G vanc

Description

G Vanc Injection (Vancomycin)

Manufacturer: Gland Pharma Pvt. Ltd. Generic Name: Vancomycin Availability: Available in Nepal

Indications:

• Septicemia
• Soft tissue infections
• Osteomyelitis
• Enterocolitis
• Colitis
• Serious staphylococcal or other Gram-positive infections
• Bacterial endocarditis

Dosage:

Adult Intravenous Dose:

• Severe staphylococcal or other Gram-positive infections, Endocarditis:
  • 500 mg every 6 hours, infused over at least 60 minutes OR
  • 1 g every 12 hours, infused over at least 100 minutes.
• Elderly: Dosage adjustment needed.

Child Intravenous Dose:

• Severe staphylococcal or other Gram-positive infections, Endocarditis:
  • <1 month: 15 mg/kg followed by 10 mg/kg IV every 12 hours for neonates in the first week of life and every 8 hours thereafter up to 1 month of age; longer dosing intervals recommended in premature infants.
  • >1 month: 10 mg/kg/day IV divided every 6 hours; individual dose not to exceed 1 g.

Renal Dose:

• Renal impairment:
  • Patient on intermittent hemodialysis: Loading dose: 15-25 mg/kg on day 1, followed by 5-10 mg/kg maintenance dose after each dialysis run.
  • Anuric patient (without kidney function) on dialysis: Initially, 15 mg/kg. Maintenance: 1.9 mg/kg every 24 hours.

Administration:

IV Preparation:

• Add 10 mL of Sterile Water for Injection (SWI) to a 500-mg vial and 20 mL of SWI to a 1-g vial to yield a 50 mg/mL solution. Further dilution is required, depending on the method of administration.
• Intermittent infusion: Dilute 500 mg with $\ge$100 mL of diluent and 1 g with $\ge$200 mL of diluent (Normal Saline [NS] or Dextrose 5% in Water [D5W]).
• Continuous infusion: Dilute in sufficient amount 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.

Contraindications:

• Hypersensitivity to the drug.
• History of impaired hearing.
• Intramuscular (IM) administration.

Precautions:

• Patients with allergic reaction to teicoplanin.
• Previous hearing loss.
• Inflammatory bowel disease.
• Renal impairment.
• Elderly patients.
• Pregnancy and lactation.

Monitoring Parameters:

• Regularly determine 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.

Pregnancy and Lactation:

• Lactation: Drug enters breast milk; not recommended.
• Pregnancy: Use with caution.

Interactions:

• General anesthesia may enhance the adverse effects of vancomycin.
• Increased risk of ototoxicity and nephrotoxicity with aminoglycosides, polymyxins, ciclosporin, cisplatin, and loop diuretics.
• Increased potential of neuromuscular blockade with suxamethonium or vecuronium.

Adverse Effects:

>10%:

• Erythematous rash on face and upper body (“red neck” or “red man syndrome,” related to infusion rate).
• Hypotension accompanied by flushing.

1-10%:

• Chills
• Drug fever
• Eosinophilia
• Rash
• Reversible neutropenia
• Phlebitis

<1%:

• Nephrotoxicity
• Ototoxicity (especially with large doses)
• Stevens-Johnson syndrome
• Thrombocytopenia
• Vasculitis

Potentially Fatal Adverse Effects:

• Stevens-Johnson syndrome.
• Toxic epidermal necrolysis.
• Blood dyscrasias such as neutropenia or thrombocytopenia.

Mechanism of Action: Vancomycin binds tightly to the D-alanyl-D-alanine portion of the cell wall precursor, causing blockage of glycopeptide polymerization, which produces immediate inhibition of cell wall synthesis and secondary damage to the cytoplasmic membrane.

Note: Farmaco Nepal drug index information on G Vanc Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.