section name header

Pronunciation

van-koe-MYE-sin

Classifications

Therapeutic Classification: anti-infectives

Indications

REMS

Action

Therapeutic Effects:

Spectrum:

Pharmacokinetics

Absorption: Poorly absorbed from the GI tract.

Distribution: Widely distributed to tissues. Some penetration (20–30%) of CSF.

Metabolism/Excretion: Oral doses excreted primarily in the feces; IV vancomycin eliminated almost entirely by the kidneys.

Half-life: Neonates: 6–10 hr; Children 3 mo–3 yr: 4 hr; Children >3 yr: 2–2.3 hr; Adults: 5–8 hr ( in renal impairment).

Time/Action Profile

(plasma concentrations)

ROUTEONSETPEAKDURATION
IVrapidend of infusion12–24 hr

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: hypotension.

Derm: ACUTE GENERALIZED EXANTHEMATOUS PUSTULOSIS, DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS, LINEAR IGA BULLOUS DERMATOSIS, rash, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS.

EENT: ototoxicity.

GI: nausea, vomiting.

GU: nephrotoxicity.

Hemat: eosinophilia, leukopenia.

Local: phlebitis.

MS: back and neck pain.
Misc: chills, fever, (INCLUDING ANAPHYLAXIS)HYPERSENSITIVITY REACTIONS , vancomycin flushing syndrome (with rapid infusion).

Interactions

Drug-Drug:

Route/Dosage

see Calculator

Serious Systemic Infections

Renal Impairment

Endocarditis Prophylaxis in Penicillin-Allergic Patients

Diarrhea Due to C. difficile

Staphylococcal Enterocolitis

Availability

(Generic available)

Assessment

Lab Test Considerations: Toxicity and Overdose:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Firvanq, Vancocin