Vancomin
Generic Name
Vancomycin
Manufacturer
Various (e.g., Example Pharma Co.)
Country
Global
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| vancomin 1 gm injection | ৳ 483.25 | N/A |
Description
Overview of the medicine
Vancomycin is a glycopeptide antibiotic used to treat severe, life-threatening infections caused by Gram-positive bacteria that are resistant to other antibiotics, particularly methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile colitis.
Uses & Indications
Dosage
Adults
For systemic infections: 15-20 mg/kg IV every 8-12 hours, typically not exceeding 2 gm per dose or 3-4 gm per day. Dosing should be guided by therapeutic drug monitoring (TDM).
Elderly
Dosage adjustments are often necessary due to age-related decline in renal function. Initial doses may be lower, and careful monitoring of vancomycin levels and renal function is crucial.
Renal_impairment
Significant dosage adjustment is required based on creatinine clearance. Close monitoring of serum vancomycin levels is essential to prevent toxicity. Dosing intervals may need to be extended or total daily dose reduced.
How to Take
Administer intravenously via slow infusion over at least 60 minutes (for doses up to 1 gm) to avoid 'Red Man Syndrome'. For larger doses, infusion time should be extended. Dilute reconstituted powder before infusion according to manufacturer's instructions.
Mechanism of Action
Vancomycin inhibits bacterial cell wall synthesis by binding to the D-Ala-D-Ala terminus of peptidoglycan precursors, preventing transpeptidation and transglycosylation. This results in bacterial cell lysis and death.
Pharmacokinetics
Onset
Rapid onset of action when administered intravenously.
Excretion
Primarily renal excretion (glomerular filtration); approximately 80-90% of an intravenous dose is excreted unchanged in the urine within 24 hours.
Half life
4-6 hours in adults with normal renal function; significantly prolonged in renal impairment.
Absorption
Poorly absorbed orally; administered intravenously for systemic infections, or orally for C. difficile colitis (acting locally in the gut).
Metabolism
Minimally metabolized; less than 5% of a dose undergoes metabolism.
Side Effects
Contraindications
- Known hypersensitivity to vancomycin or any component of the formulation
- Previous severe allergic reaction to vancomycin
Drug Interactions
Loop diuretics (e.g., Furosemide)
May increase the risk of ototoxicity.
Aminoglycosides (e.g., Gentamicin, Amikacin)
Increased risk of nephrotoxicity and ototoxicity. Concurrent use should be carefully monitored.
Neuromuscular blockers (e.g., Succinylcholine)
May potentiate and prolong neuromuscular blockade.
Amphotericin B, Cisplatin, Cyclosporine, NSAIDs
Increased risk of nephrotoxicity.
Storage
Store intact vials at room temperature (20-25°C), protected from light. Do not freeze. Reconstituted and diluted solutions should be refrigerated (2-8°C) or used immediately, as per specific product guidelines.
Overdose
Management involves supportive care, maintaining hydration, and monitoring renal function. Hemodialysis or hemofiltration may be beneficial for removing vancomycin from the blood, especially in patients with renal failure.
Pregnancy & Lactation
Pregnancy Category C. Vancomycin crosses the placenta; use only if clearly needed and the potential benefit justifies the potential risk to the fetus. Excreted in breast milk, use with caution; observe infant for adverse effects like diarrhea or thrush.
Side Effects
Contraindications
- Known hypersensitivity to vancomycin or any component of the formulation
- Previous severe allergic reaction to vancomycin
Drug Interactions
Loop diuretics (e.g., Furosemide)
May increase the risk of ototoxicity.
Aminoglycosides (e.g., Gentamicin, Amikacin)
Increased risk of nephrotoxicity and ototoxicity. Concurrent use should be carefully monitored.
Neuromuscular blockers (e.g., Succinylcholine)
May potentiate and prolong neuromuscular blockade.
Amphotericin B, Cisplatin, Cyclosporine, NSAIDs
Increased risk of nephrotoxicity.
Storage
Store intact vials at room temperature (20-25°C), protected from light. Do not freeze. Reconstituted and diluted solutions should be refrigerated (2-8°C) or used immediately, as per specific product guidelines.
Overdose
Management involves supportive care, maintaining hydration, and monitoring renal function. Hemodialysis or hemofiltration may be beneficial for removing vancomycin from the blood, especially in patients with renal failure.
Pregnancy & Lactation
Pregnancy Category C. Vancomycin crosses the placenta; use only if clearly needed and the potential benefit justifies the potential risk to the fetus. Excreted in breast milk, use with caution; observe infant for adverse effects like diarrhea or thrush.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years for intact vials when stored properly. Reconstituted solutions have limited shelf life (e.g., 14 days refrigerated, or 24 hours at room temperature, depending on diluent). Refer to package insert for specific details.
Availability
Hospitals, retail pharmacies (requires special handling)
Approval Status
Approved by major regulatory authorities worldwide
Patent Status
Generic available, original patent expired
WHO Essential Medicine
YesClinical Trials
Vancomycin has been extensively studied and validated in numerous clinical trials since its introduction, demonstrating efficacy against various Gram-positive bacterial infections. Ongoing research focuses on optimizing dosing strategies and exploring new indications.
Lab Monitoring
- Serum vancomycin trough levels (essential for optimizing efficacy and minimizing toxicity)
- Renal function (BUN, serum creatinine, creatinine clearance)
- Audiometric monitoring (especially in elderly, those with pre-existing hearing loss, or on concomitant ototoxic drugs)
- Complete Blood Count (CBC) with differential
Doctor Notes
- Therapeutic drug monitoring (TDM) with trough level measurements is critical for vancomycin to ensure optimal therapeutic outcomes and minimize toxicity, especially in patients with fluctuating renal function or severe infections.
- Always ensure slow intravenous infusion over at least 60 minutes to prevent 'Red Man Syndrome'.
- Careful dose adjustments are necessary in patients with renal impairment, obesity, or in critically ill settings.
- Monitor for signs of nephrotoxicity (rising creatinine) and ototoxicity (hearing changes).
Patient Guidelines
- Report any signs of an allergic reaction (e.g., rash, itching, swelling, difficulty breathing) immediately.
- Inform your doctor if you experience dizziness, ringing in your ears, hearing changes, or decreased urine output.
- Complete the full course of treatment as prescribed, even if you start to feel better.
- Ensure slow infusion rate if administering at home (though typically hospital-administered).
Missed Dose Advice
As Vancomycin is typically administered in a hospital setting, a missed dose should be immediately reported to the healthcare provider. Do not attempt to self-administer or double the next dose.
Driving Precautions
Vancomycin may cause dizziness or visual disturbances in some patients. Exercise caution when driving or operating machinery until you know how this medication affects you.
Lifestyle Advice
- Maintain good hydration during treatment to support kidney function.
- Avoid concurrent use of other nephrotoxic or ototoxic drugs if possible, or use with extreme caution under medical supervision.
- Report any new or worsening symptoms promptly.
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