Vancomin
Generic Name
Vancomycin
Manufacturer
Example Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
Variant | Unit Price | Strip Price |
---|---|---|
vancomin 500 mg injection | ৳ 250.94 | N/A |
Description
Overview of the medicine
Vancomycin is a glycopeptide antibiotic used to treat serious bacterial infections, especially those caused by Gram-positive bacteria resistant to other antibiotics, such as MRSA.
Uses & Indications
Dosage
Adults
Typical dose: 15-20 mg/kg intravenously (IV) every 8-12 hours, not exceeding 2g per single dose or 4g per day. Standard dosing often starts at 1g IV every 12 hours.
Elderly
Dosage should be individualized based on renal function, often requiring lower doses or extended dosing intervals due to age-related decline in renal function.
Renal_impairment
Significant dosage reduction or extension of dosing intervals is required based on creatinine clearance. Serum vancomycin trough levels must be monitored to guide dosing.
How to Take
Vancomycin injection must be administered by slow intravenous infusion over at least 60 minutes to avoid rapid infusion-related reactions (e.g., Red Man Syndrome). The solution should be reconstituted and diluted according to manufacturer guidelines.
Mechanism of Action
Vancomycin inhibits bacterial cell wall synthesis by binding to the D-Ala-D-Ala terminus of peptidoglycan precursors, thereby preventing the cross-linking of peptidoglycan chains. This leads to cell lysis and bacterial death.
Pharmacokinetics
Onset
Rapid (systemic effects typically observed within hours of IV administration).
Excretion
Primarily renal; approximately 80-90% of an intravenous dose is excreted unchanged in the urine within 24 hours via glomerular filtration.
Half life
Approximately 4-6 hours in adults with normal renal function; significantly prolonged in renal impairment.
Absorption
Poor oral absorption, therefore administered intravenously for systemic infections. Peak serum concentrations are reached within 2 hours after the end of an intravenous infusion.
Metabolism
Minimally metabolized; less than 5% of a dose is metabolized.
Side Effects
Contraindications
- Known hypersensitivity to vancomycin or any component of the formulation.
Drug Interactions
General anesthetics
Concurrent administration may induce erythema and histamine-like flushing (Red Man Syndrome).
Cisplatin, Amphotericin B
Increased risk of nephrotoxicity.
Loop diuretics (e.g., furosemide)
Increased risk of ototoxicity.
NSAIDs (e.g., ibuprofen, naproxen)
Potential for increased nephrotoxicity when combined with vancomycin, especially in patients with pre-existing renal impairment.
Aminoglycosides (e.g., gentamicin, amikacin)
Increased risk of nephrotoxicity and ototoxicity.
Storage
Store unopened vials at controlled room temperature (20-25°C), protected from light. Reconstituted and diluted solutions should be stored in a refrigerator (2-8°C) and used within 24-96 hours, depending on the diluent and manufacturer guidelines.
Overdose
Overdose can lead to severe nephrotoxicity and ototoxicity. Management is primarily symptomatic and supportive, including maintaining hydration and diuresis. Hemodialysis and hemofiltration have been shown to remove vancomycin from the blood and may be beneficial in severe cases.
Pregnancy & Lactation
Pregnancy Category C. Vancomycin should be used during pregnancy only if clearly needed and the potential benefits justify the potential risks to the fetus. It is excreted in human milk; caution should be exercised when vancomycin is administered to a nursing woman.
Side Effects
Contraindications
- Known hypersensitivity to vancomycin or any component of the formulation.
Drug Interactions
General anesthetics
Concurrent administration may induce erythema and histamine-like flushing (Red Man Syndrome).
Cisplatin, Amphotericin B
Increased risk of nephrotoxicity.
Loop diuretics (e.g., furosemide)
Increased risk of ototoxicity.
NSAIDs (e.g., ibuprofen, naproxen)
Potential for increased nephrotoxicity when combined with vancomycin, especially in patients with pre-existing renal impairment.
Aminoglycosides (e.g., gentamicin, amikacin)
Increased risk of nephrotoxicity and ototoxicity.
Storage
Store unopened vials at controlled room temperature (20-25°C), protected from light. Reconstituted and diluted solutions should be stored in a refrigerator (2-8°C) and used within 24-96 hours, depending on the diluent and manufacturer guidelines.
Overdose
Overdose can lead to severe nephrotoxicity and ototoxicity. Management is primarily symptomatic and supportive, including maintaining hydration and diuresis. Hemodialysis and hemofiltration have been shown to remove vancomycin from the blood and may be beneficial in severe cases.
Pregnancy & Lactation
Pregnancy Category C. Vancomycin should be used during pregnancy only if clearly needed and the potential benefits justify the potential risks to the fetus. It is excreted in human milk; caution should be exercised when vancomycin is administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Shelf life varies by manufacturer, typically 2-3 years for unopened vials when stored as recommended. Reconstituted solutions have limited stability.
Availability
Hospitals, pharmacies
Approval Status
Approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Vancomycin has been extensively studied since its introduction. Current clinical trials focus on optimizing dosing strategies, investigating new formulations (e.g., liposomal vancomycin), and exploring its role in emerging resistant pathogens.
Lab Monitoring
- Renal function tests (serum creatinine, blood urea nitrogen - BUN) should be monitored regularly, especially in patients with pre-existing renal impairment, elderly, or those receiving concomitant nephrotoxic drugs.
- Vancomycin serum trough levels must be monitored to ensure therapeutic efficacy and minimize toxicity, typically before the fourth or fifth dose.
- Complete blood count (CBC) should be monitored periodically.
- Audiometric testing should be considered in patients at high risk of ototoxicity.
Doctor Notes
- Crucially monitor vancomycin serum trough levels, particularly in renally impaired patients, critical care patients, and those receiving concurrent nephrotoxic agents, to ensure therapeutic efficacy and avoid toxicity.
- Adjust dosage based on renal function (creatinine clearance) and therapeutic drug monitoring. Initial doses for severe infections might be higher, followed by level-guided adjustments.
- Infuse slowly (over at least 60 minutes) to minimize infusion-related reactions (Red Man Syndrome).
Patient Guidelines
- Patients should be informed about the importance of slow infusion to prevent 'Red Man Syndrome'.
- Report any changes in hearing, ringing in the ears, or dizziness immediately.
- Report any decrease in urine output or signs of kidney problems.
- Complete the full course of treatment as prescribed, even if symptoms improve.
Missed Dose Advice
If a dose is missed, administer it as soon as remembered, unless it is almost time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose. Consult your doctor or pharmacist.
Driving Precautions
Vancomycin may cause dizziness, which could impair the ability to drive or operate machinery. Patients should exercise caution until they know how the medicine affects them.
Lifestyle Advice
- Maintain adequate hydration during treatment to support renal function and minimize the risk of nephrotoxicity.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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