Vancomycin Side Effects

Medically reviewed by Drugs.com. Last updated on Oct 30, 2023.

Applies to vancomycin: intravenous powder for solution, intravenous solution.

Other dosage forms:

• oral capsule, oral powder for solution, oral powder for suspension

Serious side effects of vancomycin

Along with its needed effects, vancomycin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking vancomycin:

Rare

• black, tarry stools
• bleeding gums
• blood in the urine or stools
• continuing ringing or buzzing or other unexplained noise in the ears
• cough or hoarseness
• dizziness or lightheadedness
• feeling of constant movement of self or surroundings
• feeling of fullness in the ears
• fever with or without chills
• general feeling of tiredness or weakness
• hearing loss
• loss of balance
• lower back or side pain
• painful or difficult urination
• pale skin
• pinpoint red spots on the skin
• ringing or buzzing in the ears
• sensation of spinning
• sore throat
• sores, ulcers, or white spots on the lips or in the mouth
• trouble in hearing
• unusual bleeding or bruising
• unusual tiredness or weakness

Incidence not known

• abdominal or stomach cramps or tenderness
• back pain
• blistering, peeling, loosening of the skin
• bloating
• bluish color
• blurred vision
• change in frequency of urination or amount of urine
• changes in skin color
• chest pain
• chest tightness
• confusion
• cracks in the skin
• diarrhea, watery and severe, which may also be bloody
• difficulty with swallowing
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• drowsiness
• fast heartbeat
• flushing
• headache
• hives, itching, or skin rash
• increased thirst
• joint or muscle pain
• loss of appetite
• loss of heat from the body
• nausea or vomiting
• pain, tenderness, or swelling of the foot or leg
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• red skin lesions, often with a purple center
• red, irritated eyes
• red, swollen skin
• redness, soreness, or itching skin
• scaly skin
• sores, welting, or blisters
• sweating
• swelling of the feet or lower legs
• swollen glands
• unusual weight loss

For healthcare professionals

Applies to vancomycin: compounding powder, intravenous powder for injection, intravenous solution, oral capsule, oral powder for reconstitution, oral solution.

General

The most commonly reported side effects include nausea, abdominal pain, and hypokalemia.^[Ref]

Gastrointestinal

• Very common (10% or more): Nausea (up to 17%), abdominal pain (up to 15%)
• Common (1% to 10%): Vomiting, diarrhea, flatulence
• Uncommon (0.1% to 1%): Mild gastrointestinal tract disturbances
• Very rare (less than 0.01%): Pseudomembranous enterocolitis/colitis
• Frequency not reported: Chemical peritonitis, constipation, indigestion, stomachache^[Ref]

Chemical peritonitis occurred with intraperitoneal administration.

Mild gastrointestinal tract disturbances occurred with oral administration.^[Ref]

Metabolic

• Very common (10% or more): Hypokalemia (up to 13%)^[Ref]

Dermatologic

• Common (1% to 10%): Exanthema, pruritus, vancomycin infusion reaction, redness of the face/upper arms, urticaria
• Uncommon (0.1% to 1%): Erythema, itch
• Rare (0.01% to 0.1%): Toxic epidermal necrolysis
• Very rare (less than 0.01%): Exfoliative dermatitis, linear IgA bullous dermatosis, Lyell's syndrome, Stevens-Johnson syndrome
• Frequency not reported: Acute generalized exanthematous pustulosis (AGEP), erythematous macular rash with intense pruritus over face/neck/upper body, rash, red neck^[Ref]

Cardiovascular

• Common (1% to 10%): Decrease in blood pressure, flushing of the upper body, peripheral edema, phlebitis
• Uncommon (0.1% to 1%): Thrombophlebitis
• Rare (0.01% to 0.1%): Vasculitis
• Very rare (less than 0.01%): Cardiac arrest
• Frequency not reported: Bradycardia, cardiogenic shock, generalized flushing, hypotension, palpitations, substernal pressure, tachycardia
• Postmarketing reports: Chest pain^[Ref]

Hypotension, bradycardia, cardiogenic shock, and cardiac arrest have occurred with rapid bolus administration.^[Ref]

Renal

• Common (1% to 10%): Increased serum creatinine, increased serum urea, nephrotoxicity, renal insufficiency
• Rare (0.01% to 0.1%): Acute renal failure, interstitial nephritis
• Frequency not reported: Acute kidney injury, Acute tubular necrosis, azotemia, blood urea nitrogen (BUN) concentrations increased, uremia, transient increased urea^[Ref]

Renal failure was most commonly characterized by increased serum creatinine levels or BUN concentrations.

Azotemia usually resolved upon discontinuation of treatment.^[Ref]

Other

• Common (1% to 10%): Fatigue, mucosal inflammation, pyrexia
• Uncommon (0.1% to 1%): Chills, fever, pain, permanent hearing loss, transient hearing loss
• Rare (0.01% to 0.1%): Drug fever, ototoxicity, rigors, shivering, tinnitus^[Ref]

Respiratory

• Common (1% to 10%): Dyspnea, stridor
• Frequency not reported: Wheezing^[Ref]

Musculoskeletal

• Common (1% to 10%): Back pain
• Rare (0.01% to 0.1%): Back and chest muscle pain and spasm^[Ref]

Nervous system

• Common (1% to 10%): Headache
• Rare (0.01% to 0.1%): Dizziness, vertigo^[Ref]

Genitourinary

• Common (1% to 10%): Urinary tract infection
• Frequency not reported: Granular urinary casts^[Ref]

Hematologic

• Uncommon (0.1% to 1%): Eosinophilia,
• Rare (0.01% to 0.1%): Agranulocytosis, leukopenia, pancytopenia, reversible agranulocytosis, reversible neutropenia, thrombocytopenia
• Frequency not reported: Anemia^[Ref]

Hypersensitivity

• Rare (0.01% to 0.1%): Anaphylactic reactions, anaphylaxis, hypersensitivity reactions
• Frequency not reported: Anaphylactoid reaction^[Ref]

Immunologic

• Rare (0.01% to 0.1%): Superinfection
• Frequency not reported: Drug rash with eosinophilia and systemic symptoms (DRESS), non-susceptible organism overgrowth^[Ref]

Local

• Frequency not reported: Injection site inflammation, injection site pruritus, necrosis, tissue irritation^[Ref]

Ocular

• Frequency not reported: Hemorrhagic occlusive retinal vasculitis (HORV), permanent vision loss^[Ref]

HORV occurred in patients given this drug via intracameral or intravitreal route during/after cataract surgery.^[Ref]

Psychiatric

• Frequency not reported: Depression, insomnia^[Ref]

Hepatic

• Frequency not reported: Transaminase elevations^[Ref]

Frequently asked questions

• Can you drink alcohol while taking vancomycin?
• What is the difference between Firvanq and the CutisPharma FIRST-Vancomycin Compounding Kit?

Further information

Vancomycin side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer