Vancomycin 1gm Inj, 1 Vial

Vancomycin is a tricyclic glycopeptide antibiotic that inhibits bacterial cell wall synthesis. It binds with high affinity to the D-Ala-D-Ala terminus of peptidoglycan precursors, preventing the transglycosylation and transpeptidation steps necessary for cell wall elongation and cross-linking. This leads to increased cell wall permeability and inhibition of RNA synthesis, ultimately resulting in bacterial cell 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, any of 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 identify potential interactions between this medication and other substances.
* Any existing health problems, as this medication may interact with certain conditions.

To ensure your safety, it is crucial to verify that this medication can be taken safely 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, 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 also recommend periodic hearing tests during treatment.

To minimize the risk of a secondary 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 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 with your doctor.

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): Increased risk of ototoxicity.
• Other nephrotoxic drugs (e.g., amphotericin B, cyclosporine, tacrolimus, NSAIDs, cisplatin): Increased risk of nephrotoxicity.
• Neuromuscular blocking agents (e.g., succinylcholine, rocuronium): May prolong neuromuscular blockade.

• Metformin: Vancomycin may increase metformin concentrations by inhibiting OCT1/2 transporters, though clinical significance is often low.
• Cholestyramine/Colestipol (oral vancomycin): May bind to oral vancomycin, reducing its efficacy for C. difficile infection.

• Signs of nephrotoxicity (decreased urine output, edema, fatigue, elevated BUN/Cr)
• Signs of ototoxicity (tinnitus, hearing loss, vertigo)
• Signs of Red Man Syndrome (flushing, rash, pruritus, urticaria, hypotension, tachycardia, muscle spasms, dyspnea, chest pain, angioedema - typically during or shortly after infusion)
• Hypersensitivity reactions (rash, fever, chills)
• Gastrointestinal upset (nausea, vomiting, diarrhea)
• Injection site reactions (pain, phlebitis)

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 data suggest no increased risk of major birth defects, but animal studies have shown some adverse effects. Close monitoring of maternal vancomycin levels and fetal auditory function may be considered.

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 risks to the infant include alteration of bowel flora, diarrhea, and interference with interpretation of cultures if fever workup is needed. Use with caution; monitor the infant for gastrointestinal upset (e.g., diarrhea, thrush) or rash.

Dosing is weight-based and requires careful calculation and monitoring, especially in neonates and infants due to immature renal function. Therapeutic drug monitoring (trough levels) is essential to ensure efficacy and minimize toxicity. Renal function should be closely monitored.

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

• Infuse vancomycin slowly over at least 60 minutes (or at a rate not exceeding 10 mg/min) to prevent Red Man Syndrome.
• Therapeutic drug monitoring (trough levels) is crucial for optimizing efficacy and minimizing toxicity, especially in patients with changing renal function, severe infections, or prolonged therapy.
• Hydration is important to help prevent nephrotoxicity.
• Vancomycin is not effective against Gram-negative bacteria or atypical organisms.
• Oral vancomycin is used ONLY for Clostridioides difficile infection (CDI) due to its poor systemic absorption; IV vancomycin is NOT effective for CDI.

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

If your symptoms or health problems do not improve or worsen over time, it is essential to contact your doctor for further evaluation and guidance.

To ensure safe use, do not share your medication with others, and never take someone else's medication. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion.

Proper disposal of unused or expired medications is crucial. Do not flush medications down the toilet or pour them down the drain unless specifically instructed to do so. If you are unsure about the correct disposal method, consult your pharmacist for guidance. Many communities have 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, do not hesitate to discuss them 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 critical information, including the name of the medication, the amount taken, and the time it was taken, to ensure prompt and effective treatment.