Vancomycin
- Atc Codes:A07AA09#J01XA01
- CAS Codes:1404-93-9#1404-90-6
- PHARMGKB ID:1404-93-9#1404-90-6
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Vancocin, Vancomycin; Belgium: Vamysin, Vancocin; Bulgaria: Edicin, Vancocin, Vancoled, Vancomycin; Czech Republic: Edicin, Vancocin; Denmark: Vancocin, Vancomycin; Estonia: Edicin, Vancomycin; Finland: Vancomycin; France: Vancomycine; Germany: Vanco, Vancomycin; Greece: Vancocin, Vancomycin, Voncon; Hungary: Vancocin, Vancomycin; Ireland: Vancocin, Vancomycin; Italy: Vanco, Vancocina, Zengac; Latvia: Vancomycin; Lithuania: Vancomycin; Luxembourg: Vamysin, Vancomycine; Netherlands: Vancocin, Vancomycine; Poland: Edicin, Vancocin, Vancoled, Vancomycin, Vanmixan; Portugal: Vancomicina; Slovakia: Edicin; Spain: Diatracín, Vancomicina; Sweden: Vancocin, Vancomycin; UK: Vancocin, Vancomycin.
North America
Canada: Vancocin, Vancomycin; USA: Vancocin, Vancomycin.
Latin America
Argentina: Icoplax, Riverván, Vancomax, Vancomicina, Vancotenk, Varedet; Brazil: Amplobac, Vanclomin, Vancoabbott, Vancocina, Vancomicina, Vancoson, Vancotrat; Mexico: Estavam, Vacsol, Vanaurus, Vancocín, Vancomicina, Vancox.
Asia
Japan: Solrein, Storacin, Vancomycin, Vanmycin.
Drug combinations
Chemistry
Vancomycin Hydrochloride: C~66~H~75~Cl~2~N~9~O~24~ HCl. Mw: 1485.71. (1) (S~a~)-(3S,6R,7R,22R,23S,26S,36R,38aR)-44-[[2-O-(3-Amino-2,3,6-trideoxy-3-C-methyl-α-L-lyxo-hexopyranosyl)-β-D-glucopyranosyl]oxy]-3-(carbamoylmethyl)-10,19-dichloro-2,3,4,5,6,7,23,24,25,26,36,37,38,38a-tetradecahydro-7,22,28,30,32-pentahydroxy-6-[(2R)-4-methyl-2-(methylamino)valeramido]-2,5,24,38,39-pentaoxo-22H-8,11:18,21-dietheno-23,36-(iminomethano)-13,16:31,35-dimetheno-1H,16H-[1,6,9]oxadiazacyclohexadecino[4,5-m][10,2,16]benzoxadiazacyclotetracosine-26-carboxylic acid, monohydrochloride; (2) [3S-[3R*,6S*(S*),7S*,22S*,23R*,26R*,36S*,38aS*]]-3-(2-Amino-2-oxoethyl)-44-[[2-O-(3-amino-2,3,6-trideoxy-3-C-methyl-α-L-lyxo-hexopyranosyl)-β-D-glucopyranosyl]oxy]-10,19-dichloro-2,3,4,5,6,7,23,24,25,26,36,37,38,38a-tetradecahydro-7,22,28,30,32-pentahydroxy-6-[[4-methyl-2-(methylamino)-1-oxopentyl]amino]-2,5,24,38,39-pentaoxo-22H-8,11:18,21-dietheno-23,36-(iminomethano)-13,16:31,35-dimetheno-1H,16H-[1,6,9]oxadiazacyclohexadecino[4,5-m][10,2,16]benzoxadiazacyclotetracosine-26-carboxylic acid, monohydrochloride. CAS-1404-93-9; CAS-1404-90-6 (vancomycin).
Pharmacologic Category
Miscellaneous Antibacterials; Glycopeptides. (ATC-Code: A07AA09; J01XA01).
Mechanism of action
Inhibits bacterial cell wall synthesis by blocking glycopeptide polymerization through binding tightly to D-alanyl-D-alanine portion of cell wall precursor.
Therapeutic use
Treatment of infections caused by staphylococcal species and streptococcal species. Used orally for staphylococcal enterocolitis or for antibiotic-associated pseudomembranous colitis produced by C. difficile.
Pregnancy and lactiation implications
Crosses placenta. Has not caused adverse fetal effects (including hearing loss or nephrotoxicity), when administered during pregnancy. Case report published of a vancomycin dose rapidly administered over 3 minutes leading to maternal hypotension and fetal bradycardia. Pharmacokinetics of vancomycin may be altered during pregnancy. Recommended for use in pregnant women for prevention of early-onset group B streptococcal disease in newborns. Use during breast-feeding not recommended.
Unlabeled use
Bacterial endophthalmitis.
Contraindications
Hypersensitivity to vancomycin or any component of the formulation. Avoid in previous severe hearing loss.
Warnings and precautions
May cause nephrotoxicity. May cause neurotoxicity. Ototoxicity (proportional to amount of drug given and duration of treatment), and tinnitus or vertigo (may be indications of vestibular injury and impending bilateral irreversible damage) can occur. Increased risk of neutropenia with prolonged therapy (>1 week) or total doses exceeding 25 g. Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea and pseudomembranous colitis. Use with caution in renal impairment or those receiving other nephrotoxic or ototoxic drugs. Oral vancomycin only indicated for treatment of pseudomembranous colitis due to C. difficile, and enterocolitis due to S. aureus; not effective for systemic infections. Parenteral vancomycin not effective for treatment of colitis due to C. difficile and enterocolitis due to S. aureus. Rapid I.V. administration may result in hypotension, flushing, erythema, urticaria, and/or pruritus.