Vancomycin 1000mg Inj

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 transpeptidation (cross-linking) and transglycosylation (elongation) steps, leading to cell wall weakening and bacterial lysis. 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
Rapid infusion of this medication can cause:
+ 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. Many people may not experience any side effects or only minor ones. If you are concerned about any of the following side effects or if they persist, 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, consult 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.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor and pharmacist assess potential interactions between this medication and other substances you are taking.
* Any existing health problems, as this medication may interact with certain conditions or exacerbate underlying health issues.

To ensure your safety, it is crucial to verify that it is safe to take this medication in conjunction with all your other medications and health conditions. 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 or kidney failure, notify your doctor, as this medication can cause kidney issues. Your doctor will likely recommend regular blood work and other laboratory tests 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.

As with many antibiotics, diarrhea is a common side effect. However, in rare cases, a severe form of diarrhea called C. diff-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 guidance.

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

If you are 65 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 starting 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, bumetanide): Increased risk of ototoxicity.
• Amphotericin B: Increased risk of nephrotoxicity.
• Cyclosporine, Tacrolimus: Increased risk of nephrotoxicity.
• Cisplatin: Increased risk of nephrotoxicity and ototoxicity.
• Neuromuscular blocking agents (e.g., succinylcholine, rocuronium): Vancomycin may enhance or prolong the neuromuscular blockade.

• Metformin: Vancomycin may increase metformin levels by inhibiting renal tubular secretion (theoretical, clinical significance unclear).
• Cholestyramine (oral vancomycin): May bind to oral vancomycin, reducing its efficacy for C. difficile infection.
• Radiocontrast agents: Increased risk of acute kidney injury when co-administered with other nephrotoxic agents including vancomycin.

• Signs of nephrotoxicity (decreased urine output, edema, 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, signs of infection)

Vancomycin is classified as Pregnancy Category C. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Limited human data suggest low risk, but animal studies are lacking or show some risk. Therapeutic drug monitoring is crucial.

Vancomycin is excreted into breast milk in small amounts. Due to poor oral absorption by the infant, systemic exposure is expected to be low. However, potential for alteration of infant gut flora, allergic sensitization, or direct effects on the infant (e.g., ototoxicity, nephrotoxicity) exists, though unlikely. Monitor infant for diarrhea, candidiasis, or rash. Use with caution.

Dosing is weight-based and adjusted for age, especially in neonates and infants due to differences in renal function and volume of distribution. Therapeutic drug monitoring (trough levels) is essential to ensure efficacy and minimize toxicity. Neonates and young infants have immature renal function, requiring longer dosing intervals.

Elderly patients are more likely to have age-related decreases in renal function, which can lead to reduced vancomycin clearance and increased risk of toxicity. Dose adjustments based on renal function are frequently necessary. Close monitoring of renal function and vancomycin trough levels is critical.

• Always administer vancomycin IV infusions slowly over at least 60 minutes (or 10 mg/min) to prevent Red Man Syndrome.
• Therapeutic drug monitoring (trough levels) is essential for optimizing efficacy and minimizing toxicity, especially in patients with unstable renal function, severe infections, or those receiving prolonged therapy.
• Hydration is important to minimize the risk of nephrotoxicity.
• Vancomycin is NOT absorbed orally for systemic infections; oral vancomycin is used only for Clostridioides difficile infection.
• Consider continuous infusion vancomycin in critically ill patients to maintain stable drug levels and potentially reduce nephrotoxicity, especially when targeting higher trough levels (15-20 mcg/mL).

• 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)
• Clindamycin (for some Gram-positive infections, but resistance is common)
• Trimethoprim/Sulfamethoxazole (for some MRSA infections)

If your symptoms or health problems persist or worsen, 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 for 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: do not flush them down the toilet or pour them down the drain unless instructed to do so by a healthcare professional or pharmacist. If you are unsure about the correct disposal method, consult your pharmacist, who can also inform you about potential drug take-back programs in your area. Some medications may come with an additional patient information leaflet, which your pharmacist can provide. 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.