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vancomycin

Generic Name: vancomycin (van koe MYE sin)
Brand names: Lyphocin, Vancocin HCl, Vancocin HCl Pulvules, Vancocin

What is vancomycin?

Vancomycin is an antibiotic. It fights bacteria in the body.

Vancomycin is used to treat infections of the intestines that cause colitis (inflammation of the large intestine).

Vancomycin may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about vancomycin?

Before taking vancomycin, tell your doctor if you are allergic to any drugs, or if you have kidney disease, problems with your hearing, or a chronic intestinal condition such as inflammatory bowel disease, Crohn's disease, or ulcerative colitis.

Vancomycin can cause temporary or permanent hearing loss. Stop taking this medication and call your doctor at once if you have any hearing problems or ringing in your ears.

To be sure this medication is not causing harmful effects, your hearing will need to be tested on a regular basis. Do not miss any scheduled visits to your doctor.

What should I discuss with my healthcare provider before taking vancomycin?

Do not use this medication if you are allergic to vancomycin.

Before taking vancomycin, tell your doctor if you are allergic to any drugs, or if you have:

kidney disease,
hearing problems; or
a chronic intestinal condition such as inflammatory bowel disease, Crohn's disease, or ulcerative colitis.

If you have any of these conditions, you may not be able to use vancomycin, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Vancomycin can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take vancomycin?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Vancomycin can cause temporary or permanent hearing loss. To be sure this medication is not causing harmful effects, your hearing will need to be tested on a regular basis. Do not miss any scheduled visits to your doctor.

Take this medicine with a full glass of water.

Vancomycin should be taken at evenly spaced intervals.

Measure the liquid form of vancomycin with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Take this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Vancomycin will not treat a viral infection such as the common cold or flu. Store vancomycin capsules at room temperature, away from heat and moisture. Store vancomycin oral liquid in the refrigerator, but do not allow it to freeze.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Symptoms of a vancomycin overdose are not known.

What should I avoid while taking vancomycin?

There are no restrictions on food, beverages, or activity while taking vancomycin unless otherwise directed by your doctor.

If you have diarrhea that is watery or has blood in it, call your doctor.

Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Vancomycin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using vancomycin and call your doctor at once if you have any of these serious side effects:

hearing loss, ringing in your ears;

urinating less than usual or not at all;
fever, chills, body aches, flu symptoms;
feeling light-headed, fainting;
skin rash, redness, bruising, severe tingling, numbness, pain, muscle weakness; or
severe stomach pain, diarrhea that is watery or bloody.

Keep taking vancomycin and talk to your doctor if you have any of these less serious side effects:

dizziness;
nausea;
back pain; or
muscle pain or tightness.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

Vancomycin Dosing Information

Usual Adult Dose for Bacteremia:

15 mg/kg (maximum 1 g) IV infused over 1 to 2 hours every 12 hours
Duration: 14 days, depending on the nature and severity of the infection

Usual Adult Dose for Bacterial Endocarditis Prophylaxis:

1 g IV once infused over 1 to 2 hours; infusion should be completed within 30 minutes of the start of the procedure
Gentamicin may be added for high-risk patients.

Usual Adult Dose for Bacterial Infection:

15 mg/kg (maximum 1 g) IV infused over 1 to 2 hours every 12 hours

Usual Adult Dose for Burns - External:

15 mg/kg (maximum 1 g) IV infused over 1 to 2 hours every 12 hours

Usual Adult Dose for Endocarditis:

Alternate drug for patients who are unable to tolerate penicillin or ceftriaxone, and for oxacillin-resistant staphylococcal strains: 15 mg/kg IV infused over 1 to 2 hours every 12 hours with or without other antibiotics depending on the nature of the infection
Duration: 4 to 6 weeks or more depending on the nature of the infection
Maximum dose: 2 g/day unless serum concentrations are low (recommended peak 30 to 45 mcg/mL and trough 10 to 15 mcg/mL)

Refer to current published guidelines for detailed recommendations.

Usual Adult Dose for Pseudomembranous Colitis:

125 mg to 500 mg orally 4 times a day
Duration: 7 to 10 days

Usual Adult Dose for Enterocolitis:

125 mg to 500 mg orally 4 times a day
Duration: 7 to 10 days

Usual Adult Dose for Febrile Neutropenia:

15 mg/kg (maximum 1 g) IV infused over 1 to 2 hours every 12 hours
Duration: Once the patient is stable, afebrile for at least 24 hours, and the absolute neutrophil count is greater than 500/mm3, oral antibiotics may be substituted if antibiotic therapy is to be continued.

Usual Adult Dose for Meningitis:

Intravenous: 7.5 to 15 mg/kg IV infused over 1 to 2 hours every 6 to 12 hours (up to 2 to 3 g/day)
Duration: 10 to 14 days or at least one week after the patient becomes afebrile and cerebrospinal fluid normalizes

Intraventricular: 5 mg to 20 mg of a preservative-free formulation have been administered up to every 24 hours

Usual Adult Dose for Nosocomial Pneumonia:

Due to methicillin-resistant Staphylococcus aureus (MRSA): 15 mg/kg (maximum 1 g) IV infused over 1 to 2 hours every 12 hours
Recommended trough levels: 15 to 20 mcg/mL

Initial empiric treatment with broad-spectrum coverage according to the hospital's and/or ICU's antibiogram is recommended if multidrug-resistant organisms are suspected.

