Tocoban
Generic Name
Vancomycin
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| tocoban 375 mg injection | ৳ 2,500.00 | N/A |
Description
Overview of the medicine
Tocoban injection is an antibiotic used to treat serious bacterial infections, especially those caused by methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile-associated diarrhea (oral form).
Uses & Indications
Dosage
Adults
For systemic infections: 15 mg/kg IV every 8-12 hours, not exceeding 2 grams per dose. Max daily dose typically 3-4 grams.
Elderly
Dosage should be adjusted based on renal function, often requiring lower doses or less frequent administration.
Renal_impairment
Significant dosage reduction is required; dosing interval and amount must be carefully adjusted based on creatinine clearance and vancomycin serum levels.
How to Take
Tocoban 375 mg Injection is administered by slow intravenous infusion, typically over 60-90 minutes, by a healthcare professional. Rapid infusion can lead to 'red man' syndrome.
Mechanism of Action
Vancomycin inhibits bacterial cell wall synthesis by binding to the D-Ala-D-Ala terminus of peptidoglycan precursors, leading to cell lysis and bacterial death.
Pharmacokinetics
Onset
Rapidly distributed after intravenous infusion, reaching therapeutic concentrations quickly.
Excretion
Primarily excreted unchanged by glomerular filtration in the kidneys.
Half life
Approximately 4-6 hours in adults with normal renal function.
Absorption
Poorly absorbed orally; therefore, it is administered intravenously for systemic infections. Oral administration is used for local action in the gut.
Metabolism
Minimally metabolized; nearly all administered vancomycin is excreted unchanged.
Side Effects
Contraindications
- Known hypersensitivity to vancomycin or any of its excipients.
Drug Interactions
Anesthetic Agents
Concomitant use may increase the risk of 'red man' syndrome.
Neuromuscular Blockers
May potentiate the neuromuscular blocking effects.
Loop Diuretics (e.g., Furosemide)
May increase the risk of ototoxicity.
Aminoglycosides (e.g., Gentamicin)
Increased risk of nephrotoxicity and ototoxicity.
Storage
Store at room temperature (20-25°C), protect from light. Reconstituted solutions have specific storage conditions and expiry (e.g., 24 hours at room temperature, 14 days refrigerated).
Overdose
Overdose management is primarily supportive care, including maintaining renal function and fluid balance. Hemodialysis can remove vancomycin from the blood, but its effectiveness is limited.
Pregnancy & Lactation
Pregnancy Category C. Vancomycin crosses the placental barrier. Use in pregnancy only if clearly needed. It is excreted into breast milk; caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Known hypersensitivity to vancomycin or any of its excipients.
Drug Interactions
Anesthetic Agents
Concomitant use may increase the risk of 'red man' syndrome.
Neuromuscular Blockers
May potentiate the neuromuscular blocking effects.
Loop Diuretics (e.g., Furosemide)
May increase the risk of ototoxicity.
Aminoglycosides (e.g., Gentamicin)
Increased risk of nephrotoxicity and ototoxicity.
Storage
Store at room temperature (20-25°C), protect from light. Reconstituted solutions have specific storage conditions and expiry (e.g., 24 hours at room temperature, 14 days refrigerated).
Overdose
Overdose management is primarily supportive care, including maintaining renal function and fluid balance. Hemodialysis can remove vancomycin from the blood, but its effectiveness is limited.
Pregnancy & Lactation
Pregnancy Category C. Vancomycin crosses the placental barrier. Use in pregnancy only if clearly needed. It is excreted into breast milk; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years, check specific packaging for exact expiry date.
Availability
Hospitals, Pharmacies
Approval Status
Approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Ongoing clinical trials focus on optimizing vancomycin dosing in specific populations (e.g., critically ill, obese patients), monitoring for resistance, and exploring new glycopeptide derivatives.
Lab Monitoring
- Renal function tests (serum creatinine, blood urea nitrogen - BUN) daily or every 2-3 days during therapy
- Vancomycin serum trough levels, typically before the 4th or 5th dose to guide dosing
- Complete blood count (CBC) periodically, especially with prolonged therapy
- Audiograms (if prolonged therapy, high doses, or pre-existing hearing impairment)
Doctor Notes
- Carefully monitor renal function and vancomycin serum trough levels to ensure efficacy and minimize toxicity, especially in patients with impaired renal function, elderly, or those on concomitant nephrotoxic drugs.
- Infuse slowly over at least 60 minutes to prevent 'red man' syndrome. Pre-treatment with antihistamines may be considered for high-risk patients.
- Consider alternative antibiotics if MRSA is confirmed sensitive to narrower-spectrum agents.
Patient Guidelines
- Inform your healthcare provider about any allergies, especially to vancomycin.
- Report any unusual side effects, such as ringing in the ears, hearing changes, or decreased urine output.
- Ensure the infusion is given slowly to avoid 'red man' syndrome.
Missed Dose Advice
Since this medicine is administered by a healthcare professional, a missed dose is unlikely. If a scheduled dose is missed, inform your doctor or nurse immediately to reschedule.
Driving Precautions
Tocoban is unlikely to affect the ability to drive or operate machinery. However, if you experience dizziness or other side effects, avoid these activities.
Lifestyle Advice
- Maintain adequate hydration during therapy.
- Follow your doctor's instructions for any concurrent conditions.
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International brand names for this medicine. Click a brand to search for detailed information.
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