Vancomycin 1.5mg Inj, 1 Vial

Vancomycin is a tricyclic glycopeptide antibiotic that inhibits bacterial cell wall synthesis by binding to the D-Ala-D-Ala terminus of the peptidoglycan precursor. This binding prevents the transpeptidation (cross-linking) and transglycosylation (elongation) steps, leading to cell lysis and bacterial death. It is bactericidal against susceptible Gram-positive organisms.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek medical attention immediately:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of kidney problems, including:
+ Inability to pass urine
+ Changes in urine output
+ Blood in the urine
+ Sudden weight gain
Severe skin reactions, such as:
+ Stevens-Johnson syndrome (SJS)
+ Toxic epidermal necrolysis (TEN)
+ Other serious reactions that can affect body organs and be life-threatening
+ Symptoms may include:
- Red, swollen, blistered, or peeling skin
- Red or irritated eyes
- Sores in the mouth, throat, nose, eyes, genitals, or skin
- Fever
- Chills
- Body aches
- Shortness of breath
- Swollen glands
If you receive this medication through a vein (intravenous injection):
+ Fever
+ Chills
+ Sore throat
+ Pain when passing urine
+ Changes in balance
+ Flushing
+ Rash on the face, neck, trunk, and arms during infusion
If the medication is administered too quickly, you may experience:
+ Shortness of breath or wheezing
+ Itching
+ Muscle pain
+ Chest pain
+ Signs of low blood pressure, such as dizziness or fainting
If the medication leaks from the vein, it can cause tissue damage. Inform your nurse immediately if you experience:
+ Redness
+ Burning
+ Pain
+ Swelling
+ Blisters
+ Skin sores
+ Leaking of fluid at the injection site

Other Possible Side Effects

Like all medications, this drug can cause side effects, although not everyone will experience them. If you have any of the following side effects or any other concerns, contact your doctor:

Diarrhea
Stomach pain
Upset stomach
Vomiting

This is not an exhaustive list of possible side effects. If you have questions or concerns, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is crucial to avoid potential interactions between this medication and other substances.
Any existing health problems, as they may affect the safety and efficacy of this medication.

To ensure your safety, it is vital to:

Discuss all your medications and health problems with your doctor and pharmacist to verify that it is safe to take this medication in conjunction with your other treatments.
* Avoid starting, stopping, or changing the dosage of any medication without first consulting your doctor. This will help prevent potential interactions or adverse effects.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

If you have a history of kidney problems, such as kidney failure, notify your doctor, as this medication can cause kidney issues. Your doctor will likely recommend regular blood tests and other laboratory evaluations to monitor your condition.

Long-term use of this medication may increase the risk of permanent hearing loss. Do not exceed the prescribed duration of treatment, and immediately report any changes in your hearing or hearing loss to your doctor. Your doctor may also recommend regular hearing tests during treatment.

To minimize the risk of a second infection, do not use this medication for longer than prescribed.

Antibiotics, including this medication, can cause diarrhea, which is usually mild. However, in rare cases, a severe form of diarrhea called Clostridioides difficile-associated diarrhea (CDAD) can occur, potentially leading to life-threatening bowel problems. CDAD may develop during or after treatment, sometimes several months later. If you experience stomach pain, cramps, or loose, watery, or bloody stools, contact your doctor promptly. Before treating diarrhea, consult your doctor for advice.

This medication is not approved for injection into the eye, as it can cause severe eye problems, including permanent vision loss.

If you are 65 years or older, use this medication with caution, as you may be more susceptible to side effects.

If you are pregnant, plan to become pregnant, or are breastfeeding, discuss the potential benefits and risks with your doctor. For women of childbearing age, your doctor may require a pregnancy test before initiating treatment to confirm that you are not pregnant.

• Aminoglycosides (e.g., gentamicin, tobramycin, amikacin): Increased risk of nephrotoxicity and ototoxicity.
• Loop diuretics (e.g., furosemide): May increase risk of ototoxicity.
• Cisplatin: Increased risk of nephrotoxicity and ototoxicity.
• Cyclosporine, Tacrolimus: Increased risk of nephrotoxicity.
• Neuromuscular blocking agents (e.g., succinylcholine, rocuronium): May prolong neuromuscular blockade.