Duration: The duration of treatment should be as short as clinically possible (e.g., as little as 7 days) to reduce the risk of superinfections with resistant organisms.

Usual Adult Dose for Osteomyelitis:

15 mg/kg (maximum 1 g) IV infused over 1 to 2 hours every 12 hours
Duration: 3 to 6 weeks; oral antibiotics may be required for chronic osteomyelitis for an additional 1 to 2 months

Usual Adult Dose for Peritonitis:

Intravenous: 15 mg/kg (maximum 1 g) IV infused over 1 to 2 hours every 12 hours
Duration: 14 days, depending on the nature and severity of the infection

Intraperitoneal:
CAPD patients: 15 to 30 mg/kg every 5 to 7 days or 30 to 50 mg/L exchange; dosages may be increased by 25% in nonanuric patients
Duration: 14 to 21 days, depending on the nature and severity of the infection

Usual Adult Dose for Pneumonia:

15 mg/kg (maximum 1 g) IV infused over 1 to 2 hours every 12 hours
Duration: 14 to 21 days, depending on the nature and severity of the infection

Usual Adult Dose for Prevention of Perinatal Group B Streptococcal Disease:

If patient has immediate penicillin hypersensitivity and susceptibility is unknown, testing is not possible, or the isolates are resistant to erythromycin or clindamycin: 1 g IV every 12 hours until delivery

Usual Adult Dose for Sepsis:

15 mg/kg (maximum 1 g) IV infused over 1 to 2 hours every 12 hours
Duration: 10 to 14 days, depending on the nature and severity of the infection; longer therapy may be necessary in neutropenic or immunocompromised patients

Usual Adult Dose for Shunt Infection:

Intravenous: 7.5 to 15 mg/kg IV infused over 1 to 2 hours every 12 hours (up to 2 to 3 g/day)
Intraventricular: 5 mg to 20 mg of a preservative-free formulation have been administered up to every 24 hours

Usual Adult Dose for Skin or Soft Tissue Infection:

15 mg/kg (maximum 1 g) IV infused over 1 to 2 hours every 12 hours
Duration: 10 to 14 days, depending on the nature and severity of the infection

Usual Adult Dose for Surgical Prophylaxis:

1 g IV infused over 1 to 2 hours; infusion should be completed within 30 minutes of the start of the procedure
The dose may be repeated if the procedure lasts longer than 6 hours.

Usual Pediatric Dose for Bacterial Infection:

7 days or less, 1199 g or less: 15 mg/kg IV every 24 hours
7 days or less, 1200 to 2000 g: 10 to 15 mg/kg IV every 12 to 18 hours
7 days or less, 2001 g or more: 10 to 15 mg/kg IV every 8 to 12 hours

8 days up to 1 month, 1199 g or less: 15 mg/kg IV every 24 hours
8 days up to 1 month, 1200 to 2000 g: 10 to 15 mg/kg IV every 8 to 12 hours
8 days up to 1 month, 2001 g or more: 10 to 20 mg/kg IV every 6 to 8 hours (up to 60 mg/kg/day)

1 month to 18 years: 10 to 15 mg/kg IV every 6 to 8 hours (total 40 to 60 mg/kg/day)
Maximum dose: 4 g/day for patients with severe infections

Usual Pediatric Dose for Bacterial Endocarditis Prophylaxis:

1 year or older:
For patients allergic to ampicillin or amoxicillin: 20 mg/kg IV (maximum 1 g) once infused over 1 to 2 hours; infusion should be completed within 30 minutes of the start of the procedure
Gentamicin 1.5 mg/kg (maximum 120 mg) IV or IM may be added for high-risk patients.

Usual Pediatric Dose for Peritonitis:

CAPD patients: 30 mg/kg intraperitoneally every 5 to 7 days or 30 mg/L exchange

Usual Pediatric Dose for Pseudomembranous Colitis:

1 to 18 years: 40 mg/kg/day orally in 3 or 4 divided doses
Maximum dose: 2 g/day
Duration: 7 to 10 days

Usual Pediatric Dose for Enterocolitis:

1 to 18 years: 40 mg/kg/day orally in 3 or 4 divided doses
Maximum dose: 2 g/day
Duration: 7 to 10 days

Usual Pediatric Dose for Surgical Prophylaxis:

15 mg/kg IV infused over 1 hour, with or without gentamicin; infusion should be completed within 30 minutes of the start of the procedure

What other drugs will affect vancomycin?

Before taking vancomycin, tell your doctor if you are using any of these other antibiotic medications:

amikacin (Amikin);
gentamicin (Garamycin);
kanamycin (Kantrex);
neomycin (Mycifradin, Neo-Fradin, Neo-Tab);
netilmicin (Netromycin);
streptomycin; or
tobramycin (Nebcin, Tobi).

If you are using any of these drugs, you may not be able to use vancomycin, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect vancomycin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist has information about vancomycin written for health professionals that you may read.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.