Composition
Inj 500 mg/1 gm: Vancomycin (as HCI) 500 mg (10 ml)/1 gm (20 ml).
Indications & Dosage
Infections due to Gram-positive bacteria including endocarditis, osteomyelitis, septicaemia and soft-tissueinfections: BY IV INF: Adult: 1-1.5 g every 12 hours Elderly: 500 mg every 12 hours, alternatively 1 g once daily Infants & Neonates:15 mg/ kg 1 dose then 10 mg/kg every 12 hr for 1st week of life, every 8 hr up to 1 month of age. Surgical prophylaxis (when high risk of MRSA): BY IV INF: Adult: 1 g for 1 dose. Peritonitis associated with peritoneal dialysis: BY INTRAPERITONEAL ADMINISTRATION: Adult: (consult product literature).
Administration
Intermittent infusion over at least 60 min at a final conc not to exceed 5 mg/ ml. Administration of antihistamines just before the infusion may also prevent or minimize Red man syndrome.
Compatibility
Stable in dextran 6% in NS, D5W, D5% NS, RL, D5% RL, NS, D1OW. Y-site administration: See drug to drug IV Compatibility chart
Stability
Store vials at 20C-25C (68F-77F). After initial reconstitution with SWFI, D5W or NS, solutions are stable for 14 days if refrigerated. After further dilution with D5W or NS, the solution may be stored in a refrigerator for 14 days without significant loss of potency. Solutions diluted with D5NS, RL, D5RL may be stored in a refrigerator for 96 hours. Store pharmacy bulk packages at 20C-25C (68F-77F). Discard pharmacy bulk packages no later than 4 hours after initial closure puncture.
Precautions
Impaired renal function, previous hearing loss, elderly. Monitor blood levels, blood counts, urinalysis, and renal function tests. Monitor auditory function in elderly
Interactions
Neurotoxic or nephrotoxic drugs, anaesthetics.
Pregnancy
Caution advised
Lactation
Not recommended
Side Effects
Blood disorders, including neutropenia (usually after 1 week or cumulative dose of 25 g), interstitial nephritis, nephrotoxicity, ototoxicity (discontinue if tinnitus occurs), renal failure. Rare: Agranulocytosis, thrombocytopenia, anaphylaxis, cardiac arrest on rapid infusion, chills, dyspnea, eosinophilia, exfoliative dermatitis, fever, Red mans syndrome, nausea, pain and muscle spasm of back and chest,phlebitis, pruritus, rashes, severe hypotension and shock on rapid infusion, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria, vasculitis, wheezing