Vancomycin 750mg Inj, 1 Vial
WARNING: Some products are not for use during the first and second trimesters of pregnancy. These products contain other things that may cause harm to the unborn baby. If you are pregnant, talk with your doctor. @ COMMON USES: It is used to treat or prevent bacterial infections.If taken by mouth, some products can be used to treat certain types of bowel infections. This includes C diff.
Drug Class
Antibiotic
Pharmacologic Class
Glycopeptide Antibiotic
Pregnancy Category
Category C
FDA Approved
Jun 1958
DEA Schedule
Not Controlled
Overview
What is this medicine?
Vancomycin is an antibiotic used to treat serious bacterial infections, especially those caused by bacteria resistant to other antibiotics, like MRSA. It works by stopping bacteria from building their cell walls. It is given through a vein (IV) slowly to prevent side effects.
How to Use This Medicine
Taking Your Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. This medication is typically administered as an infusion into a vein over a period of time. In some cases, your doctor may prescribe this medication to be taken by mouth or through a feeding tube instead of as an injection.
Storing and Disposing of Your Medication
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist for guidance on proper storage.
Missing a Dose
If you miss a dose, contact your doctor to determine the best course of action.
To use this medication correctly, follow your doctor's instructions and read all the information provided. This medication is typically administered as an infusion into a vein over a period of time. In some cases, your doctor may prescribe this medication to be taken by mouth or through a feeding tube instead of as an injection.
Storing and Disposing of Your Medication
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist for guidance on proper storage.
Missing a Dose
If you miss a dose, contact your doctor to determine the best course of action.
Lifestyle & Tips
- Maintain good hydration to help protect your kidneys.
- Report any changes in hearing or ringing in your ears immediately.
- Report any rash, itching, or flushing during or after the infusion.
Available Forms & Alternatives
Available Strengths:
- Vancomycin 1000mg Inj
- Vancomycin 500mg Vial Forinjection
- Vancomycin 500mg Inj, 1 Vial
- Vancomycin 10gm Inj, 1 Vial
- Vancomycin 5gm Inj, 1 Vial
- Vancomycin 1000mg Inj (ad-Vantage)
- Vancomycin 5gm Inj, 1 Vial
- Vancomycin 750mg Inj, 1 Vial
- Vancomycin 1gm Inj, 1 Vial
- Vancomycin 125mg Capsules
- Vancomycin 250mg Capsules
- Vancomycin 1gm/200m Inj 12x200ml
- Vancomycin 250mg/5ml Oral Solution
- Vancomycin 10gm Inj, 1 Vial
- Vancomycin 1.25gm Inj 1 Vial
- Vancomycin 25mg/ml Oral Soln 300ml
- Vancomycin 25mg/ml Oral Soln 150ml
- Vancomycin 25mg/ml Oral Soln 300ml
- Vancomycin 25mg/ml Oral Soln 150ml
- Vancomycin 50mg/ml Oral Solution
- Vancomycin 1.5mg Inj, 1 Vial
- Vancomycin 1.75gm/350ml Inj, 350ml
- Vancomycin 750mg/150ml Inj, 150ml
- Vancomycin 1.5gm/300ml Inj, 300ml
- Vancomycin 500mg/100ml Inj, 100ml
- Vancomycin 125mg Capsules
- Vancomycin 250mg Capsules
- Vancomycin Hcl 1.75gm Inj, 1 Vial
- Vancomycin Hcl 2gm Sdv Inj, 1 Vial
Dosing & Administration
Adult Dosing
Standard Dose:
15-20 mg/kg IV every 8-12 hours (initial dose, adjusted based on TDM)
Dose Range:
1000 - 4000 mg
Condition-Specific Dosing:
severeInfections:
Target trough 15-20 mcg/mL (e.g., endocarditis, osteomyelitis, hospital-acquired pneumonia)
lessSevereInfections:
Target trough 10-15 mcg/mL
renalFunction:
Dose and interval adjusted based on creatinine clearance
Pediatric Dosing
Neonatal:
10-15 mg/kg IV every 12-24 hours (adjusted based on post-natal age, gestational age, and renal function)
Infant:
15 mg/kg IV every 6 hours or 10-15 mg/kg IV every 8-12 hours (adjusted based on renal function and TDM)
Child:
15 mg/kg IV every 6 hours or 10-15 mg/kg IV every 8-12 hours (adjusted based on renal function and TDM)
Adolescent:
15-20 mg/kg IV every 8-12 hours (adjusted based on renal function and TDM)
Dose Adjustments
Renal Impairment:
Mild:
CrCl 50-79 mL/min: Consider extending interval or reducing dose. Monitor levels closely.
Moderate:
CrCl 30-49 mL/min: Reduce dose (e.g., 15 mg/kg every 24-48 hours) or extend interval. Monitor levels.
Severe:
CrCl <30 mL/min: Significantly reduce dose (e.g., 15 mg/kg every 48-96 hours or less frequent) or administer loading dose then maintenance based on levels. Monitor levels.
