Vancomycin 1.75gm/350ml Inj, 350ml

Vancomycin is a tricyclic glycopeptide antibiotic that inhibits bacterial cell wall synthesis by binding with high affinity to the D-Ala-D-Ala terminus of peptidoglycan precursors. This binding prevents the transglycosylation and transpeptidation steps necessary for peptidoglycan elongation and cross-linking, leading to cell lysis and bacterial death. It also alters bacterial cell membrane permeability and RNA synthesis.

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 injection (intravenous):
+ Fever
+ Chills
+ Sore throat
+ Pain when passing urine
+ Change 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. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects, contact your doctor or seek medical attention if they bother you or persist:

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 symptoms you experienced as a result of the allergy.
Potential interactions with other medications or health conditions. This medication may affect or be affected by other drugs or health problems, so it is crucial to disclose all relevant information.

To ensure safe use, provide your doctor and pharmacist with a comprehensive list of:

All prescription and over-the-counter (OTC) medications you are taking
Natural products and vitamins you are using
* Any existing health problems

Carefully review your medications and health conditions to confirm that it is safe to take this medication in conjunction with them. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.

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 symptoms of hearing loss to your doctor. Your doctor may recommend regular hearing tests during treatment.

To minimize the risk of a secondary 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 eye problems, including permanent vision loss, when administered via this route.

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: Increased risk of nephrotoxicity.
• Tacrolimus: Increased risk of nephrotoxicity.
• Polymyxins (e.g., colistin): Increased risk of nephrotoxicity.

• Neuromuscular blockers (e.g., succinylcholine, rocuronium): Vancomycin may enhance or prolong the neuromuscular blockade.
• Metformin: Vancomycin may increase metformin concentrations (theoretical, due to shared renal transporters).
• Radiocontrast agents: Increased risk of nephrotoxicity when used concurrently or sequentially with vancomycin.

• Not available

• Red Man Syndrome (flushing, rash, pruritus, urticaria, tachycardia, hypotension, muscle spasms, dyspnea, chest pain, angioedema) - typically during or shortly after infusion
• Ototoxicity (hearing loss, tinnitus, vertigo)
• Nephrotoxicity (decreased urine output, swelling, fatigue, nausea, confusion)
• Hypersensitivity reactions (rash, fever, chills, anaphylaxis)
• Neutropenia (fever, signs of infection)
• Thrombocytopenia (unusual bleeding or bruising)
• Phlebitis/irritation at injection site

Vancomycin is generally considered for use in pregnancy only when clearly needed and the benefits outweigh the potential risks. It crosses the placenta. Category C.

Vancomycin is excreted into breast milk in small amounts. While systemic absorption by the infant is low, potential risks include alteration of bowel flora, direct effects on the infant (e.g., allergic sensitization), and interference with culture results if the infant develops a fever. Use with caution; monitor infant for adverse effects. L3 (Moderate risk).

Dosing is weight-based and often requires therapeutic drug monitoring (trough levels) due to variable pharmacokinetics, especially in neonates and infants. Renal function must be closely monitored. Higher clearance rates in children may necessitate more frequent dosing.

Elderly patients are more likely to have age-related decreases in renal function, which necessitates careful dose adjustment and frequent monitoring of vancomycin trough levels and renal function. They may also be more susceptible to ototoxicity and nephrotoxicity.

• Always administer vancomycin IV infusions slowly over at least 60 minutes (or longer for doses >1g) to minimize the risk of Red Man Syndrome.
• Therapeutic drug monitoring (trough levels) is essential for optimizing efficacy and minimizing toxicity, especially for serious infections and in patients with unstable renal function.
• Maintain adequate hydration to reduce the risk of nephrotoxicity.
• Consider a central venous catheter for prolonged therapy or high concentrations to prevent phlebitis.
• Vancomycin is NOT absorbed orally for systemic infections; oral vancomycin is used only for Clostridioides difficile infection.
• The 15-20 mcg/mL trough target is for serious infections (e.g., MRSA bacteremia, endocarditis, meningitis, osteomyelitis, HAP/VAP); for less severe infections, 10-15 mcg/mL may be appropriate.
• Be vigilant for signs of nephrotoxicity (rising SCr) and ototoxicity (hearing changes, tinnitus).

• Linezolid (for MRSA, VRE)
• Daptomycin (for MRSA, VRE)
• Ceftaroline (for MRSA)
• Tedizolid (for MRSA)
• Dalbavancin (for MRSA)
• Oritavancin (for MRSA)
• Quinupristin/Dalfopristin (for VRE, MRSA)
• Tigecycline (for MRSA, VRE, broad spectrum)

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, and do not take medication prescribed to someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly. Unless instructed otherwise, do not flush medications down the toilet or drain. If you are unsure about the proper disposal method, consult your pharmacist for guidance. Many communities offer drug take-back programs, which your pharmacist can help you locate. Some medications may come with an additional patient information leaflet; check with your pharmacist to see if this applies to your prescription. If you have any questions or concerns about your medication, discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact 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 was taken to ensure prompt and effective treatment.