• Metformin: Vancomycin may increase metformin plasma concentrations by inhibiting OCT1/2, potentially increasing risk of lactic acidosis (rare, theoretical).
• Cholestyramine, Colestipol (oral vancomycin): May bind to oral vancomycin, reducing its efficacy for C. difficile. Administer vancomycin several hours before or after.
• Other nephrotoxic or ototoxic drugs: Concurrent use should be carefully monitored.

• Signs of nephrotoxicity (decreased urine output, swelling, fatigue)
• Signs of ototoxicity (tinnitus, hearing loss, vertigo)
• Signs of Red Man Syndrome (flushing, rash, pruritus, hypotension, tachycardia during or shortly after infusion)
• Signs of hypersensitivity reactions (rash, fever, chills)
• Signs of neutropenia (fever, sore throat, signs of infection)
• Signs of thrombocytopenia (unusual bleeding or bruising)

Vancomycin is generally considered for use in pregnancy only if clearly needed, as animal studies have shown some evidence of fetal harm (ototoxicity) at high doses, and human data are limited. However, it is often used for serious Gram-positive infections where benefits outweigh risks. Therapeutic drug monitoring is crucial.

Vancomycin is excreted into breast milk in small amounts. Oral absorption by the infant is poor, so systemic effects on the infant are unlikely. However, potential for alteration of infant gut flora or allergic sensitization exists. Use with caution, monitor infant for diarrhea or rash. L3 (Moderately Safe).

Dosing is weight-based and often requires more frequent administration than adults due to faster clearance. Therapeutic drug monitoring (trough levels) is essential to ensure efficacy and minimize toxicity, especially in neonates and infants due to variable pharmacokinetics and immature renal function. Risk of nephrotoxicity and ototoxicity is present.

Elderly patients are more likely to have age-related decline in renal function, which necessitates careful dose adjustment and close monitoring of vancomycin levels and renal function. They may also be more susceptible to ototoxicity and nephrotoxicity. Lower initial doses and extended dosing intervals are often appropriate.

• Vancomycin 1.5mg Inj is an unusual dose; typical IV doses are in the range of hundreds of milligrams to grams (e.g., 500mg, 1g, 1.5g). This specific dose might be a typo or for a highly specialized, non-systemic use (e.g., ophthalmic, intrathecal, or research). Standard information provided assumes typical systemic IV use.
• Infuse IV vancomycin slowly over at least 60 minutes (or 10 mg/min) to prevent Red Man Syndrome, an infusion-related reaction.
• Therapeutic drug monitoring (TDM) with trough levels is critical for optimizing efficacy and minimizing toxicity, especially nephrotoxicity.
• Vancomycin is the drug of choice for methicillin-resistant Staphylococcus aureus (MRSA) infections.
• Oral vancomycin is NOT absorbed systemically and is used exclusively for Clostridioides difficile infection (CDI). IV vancomycin is ineffective for CDI.
• Concurrent use with other nephrotoxic or ototoxic agents should be avoided or closely monitored.
• Consider continuous infusion vancomycin in critically ill patients or those with unstable renal function to maintain more stable drug levels and potentially reduce toxicity.

• Linezolid (for MRSA, VRE)
• Daptomycin (for MRSA, VRE)
• Ceftaroline (for MRSA)
• Tedizolid (for MRSA)
• Dalbavancin (for MRSA)
• Oritavancin (for MRSA)
• Fidaxomicin (for C. difficile, oral)
• Metronidazole (for C. difficile, oral/IV)

If your symptoms or health problems do not improve or worsen over time, it is essential to contact your doctor for further guidance. To ensure safe use, never share your medication with others or take someone else's medication. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Properly dispose of unused or expired medications by checking with your pharmacist for the recommended disposal method. Unless instructed to do so, avoid flushing medications down the toilet or pouring them down the drain, as this can harm the environment. Many communities offer drug take-back programs, which your pharmacist can help you locate. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, consult with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. Be prepared to provide information about the medication taken, the amount, and the time it occurred to ensure prompt and effective treatment.