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In the U.S.—

Vancocin

In Canada—

Vancocin

• Antibacterial, systemic

Vancomycin (van-koe-MYE-sin) belongs to the family of medicines called antibiotics. Antibiotics are medicines used in the treatment of infections caused by bacteria. They work by killing bacteria or preventing their growth. Vancomycin will not work for colds, flu, or other virus infections.

Vancomycin is used to treat infections in many different parts of the body. It is sometimes given with other antibiotics. Vancomycin also is used in patients with heart valve disease (e.g., rheumatic fever) or prosthetic (artificial) heart valves who are allergic to penicillin. Under certain circumstances, this medicine also may be used to prevent endocarditis (inflammation of the lining of the heart) in these patients who are having dental work done or surgery on the upper respiratory tract (for example, nose or throat). Vancomycin also may be used for other conditions as determined by your doctor.

Vancomycin given by injection is used mainly for serious infections for which other medicines may not work. However, this medicine may cause some serious side effects, including damage to your hearing and kidneys. These side effects may be more likely to occur in elderly patients. You and your doctor should talk about the good this medicine will do as well as the risks associated with receiving it.

Vancomycin is available only with your doctor's prescription, in the following dosage form:

Parenteral
• Injection (U.S. and Canada)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For vancomycin, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to vancomycin. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Vancomycin has not been reported to cause hearing loss or kidney damage in the infants of women given vancomycin during their second or third trimester of pregnancy.

Breast-feeding—Vancomycin passes into breast milk. However, this medicine has not been reported to cause problems in nursing babies.

Children—Vancomycin can cause serious side effects in any patient. Therefore, it is especially important that you discuss with the child's doctor the good that this medicine will do as well as the risks of using it.

Older adults—Elderly people may be especially sensitive to the effects of vancomycin. This may increase the chance of hearing loss or kidney damage.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving vancomycin, it is especially important that your health care professional know if you are taking any of the following:

• Aminoglycosides by injection (amikacin [e.g., Amikin], gentamicin [e.g., Garamycin], kanamycin [e.g., Kantrex], netilmicin [e.g., Netromycin], streptomycin, tobramycin [e.g., Nebcin]) or
• Amphotericin B by injection (e.g., Fungizone) or
• Bacitracin by injection or
• Bumetanide by injection (e.g., Bumex) or
• Capreomycin (e.g., Capastat) or
• Cisplatin (e.g., Platinol) or
• Cyclosporine (e.g., Sandimmune) or
• Ethacrynic acid by injection (e.g., Edecrin) or
• Furosemide by injection (e.g., Lasix) or
• Paromomycin (e.g., Humatin) or
• Polymyxins, especially colistimethate (e.g., Coly-Mycin M) and polymyxin B (e.g., Aerosporin) or
• Streptozocin (e.g., Zanosar) or
• Vecuronium (e.g., Norcuron)—Use of these medicines with vancomycin may increase the chance of side effects

• Dexamethasone (e.g., Dalalone L.A., Decadrol, Decadron)—Use of dexamethasone with vancomycin may keep vancomycin from working properly

Other medical problems—The presence of other medical problems may affect the use of vancomycin. Make sure you tell your doctor if you have any other medical problems, especially:

• Kidney disease or
• Loss of hearing, or deafness, history of—Patients with kidney disease or a history of hearing loss or deafness may have an increased chance of side effects

Some medicines given by injection may sometimes be given at home to patients who do not need to be in the hospital for the full time of treatment. If you are receiving this medicine at home, make sure you clearly understand and carefully follow your doctor's instructions.

To help clear up your infection completely, vancomycin must be given for the full time of treatment, even if you begin to feel better after a few days. Also, this medicine works best when there is a constant amount in the blood. To help keep the amount constant, vancomycin must be given on a regular schedule.

Dosing—

The dose of vancomycin will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of vancomycin. If your dose is different, do not change it unless your doctor tells you to do so.

• For injection dosage form:
  • For treatment of bacterial infections:
    • Adults and teenagers—7.5 mg per kg (3.4 mg per pound) of body weight, or 500 mg, injected into a vein every six hours; or 15 mg per kg (6.8 mg per pound) of body weight, or 1 gram, injected into a vein every twelve hours.
    • Children 1 month to 12 years of age—10 mg per kg (4.5 mg per pound) of body weight injected into a vein every six hours; or 20 mg per kg (9.1 mg per pound) of body weight injected into a vein every twelve hours.
    • Infants 1 week to 1 month of age—15 mg per kg (6.8 mg per pound) of body weight injected into a vein at first, then 10 mg per kg (4.5 mg per pound) of body weight injected into a vein every eight hours.
    • Newborns up to 1 week of age—15 mg per kg (6.8 mg per pound) of body weight injected into a vein at first, then 10 mg per kg (4.5 mg per pound) of body weight injected into a vein every twelve hours.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your health care professional immediately if any of the following side effects occur:

• Less common
  • Change in the frequency of urination or amount of urine;  chills;  coughing;  difficulty in breathing;  drowsiness;  fever;  increased thirst;  loss of appetite;  nausea or vomiting;  sore throat;  weakness 
  
  

• Rare
  • Abdominal tenderness;  abnormal bleeding or bruising;  large blisters on arms, legs, hands, feet, or upper body;  loss of hearing;  ringing or buzzing or a feeling of fullness in the ears;  severe abdominal or stomach cramps and pain;  watery and severe diarrhea, which may also be bloody 
  
  

  Some of the above side effects also may occur up to several weeks after you stop receiving this medicine.

• Symptoms of “red man syndrome”--Less common
  • Chills or fever;  fainting;  fast heartbeat;  hives;  itching ;  low blood pressure;  nausea or vomiting;  rash or redness of the face, base of neck, upper body, back, and arms 
  
  

  Symptoms of the “red man syndrome” are more common when vancomycin is given by direct or rapid injection.

The above side effects, except the “red man syndrome,” are more likely to occur in the elderly, who are usually more sensitive to the effects of vancomycin.

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 06/15/1999