telavancin

Contraindicated in:

Hypersensitivity;
Congenital long QT syndrome, known prolongation of the QT interval, uncompensated HF, or severe left ventricular hypertrophy (↑ risk of fatal arrhythmias);
Concurrent use of unfractionated heparin;
OB: Pregnancy.

Use Cautiously in:

Renal impairment (↓ dose if CCr ≤50 mL/min) (efficacy may be ↓ in patients with complicated skin/skin structure infections and CCr ≤50 mL/min) (↑ risk of mortality in patients with hospital-acquired or ventilator-associated pneumonia and CCr ≤50 mL/min; use only if benefit outweighs risk);
Diabetes, HF, or hypertension (↑ risk of renal impairment);
Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
Pedi: Safety and effectiveness not established in children (may be associated with poor outcomes in children <1 yr who have immature renal function);
Geri: Consider age-related ↓ in renal function in older adults.

Adv. Reactions/Side Effects ⬆ ⬇

CV: QT interval prolongation

GI: nausea, taste disturbance, vomiting, abdominal pain, CLOSTRIDIOIDES DIFFICILE-ASSOCIATED DIARRHEA (CDAD)

GU: foamy urine, nephrotoxicity

Neuro: dizziness

Misc: ANAPHYLAXIS, infusion reactions

Interactions ⬆ ⬇

Drug-drug:

May artificially prolong activated partial thromboplastin time for up to 18 hr when used with unfractionated heparin; concurrent use contraindicated.
QT interval prolonging medications may ↑ risk of arrhythmias.
NSAIDs, ACE inhibitors, and loop diuretics may ↑ risk of nephrotoxicity.

Availability ⬆ ⬇

Lyophilized powder for injection: 750 mg/vial

Route/Dosage ⬆ ⬇

Complicated Skin/Skin Structure Infections

IV (Adults ): 10 mg/kg ever 24 hr for 7–14 days.

Renal Impairment

IV (Adults ): CCr 30–50 mL/min: 7.5 mg/kg every 24 hr; CCr 10–≤30 mL/min: 10 mg/kg every 48 hr.

Hospital-Acquired/Ventilator-Associated Bacterial Pneumonia

IV (Adults ): 10 mg/kg ever 24 hr for 7–21 days.

Renal Impairment

IV (Adults ): CCr 30–50 mL/min: 7.5 mg/kg every 24 hr; CCr 10–≤30 mL/min: 10 mg/kg every 48 hr.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Inhibits bacterial cell wall synthesis by interfering with the polymerization and cross-linking of peptidoglycan.

Therapeutic effects:

Bactericidal action against susceptible organisms.

Spectrum:

Active against Staphylococcus aureus (including methicillin-susceptible and -resistant strains), Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus anginosus (including S. anginosus, S. intermedius, and S. constellatus), and Enterococcus faecalis (vancomycin-susceptible strains only).

Classifications ⬆ ⬇

Therapeutic Classification: anti-infectives

Pharmacologic Classification: lipoglycopeptides

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Minimal distribution to tissues.

Metabolism/Excretion: Metabolism is not known; 76% excreted unchanged in urine <1% in feces.

Half-Life: 8 hr.

Time/Action Profile ⬆ ⬇

( plasma concentrations)

ROUTE		ONSET		PEAK		DURATION
IV		unknown		end of infusion		24 hr

Patient/Family Teaching ⬆ ⬇

Explain the purpose and side effects of telavancin. If an appointment is missed, contact health care provider as soon as possible to reschedule. Advise patient to read Medication Guide before starting and periodically during therapy in case of changes.
Instruct the patient to notify health care provider if symptoms do not improve.
Advise patient to report signs of superinfection (black, furry overgrowth on the tongue; vaginal itching or discharge; loose or foul-smelling stools).
Instruct patient to notify health care provider if fever and diarrhea develop, especially if stool contains blood, pus, or mucus. Advise patient not to treat diarrhea without consulting health care provider.
Inform patient that common side effects include taste disturbance, nausea, vomiting, headache, and foamy urine. Notify health care provider if difficulty breathing, chest pain, or palpitations occur.
Advise patients and family to call 911 and seek urgent treatment for signs and symptoms of infusion-related reactions or anaphylaxis (flushing; difficulty breathing; chest tightness; hives; rash; feeling light-headed; itching; swelling of the face, lips, tongue, or throat).
Instruct patient to notify health care provider of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care provider before taking any new medications.
Rep: May cause fetal harm. Advise women of reproductive potential to use effective contraception during therapy and for 2 days after last dose and to notify health care provider if pregnancy is suspected. Inform patient of pregnancy exposure registry that monitors pregnancy outcomes in women exposed to telavancin during pregnancy. Encourage pregnant patients to enroll in the VIBATIV pregnancy registry by calling 1-877-484-2700. May impair fertility in men.

Pronunciation ⬆ ⬇

Code ⬆

NDC Code

42513- Livzon Group Fuzhou Fuxing Pharmaceutical Co., Ltd.
- 42513-0012-
  - 42513-0012-1- .5 kg in 1 BOTTLE (42513-0012-1)

65129- ScinoPharm Taiwan Ltd.
- 65129-3104-
  - 65129-3104-0- 5.5 kg in 1 BAG (65129-3104-0)

66220- Cumberland Pharmaceuticals Inc.
- 66220-315- VIBATIV
  - 66220-315-11- 1 VIAL, SINGLE-DOSE in 1 CARTON (66220-315-11) / 50 mL in 1 VIAL, SINGLE-DOSE

66220- Cumberland Pharmaceuticals Inc.
- 66220-315- VIBATIV
  - 66220-315-22- 12 VIAL, SINGLE-DOSE in 1 CARTON (66220-315-22) / 50 mL in 1 VIAL, SINGLE-DOSE

66220- Cumberland Pharmaceuticals Inc.
- 66220-315- VIBATIV
  - 66220-315-44- 4 VIAL, SINGLE-DOSE in 1 CARTON (66220-315-44) / 50 mL in 1 VIAL, SINGLE-DOSE

71124- Samsung BioLogics Co. LTD
- 71124-0005-
  - 71124-0005-1- 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (71124-0005-1)

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Indications ⬇

Contraind./Precautions ⬆ ⬇