Dialysis:
Hemodialysis: Administer 15 mg/kg loading dose, then maintenance doses (e.g., 500-1000 mg) after each dialysis session or based on trough levels. Peritoneal Dialysis: 15-30 mg/kg IV single dose, then 15 mg/kg IV weekly or 20 mg/L in each bag of dialysate. Monitor levels.
Hepatic Impairment:
Mild:
No specific dose adjustment required, as vancomycin is minimally metabolized by the liver.
Moderate:
No specific dose adjustment required.
Severe:
No specific dose adjustment required.
Pharmacology
Mechanism of Action
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, leading to inhibition of cell wall formation and increased bacterial cell membrane permeability and RNA synthesis.
Pharmacokinetics
Absorption:
Bioavailability:
100% (IV)
Tmax:
Not applicable (IV infusion)
FoodEffect:
Not applicable (IV infusion)
Distribution:
Vd:
0.4-1 L/kg
ProteinBinding:
10-50%
CnssPenetration:
Limited (in non-inflamed meninges); increased with meningeal inflammation
Elimination:
HalfLife:
4-6 hours (normal renal function); significantly prolonged in renal impairment
Clearance:
Primarily renal clearance (glomerular filtration)
ExcretionRoute:
Renal (urine)
Unchanged:
>80-90%
Pharmacodynamics
OnsetOfAction:
Rapid (within minutes of IV infusion)
PeakEffect:
End of infusion
DurationOfAction:
Dependent on renal function and dosing interval; typically maintains therapeutic levels for 6-12 hours with appropriate dosing
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Immediately
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 right away:
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
Additional Side Effects to Watch for When Receiving This Medication by Injection:
Fever
Chills
Sore throat
Pain when passing urine
Change in balance
Flushing
Rash on the face, neck, trunk, and arms during infusion
Potential Complications of Rapid Infusion:
Shortness of breath or wheezing
Itching
Muscle pain
Chest pain
Signs of low blood pressure, such as dizziness or fainting
If you experience any of these symptoms, inform your doctor immediately.
Tissue Damage Warning:
If the medication leaks from the vein, it can cause tissue damage. Notify your nurse if you experience:
Redness
Burning
Pain
Swelling
Blisters
Skin sores
Leaking of fluid at the injection site
Other Possible Side Effects:
Most people do not experience significant side effects, but some may occur. If you are bothered by 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 potential 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.
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 right away:
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
Additional Side Effects to Watch for When Receiving This Medication by Injection:
Fever
Chills
Sore throat
Pain when passing urine
Change in balance
Flushing
Rash on the face, neck, trunk, and arms during infusion
Potential Complications of Rapid Infusion:
Shortness of breath or wheezing
Itching
Muscle pain
Chest pain
Signs of low blood pressure, such as dizziness or fainting
If you experience any of these symptoms, inform your doctor immediately.
Tissue Damage Warning:
If the medication leaks from the vein, it can cause tissue damage. Notify your nurse if you experience:
Redness
Burning
Pain
Swelling
Blisters
Skin sores
Leaking of fluid at the injection site
Other Possible Side Effects:
Most people do not experience significant side effects, but some may occur. If you are bothered by 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 potential 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.
Seek Immediate Medical Attention If You Experience:
- Severe rash, hives, or itching
- Swelling of the face, lips, tongue, or throat
- Difficulty breathing or swallowing
- Dizziness or lightheadedness
- Ringing in the ears (tinnitus)
- Hearing loss
- Decreased urination
- Unusual tiredness or weakness
- Pain, redness, or swelling at the injection site
Before Using This Medicine
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 assess 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 crucial to verify that this medication can be taken with all your current medications and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor. By sharing this information, you can help your doctor make informed decisions about your treatment and minimize potential risks.
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 assess 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 crucial to verify that this medication can be taken with all your current medications and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor. By sharing this information, you can help your doctor make informed decisions about your treatment and minimize potential risks.
Precautions & Cautions
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 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 may be severe in rare cases, leading to a potentially life-threatening bowel condition known as C. diff-associated diarrhea (CDAD). 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 intended 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. If you are of childbearing age, your doctor may require a pregnancy test before initiating treatment to confirm that you are not pregnant.
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 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 may be severe in rare cases, leading to a potentially life-threatening bowel condition known as C. diff-associated diarrhea (CDAD). 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 intended 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. If you are of childbearing age, your doctor may require a pregnancy test before initiating treatment to confirm that you are not pregnant.
Overdose Information
Overdose Symptoms:
- Severe nephrotoxicity (acute kidney injury)
- Ototoxicity (hearing loss, tinnitus, vertigo)
- Profound hypotension
- Red Man Syndrome (severe flushing, rash, shock)
What to Do:
Call 911 or Poison Control (1-800-222-1222). Treatment is supportive, including maintaining hydration, monitoring renal function, and potentially hemodialysis to remove vancomycin from the blood in severe cases.
Drug Interactions
Major Interactions
- 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.
- Neuromuscular blocking agents (e.g., succinylcholine, rocuronium): May potentiate or prolong neuromuscular blockade.
Moderate Interactions
- Metformin: Vancomycin may increase metformin concentrations by inhibiting OCT1/2 transporters, though clinical significance is often low.
