Oritavancin diphosphate is available in 2 different formulations: oritavancin diphosphate (Orbactiv, Melinta) and oritavancin diphosphate (Kimyrsa, Melinta).2927; 3679 The formulations differ in vial size, preparation, and administration; in addition, there are diluent compatibility differences.2927; 3679
Oritavancin diphosphate (Orbactiv, Melinta) is available as a lyophilized powder in single-dose (preservative-free) vials containing the equivalent of 400 mg of oritavancin.2927 Vials also contain mannitol and phosphoric acid to adjust the pH.2927 Each vial should be reconstituted with 40 mL of sterile water for injection to yield a solution containing 10 mg/mL of oritavancin.2927 To avoid foaming, each vial should be gently swirled until the contents are completely dissolved.2927 The reconstituted solution should be visually inspected for particulate matter and discoloration prior to use.2927
To prepare a 1.2-g dose of oritavancin (Orbactiv), 120 mL should be removed from a 1-L intravenous bag of dextrose 5% and discarded.2927 From each of 3 reconstituted vials of oritavancin, 40 mL should be withdrawn and transferred to the dextrose 5% bag to bring the total bag volume to 1 L, yielding a solution with a final oritavancin concentration of 1.2 mg/mL.2927 Saline-based infusion solutions must not be used for dilution of oritivancin diphosphate (Orbactiv) since precipitation may result.2927
Oritavancin diphosphate (Kimyrsa, Melinta) is available as a lyophilized powder in single-dose (preservative-free) vials containing the equivalent of 1200 mg of oritavancin.3679 Vials also contain hydroxypropyl ß-cyclodextrin 2400 mg, mannitol 800 mg, and phosphoric acid or sodium hydroxide to adjust the pH.3679 Each vial should be reconstituted with 40 mL of sterile water for injection to yield a solution containing 30 mg/mL of oritavancin.3679 To avoid foaming, each vial should be gently swirled until the contents are completely dissolved.3679 The reconstituted solution should be visually inspected for particulate matter and discoloration prior to use.3679
To prepare a 1.2-g dose of oritavancin (Kimyrsa), 40 mL should be removed from a 250-mL intravenous bag of sodium chloride 0.9% or dextrose 5% and discarded.2927 Forty mL of the reconstituted solution should be withdrawn and transferred to the bag to bring the total bag volume to 250 mL, yielding a solution with a final oritavancin concentration of 4.8 mg/mL.3679
Equivalency
Oritavancin diphosphate 444 mg is equivalent to 400 mg of oritavancin.2927
Oritavancin diphosphate 1331.16 mg is equivalent to 1200 mg of oritavancin.3679
pH
Reconstituted solutions of oritavancin diphosphate (Orbactiv) have a pH ranging from 3.1 to 4.3.2927
Reconstituted solutions of oritavancin diphosphate (Kimyrsa) have a pH ranging from 4 to 6.3679
Trade Name(s)
Kimyrsa, Orbactiv
Oritavancin diphosphate (Orbactiv) is administered by intravenous infusion over 3 hours after dilution only in dextrose 5%.2927 If a common infusion line is being used to administer other drugs in addition to oritavancin diphosphate, the line should be flushed with dextrose 5% prior to and following infusion of oritavancin diphosphate.2927 Administration of the diluted drug over 3 hours is intended to minimize the risk of infusion-related reactions; however, interruption of the infusion or reduction in the rate of infusion may be necessary if such reactions occur.2927
Oritavancin diphosphate (Kimyrsa) is administered by intravenous infusion over 1 hour after dilution in either sodium chloride 0.9% or dextrose 5%.3679 If a common infusion line is being used to administer other drugs in addition to oritavancin diphosphate, the line should be flushed with sodium chloride 0.9% or dextrose 5% prior to and following infusion of oritavancin diphosphate.3679 Interruption of the infusion or reduction in the rate of infusion may be necessary if infusion-related reactions occur.2927
Oritavancin diphosphate (Orbactiv) is a white to off-white powder that forms a clear, colorless to pale yellow solution when reconstituted with sterile water for injection and further diluted in dextrose 5%.2927 Intact vials of oritavancin diphosphate should be stored at controlled room temperature.2927 The manufacturer states that the diluted solution should be used within 6 hours of preparation when stored at room temperature or within 12 hours when refrigerated at 2 to 8°C.2927 The total time for storage (the reconstituted drug in the vial and the diluted solution in the infusion bag) and the infusion time together should not exceed 6 hours if stored at room temperature or 12 hours if stored under refrigeration.2927 Any unused portion should be discarded.2927
Oritavancin diphosphate (Kimyrsa) is a white to off-white to pink powder that forms a clear, colorless to pink solution when reconstituted with sterile water for injection and further diluted in sodium chloride 0.9% or dextrose 5%.3679 Intact vials of oritavancin diphosphate should be stored at controlled room temperature.3679 The manufacturer states that the diluted solution should be used within 4 hours of preparation when stored at room temperature or within 12 hours when refrigerated at 2 to 8°C.3679 The total time for storage (the reconstituted drug in the vial and the diluted solution in the infusion bag) and the infusion time together should not exceed 4 hours if stored at room temperature or 12 hours if stored under refrigeration.3679 Any unused portion should be discarded.3679
pH Effects
Oritavancin may be incompatible with drugs formulated at a basic or neutral pH.2927; 3679
For a list of references cited in the text of this monograph, search the monograph titled References.