Vancard IV Infusion
Vancomycin
500mg
Techno Drugs Ltd.
| Pack size | 1's Pack |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 244.78 AED |
Available as:
Indications
Vancard IV Infusion is used for:
Septicaemia, Soft tissue infections, Osteomyelitis, Enterocolitis, Colitis, Serious staphylococcal or other Gm +ve infections, Bacterial endocarditis
Adult Dose
Intravenous
Severe staphylococcal or other Gram-positive infections, Endocarditis
Adult: 500 mg 6 hrly, infused over at least 60 min or 1 g 12 hrly, infused over at least 100 min.
Elderly: Dosage adjustment needed.
Oral
Staphylococcal enterocolitis
Adult: 500-2,000 mg in 3-4 divided doses for 7-10 days.
Clostridioides difficile infection
Adult: 125 mg 6 hourly for 10 days for the 1st episode of non-severe infection; may increase to 500 mg 6 hourly for 10 days for severe or complicated infection.
Max: 2,000 mg daily. For multiple recurrences: 125 mg 4 times daily for 10 days followed by either dose tapering (gradually decreasing dose until 125 mg daily) or pulse treatment (125-500 mg every 2-3 days for at least 3 weeks).
Child Dose
Intravenous
Children
Severe staphylococcal or other Gram-positive infections, Endocarditis
<1 month: 15 mg/kg followed by 10 mg/kg IV q12hr for neonates in first week of life and q8hr thereafter up to 1 month of age; longer dosing intervals recommended in premature infants
>1 month: 10 mg/kg/day IV divided q6hr; individual dose not to exceed 1 g
Oral
Staphylococcal enterocolitis
Child: 40 mg/kg in 3-4 divided doses for 7-10 days.
Max: 2,000 mg daily.
Clostridioides difficile infection
Child: <12 years As oral solution: 10 mg/kg 6 hourly for 10 days.
Max: 2,000 mg daily. >12 years Same as adult dose.
Renal Dose
Renal impairment: Patient on intermittent haemodialysis: Loading dose: 15-25 mg/kg on day 1, followed by 5-10 mg/kg maintenance dose after each dialysis run. Anuric patient (w/o kidney function) on dialysis: Initially, 15 mg/kg. Maintenance: 1.9 mg/kg 24 hrly.
CrCl (ml/min) Dosage Recommendation
<20 Longer intervals; determine by serum concentration monitoring.
20-49 Initially, 15-20 mg/kg/dose (usual: 750-1,500 mg) 24 hrly.
>50 Initially, 15-20 mg/kg/dose (usual: 750-1,500 mg) 8-12 hrly.
Administration
IV Preparation
Add 10 mL of SWI to 500-mg vial and 20 mL of SWI to 1-g vial to yield 50 mg/mL solution; further dilution is required, depending on method of administration
Intermittent infusion: Dilute 500 mg with >100 mL of diluent and 1 g with >200 mL of diluent (NS or D5W)
Continuous infusion: Dilute in sufficient amounts to permit infusion over 24 hours
IV Administration
Intermittent (preferred): Administer over 60 minutes; not to exceed 10 mg/min
Continuous: Administer over 24 hours
Oral
May be taken with or without food.
Oral Preparation
Tap the bottom edges of the bottle to loosen the powder
Shake the diluent for a few seconds
Open the diluent and transfer about half the required volume of diluent into the vancomycin powder bottle
Shake the powder bottle vertically for ~45 seconds
Add remaining diluent into powder bottle; shake the bottle for ~30 seconds
Instruct patient to shake reconstituted solution well before each use and to use an oral dosing device that measures the appropriate volume of the oral solution in milliliters
Contra Indications
Hypersensitivity to the drug; history of impaired hearing; IM administration.
Precautions
Patient w/ allergic reaction to teicoplanin, previous hearing loss, inflammatory bowel disease. Renal impairment. Elderly. Pregnancy and lactation. Monitoring Parameters Determine regularly serial tests of auditory function and serum or blood vancomycin concentrations during treatment. Periodic urinalysis and renal function tests. Monitor leukocyte count in prolonged therapy.
