotics has allowed the growth of a certain kind of resistant bacteria in the intestines, leading to severe diarrhea. When vancomycin is given by mouth, it is not absorbed by the body but remains in the intestines, allowing it to stop the growth of the bacteria. (See also How to Use section.)

How should I take vancomycin?

This medication is usually given by injection into a vein, usually 1 or 2 times a day or as directed by your doctor. It should be injected slowly over 1 to 2 hours. The dosage is based on your medical condition, weight, kidney function, and response to treatment. (See also Side Effects.)

If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.

When taking this medication by mouth, mix each dose into at least 1 ounce (30 milliliters) of water before swallowing all of the mixture.

Antibiotics work best when the amount of medicine in your body is kept at a constant level. Therefore, use this drug at evenly spaced intervals.

Continue to use this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may allow bacteria to continue to grow, which may result in a return of the infection.

How do I store vancomycin?

Store at or below -20°C (-4°F). Do not store in the bathroom. Different brands of this medication may have different storage needs. Check the product package for instructions on how to store your brand, or ask your pharmacist. Keep all medicines away from children and pets.

You should not flush vancomycin down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using vancomycin?

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of vancomycin in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of vancomycin in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution or an adjustment in the dose for patients receiving vancomycin.

Is it safe to take vancomycin during pregnancy or breast-feeding?

There isn’t enough information about the safety of using this medication during pregnancy and breast-feeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this medication.

Know the side effects

What are the side effects of vancomycin?

If this medication is injected too fast, a condition known as “red man syndrome” may occur. Tell your doctor promptly if you have symptoms such as flushing of the upper body, dizziness, low blood pressure, or muscle pain/spasms of the chest and back.

Pain, redness, and tenderness at the injection site may occur. These effects may be reduced by injecting this medication more slowly. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: ringing in the ears, hearing problems, change in the amount of urine, easy bleeding/bruising, fever, persistent sore throat, persistent diarrhea.

Use of this medication for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with vancomycin?

Vancomycin may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Amikacin
  • Gentamicin
  • Tobramycin

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Succinylcholine
  • Warfarin

Does food or alcohol interact with vancomycin?

Vancomycin may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with vancomycin?

Vancomycin may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • Hearing problems—Use with caution. May make this condition worse.
  • Kidney disease, severe or
  • Other inflammatory bowel disorders—May increase risk for more serious side effects.

Understand the dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this medication.

What is the dose of vancomycin for an adult?

Usual Adult Dose for Bacterial Infection

15 to 20 mg/kg IV every 8 to 12 hours (2 to 3 g/day); a loading dose of 25 to 30 mg/kg can be considered for seriously ill patients

The manufacturer recommends 500 mg IV every 6 hours or 1 g IV every 12 hours.

Usual Adult Dose for Bacteremia

15 to 20 mg/kg IV every 8 to 12 hours

Duration: 2 to 6 weeks, depending on the nature and severity of the infection

Usual Adult Dose for Bacterial Endocarditis Prophylaxis

For patients allergic to penicillin: 1 g IV once; infusion should be completed within 30 minutes of the start of the procedure

Gentamicin may be added for high-risk patients.

Usual Adult Dose for Endocarditis

Alternate drug for patients who are unable to tolerate penicillin or ceftriaxone, and for oxacillin-resistant staphylococcal strains: 15 to 20 mg/kg IV every 8 to 12 hours with or without other antibiotics depending on the nature of the infection

Duration:

Native valve: 6 weeks

Prosthetic valve: at least 6 weeks

Maximum dose: 2 g/day unless serum concentrations are low (recommended trough: 15 to 20 mcg/mL)

Refer to current published guidelines for detailed recommendations.