- Cholestyramine: May bind to oral vancomycin, reducing its efficacy for C. difficile infection (not relevant for IV vancomycin).
Monitoring
Baseline Monitoring
Renal function (SCr, BUN)
Rationale: Vancomycin is primarily renally eliminated; renal impairment necessitates dose adjustment and increases risk of nephrotoxicity.
Timing: Prior to initiation of therapy
Weight
Rationale: Dosing is weight-based.
Timing: Prior to initiation of therapy
Hearing assessment (audiometry)
Rationale: Baseline assessment for patients at high risk of ototoxicity (e.g., pre-existing hearing loss, concomitant ototoxic drugs, prolonged therapy).
Timing: Prior to initiation for high-risk patients
Routine Monitoring
Vancomycin trough levels
Frequency: Before the 4th or 5th dose (at steady state), then at least weekly, or more frequently with dose changes, renal function changes, or clinical deterioration.
Target: 10-20 mcg/mL (15-20 mcg/mL for serious infections like endocarditis, osteomyelitis, meningitis, HAP/VAP)
Action Threshold: Levels outside target range necessitate dose adjustment; levels >20 mcg/mL increase risk of toxicity.
Renal function (SCr, BUN)
Frequency: At least 2-3 times per week, or daily in critically ill patients or those with unstable renal function.
Target: Stable baseline values
Action Threshold: Increase in SCr by âĨ0.5 mg/dL or âĨ50% from baseline (whichever is smaller) suggests acute kidney injury and requires dose adjustment or discontinuation.
Complete Blood Count (CBC)
Frequency: Weekly or as clinically indicated.
Target: Normal ranges
Action Threshold: Significant leukopenia or neutropenia may occur rarely.
Symptom Monitoring
- Red Man Syndrome (flushing, rash, pruritus, urticaria, tachycardia, hypotension) during or shortly after infusion
- Signs of nephrotoxicity (decreased urine output, edema)
- Signs of ototoxicity (tinnitus, hearing loss, vertigo)
- Infusion site reactions (pain, phlebitis, thrombophlebitis)
- Hypersensitivity reactions (rash, fever, anaphylaxis)
Special Patient Groups
Pregnancy
Category C. Use only if clearly needed. Limited human data suggest no increased risk of major birth defects, but potential for ototoxicity and nephrotoxicity in the fetus/neonate cannot be ruled out, especially with high maternal concentrations. Therapeutic drug monitoring is crucial.
Trimester-Specific Risks:
First Trimester:
Limited data, but generally considered low risk for major malformations.
Second Trimester:
Potential for fetal ototoxicity/nephrotoxicity, especially with prolonged exposure or high maternal levels.
Third Trimester:
Potential for fetal ototoxicity/nephrotoxicity, especially with prolonged exposure or high maternal levels; monitoring of neonatal renal function and hearing may be warranted.
Lactation
L3 (Moderately Safe). Vancomycin is excreted into breast milk in small amounts. Oral absorption by the infant is poor, so systemic effects are unlikely. Monitor infant for changes in gut flora (diarrhea, candidiasis) or allergic reactions. Consider alternative if infant is premature or has impaired renal function.
Infant Risk:
Low systemic risk due to poor oral absorption; potential for gut flora disruption or allergic sensitization.
Pediatric Use
Dosing is weight-based and highly individualized, requiring careful therapeutic drug monitoring (TDM) due to variable pharmacokinetics in different age groups (especially neonates and infants). Renal function must be closely monitored.
Geriatric Use
Increased risk of renal impairment, which necessitates dose adjustment and careful monitoring of renal function and vancomycin levels. Increased susceptibility to ototoxicity and nephrotoxicity. Start with lower doses and titrate based on TDM and renal function.
Clinical Information
Clinical Pearls
- Always administer vancomycin IV infusions slowly (over at least 60 minutes for doses up to 1g, or 90-120 minutes for doses >1g) to prevent Red Man Syndrome.
- Therapeutic drug monitoring (TDM) of trough levels is essential for optimizing efficacy and minimizing toxicity, especially for serious infections and in patients with unstable renal function.
- Hydration is important to reduce the risk of nephrotoxicity.
- Avoid concomitant use with other nephrotoxic or ototoxic drugs whenever possible, or monitor closely if co-administration is necessary.
- Vancomycin is ineffective for Gram-negative bacteria and atypical pathogens.
Alternative Therapies
- Linezolid (for MRSA, VRE)
- Daptomycin (for MRSA, VRE)
- Ceftaroline (for MRSA)
- Teicoplanin (glycopeptide, not widely available in US)
- Tigecycline (for MRSA, VRE, broad spectrum)
Cost & Coverage
Average Cost:
Varies widely by manufacturer and quantity (e.g., $10-$50 per 750mg vial) per 750mg vial
Generic Available:
Yes
Insurance Coverage:
Tier 1 or Tier 2 (Generic)
General Drug Facts
If your symptoms or health problems persist or worsen, it is essential to contact your doctor promptly. 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. Unless instructed to do so by a healthcare professional, do not flush medications down the toilet or drain. 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 occurred.