Lactation: Drug enters breast milk; not recommended
Pregnancy-Lactation
Pregnancy
Animal reproduction studies have not been conducted with vancomycin
Unknown whether vancomycin can affect reproduction capacity
In a controlled clinical study, potential ototoxic and nephrotoxic effects of vancomycin on infants were evaluated when administered to pregnant women for serious staphylococcal infections complicating IV drug abuse
Single-dose flexible bags only
This formulation is not recommended for use during pregnancy because it contains the excipients, PEG 400 and NADA, which caused fetal malformations in animal reproduction studies (see Contraindications)
Perform a pregnancy test in females of reproductive potential prior to prescribing this formulation
Lactation
Vancomycin is excreted in human milk
Exercise caution when vancomycin is administered to a nursing woman
Because of the potential for adverse events, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother
Interactions
General anaesth may enhance the adverse effects of vancomycin.
Increased risk of ototoxicity and nephrotoxicity w/ aminoglycosides, polymyxins, ciclosporin, cisplatin and loop diuretics. Increased potential of neuromuscular blockade w/ suxamethonium or vecuronium.
Increased frequency of erythema, histamine-like flushing, and anaphylactic reactions with anaesthetic agents.
May enhance anaesthetic-induced myocardial depression.
May reduce the efficacy of oral contraceptives.
Concomitant use with other potentially ototoxic, neurotoxic, or nephrotoxic drugs (e.g. aminoglycosides, amphotericin B, polymyxin B, bacitracin, colistin, piperacillin/tazobactam, cisplatin, loop diuretics, NSAIDs) may potentiate the toxicity of vancomycin.
Bile acid sequestrants (e.g. colestyramine) may diminish the therapeutic effect of oral vancomycin; administer several hours apart.
May enhance the neuromuscular-blocking effect of neuromuscular-blocking agents (e.g. suxamethonium, vecuronium).
Potentially Fatal: May increase the risk of anaphylactic shock with teicoplanin.
Adverse Effects
Side effects of Vancomycin :
10% (Oral)
Nausea (17%)
Abdominal pain (15%)
Hypokalemia (13%)
1-10% (Oral)
Vomiting (9%)
Diarrhea (9%)
Pyrexia (9%)
Flatulence (8%)
Urinary tract infection (8%)
Headache (7%)
Peripheral edema (6%)
Back pain (6%)
Fatigue (5%)
Nephrotoxicity (5%)
Frequency Not Defined (IV)
Immune system disorders: Hypersensitivity reactions (eg, anaphylaxis, “red man syndrome”)
Skin and subcutaneous tissue disorders: Severe dermatologic reactions such as toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome (SJS), drug reaction with eosinophilia and systemic symptoms (DRESS), acute generalized exanthematous pustulosis (AGEP), and linear lgA bullous dermatosis (LABD)
Renal and urinary disorders: Acute kidney injury and interstitial nephritis
Ear and labyrinth disorders: Tinnitus, hearing loss, vertigo
Blood and lymphatic system disorders: Agranulocytosis, neutropenia, pancytopenia, leukopenia, thrombocytopenia, eosinophilia
Gastrointestinal disorders: Pseudomembranous colitis Cardiac disorders: Cardiac arrest, chest pain
General disorders and administration site conditions: General discomfort, fever, chills, phlebitis, injection site irritation, injection site pain and necrosis following intramuscular injection, chemical peritonitis following intraperitoneal administration (Vancomycin not approved for IM and intraperitoneal administration)
Laboratory abnormalities: Elevated blood urea nitrogen, elevated serum creatinine
Musculoskeletal and connective tissue disorders: Muscle pain
Nervous system disorders: Dizziness
Respiratory, thoracic and mediastinal disorders: Wheezing, dyspnea
Vascular disorders: Hypotension, shock, vasculitis
Potentially Fatal: Stevens-Johnson syndrome; toxic epidermal necrolysis, blood dyscrasias such as neutropenia or thrombocytopenia.
Mechanism of Action
Vancomycin binds tightly to D-alanyl-D-alanine portion cell wall precursor causing blockage of glycopeptide polymerisation which produces immediate inhibition of cell wall synthesis and secondary damage to the cytoplasmic membrane.
Note
Vancard 500mg IV Infusion manufactured by Techno Drugs Ltd.. Its generic name is Vancomycin. Vancard is availble in Bangladesh.
Farmaco BD drug index information on Vancard IV Infusion is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.