Usual Adult Dose for Pseudomembranous Colitis

Clostridium difficile associated diarrhea: 125 mg orally 4 times a day for 10 days

Staphylococcal enterocolitis: 500 to 2000 mg/day given orally in 3 or 4 divided doses for 7 to 10 days

Usual Adult Dose for Enterocolitis

Clostridium difficile associated diarrhea: 125 mg orally 4 times a day for 10 days

Staphylococcal enterocolitis: 500 to 2000 mg/day given orally in 3 or 4 divided doses for 7 to 10 days

Usual Adult Dose for Meningitis

IV: 15 to 20 mg/kg IV every 8 to 12 hours

Duration: 10 to 14 days or at least 1 week after the patient becomes afebrile and cerebrospinal fluid normalizes

Intraventricular, intrathecal: 5 to 20 mg of a preservative-free formulation have been administered up to every 24 hours

Usual Adult Dose for Nosocomial Pneumonia

Hospital-acquired: 15 to 20 mg/kg IV every 8 to 12 hours

Recommended trough levels: 15 to 20 mcg/mL

Initial empiic treatment with broad-spectrum coverage according to the hospital’s and/or ICU’s antibiogram is recommended if multidrug-resistant organisms are suspected.

Duration: The duration of treatment should be as short as clinically possible (e.g., as little as 7 days) to reduce the risk of superinfections with resistant organisms.

Usual Adult Dose for Pneumonia

Due to methicillin-resistant Staphylococcus aureus (MRSA): 15 to 20 mg/kg IV every 8 to 12 hours

Duration: 7 to 21 days, depending on the nature and severity of the infection

Usual Adult Dose for Osteomyelitis

15 to 20 mg/kg IV every 8 to 12 hours

Duration: 3 to 6 weeks or at least 8 weeks if due to MRSA; oral antibiotics may be required for chronic osteomyelitis for an additional 1 to 2 months

Usual Adult Dose for Febrile Neutropenia

15 mg/kg IV every 12 hours

Duration: Once the patient is stable, afebrile for at least 24 hours, and the absolute neutrophil count is greater than 500/mm3, oral antibiotics may be substituted if antibiotic therapy is to be continued.

What is the dose of vancomycin for a child?

Usual Pediatric Dose for Bacterial Infection

Less than 7 days, less than 1200 g: 15 mg/kg IV every 24 hours

Less than 7 days, 1200 to 2000 g: 10 to 15 mg/kg IV every 12 to 18 hours

Less than 7 days, greater than 2000 g: 10 to 15 mg/kg IV every 8 to 12 hours

7 days up to 1 month, less than 1200 g: 15 mg/kg IV every 24 hours

7 days up to 1 month, 1200 to 2000 g: 10 to 15 mg/kg IV every 8 to 12 hours

7 days up to 1 month, greater than 2000 g: 10 to 15 mg/kg IV every 6 to 8 hours

1 month to 18 years: 10 to 20 mg/kg IV every 6 to 8 hours (total 40 to 60 mg/kg/day)

The manufacturer recommends an initial dose of 15 mg/kg in neonates, followed by 10 mg/kg every 12 hours for neonates in the first week of life and every 8 hours thereafter up to 1 month of age. The manufacturer recommends 10 mg/kg IV every 6 hours for pediatric patients.

Usual Pediatric Dose for Bacterial Endocarditis Prophylaxis

1 month or older:

For patients allergic to penicillin: 20 mg/kg IV (maximum 1 g) once; infusion should be completed within 30 minutes of the start of the procedure

Gentamicin 1.5 mg/kg (maximum 120 mg) IV or IM may be added for high-risk patients.

Usual Pediatric Dose for Peritonitis

CAPD patients: 30 mg/kg intraperitoneally every 5 to 7 days or 30 mg/L exchange

Usual Pediatric Dose for Pseudomembranous Colitis

1 to 18 years: 40 mg/kg/day orally in 3 or 4 divided doses

Maximum dose: 2 g/day

Duration: 7 to 10 days

Usual Pediatric Dose for Enterocolitis

1 to 18 years: 40 mg/kg/day orally in 3 or 4 divided doses

Maximum dose: 2 g/day

Duration: 7 to 10 days

Usual Pediatric Dose for Surgical Prophylaxis

15 mg/kg IV once, with or without gentamicin; infusion should be completed within 30 minutes of the start of the procedure

How is vancomycin available?

Vancomycin is available in the following dosage forms and strengths:

Solution 500 mg/100 mL; 750 mg/150 mL; 1 g/200 mL

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of vancomycin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: January 4, 2017 | Last Modified: January 4, 2017

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