Medically reviewed by Drugs.com. Last updated on Feb 25, 2022.
Dosage and Administration Overview
There are two oritavancin products (ORBACTIV and KIMYRSA™, another oritavancin product) that:
- Are supplied in different dose strengths of oritavancin [see Dosage Forms and Strengths (3)].
- Have different recommended durations of infusion [see Dosage and Administration (2.2)].
- Have different preparation instructions, including differences in reconstitution, dilution, and compatible diluents [see Dosage and Administration (2.3, 2.4)].
Carefully follow the recommended dosage and dose preparation instructions for ORBACTIV in this prescribing information (PI) [see Dosage and Administration (2.1, 2.2, 2.3, 2.4)]. Refer to the KIMYRSA prescribing information for relevant information of the other oritavancin product.
The recommended dosage of ORBACTIV is 1,200 mg administered as a single dose by intravenous infusion over 3 hours in patients 18 years and older [see Warnings and Precautions (5.3)].
Preparation of ORBACTIV for Intravenous Infusion
There are two oritavancin products (ORBACTIV and KIMYRSA, another oritavancin product) that have differences in dose strengths, duration of infusion, reconstitution and dilution instructions, and compatible diluents. Carefully follow the reconstitution, and dilution instructions with the appropriate compatible diluent for ORBACTIV specified in this prescribing information. Refer to the KIMYRSA prescribing information for relevant information of the other oritavancin product.
ORBACTIV is intended for intravenous infusion, only after reconstitution and dilution.
Three ORBACTIV 400 mg vials need to be reconstituted and diluted to prepare a single 1,200 mg intravenous dose.
Reconstitution: Aseptic technique should be used to reconstitute three ORBACTIV 400 mg vials.
- Add 40 mL of sterile water for injection (WFI) to reconstitute each vial to provide a 10 mg/mL solution per vial.
- For each vial, gently swirl the contents to avoid foaming and ensure that all ORBACTIV powder is completely dissolved to form a reconstituted solution.
- Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Each reconstituted vial should appear to be a clear, colorless to pale yellow solution, free of visible particles.
Dilution: Use ONLY 5% dextrose injection (D5W) for dilution to prepare the final intravenous solution for infusion. Do NOT use Sodium Chloride Injection for dilution as it is incompatible with ORBACTIV and may cause precipitation of the drug. Since no preservative or bacteriostatic agent is present in ORBACTIV, aseptic technique must be used in preparing the final intravenous solution as follows:
- Withdraw and discard 120 mL from a 1000 mL intravenous bag of D5W.
- Withdraw 40 mL from each of the three reconstituted vials of ORBACTIV and add to D5W intravenous bag to bring the bag volume to 1000 mL. This yields a concentration of 1.2 mg/mL.
Discard any unused portion of the reconstituted solution remaining in each vial.
Storage and Use of Intravenous Solution: Diluted intravenous solution in an infusion bag should be used within 6 hours when stored at room temperature, or used within 12 hours when refrigerated at 2 to 8°C (36 to 46°F). The combined storage time (reconstituted solution in the vial and diluted solution in the bag) and 3 hour infusion time should not exceed 6 hours at room temperature or 12 hours if refrigerated.
ORBACTIV solution for administration by 3-hour infusion is ONLY compatible with:
- 5% dextrose injection (D5W)
ORBACTIV is administered intravenously. ORBACTIV should only be diluted in D5W. Do NOT use sodium chloride injection for dilution as it is incompatible with ORBACTIV and may cause precipitation of the drug. Therefore other intravenous substances, additives or other medications mixed in sodium chloride injection should not be added to ORBACTIV single-dose vials or infused simultaneously through the same IV line or through a common intravenous port.
In addition, drugs formulated at a basic or neutral pH may be incompatible with ORBACTIV. ORBACTIV should not be administered simultaneously with commonly used intravenous drugs through a common intravenous port. If the same intravenous line is used for sequential infusion of additional medications, the line should be flushed before and after infusion of ORBACTIV with D5W.
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