Vancocin CP

Description

Vancocin CP Injection: Uses, Dosing, and Important Information

Vancocin CP Injection contains vancomycin, a powerful antibiotic used to treat serious bacterial infections, especially those caused by Gram-positive bacteria that are resistant to other antibiotics.

What Is Vancocin CP Used For?

Vancocin CP Injection is used to treat severe infections, including:

• Septicaemia: A serious bloodstream infection.
• Soft tissue infections: Infections affecting muscles, fat, and other soft tissues.
• Osteomyelitis: Bone infections.
• Enterocolitis/Colitis: Inflammation of the intestines, particularly when caused by certain bacteria.
• Serious staphylococcal or other Gram-positive infections: Infections caused by bacteria like Staphylococcus (including MRSA) and other similar bacteria.
• Bacterial endocarditis: An infection of the heart’s inner lining, often involving the heart valves.

Dosing Information

Vancocin CP is given intravenously (IV) only and must be administered under medical supervision.

Adult Dosing

• Severe Staphylococcal or other Gram-positive Infections, Endocarditis:
  • 500 mg every 6 hours, infused over at least 60 minutes.
  • Alternatively, 1 gram (1000 mg) every 12 hours, infused over at least 100 minutes.
• Elderly Patients: Dosage adjustments may be necessary. Your doctor will determine the appropriate dose.

Child Dosing (Intravenous)

• Severe Staphylococcal or other Gram-positive Infections, Endocarditis:
  • For infants less than 1 month old:
    • Initial dose: 15 mg/kg, followed by 10 mg/kg IV.
    • Dosing frequency: Every 12 hours for neonates in their first week of life, and every 8 hours thereafter up to 1 month of age.
    • Longer dosing intervals may be recommended for premature infants.
  • For children older than 1 month: 10 mg/kg/day IV, divided and given every 6 hours.
    • Important: An individual dose should not exceed 1 gram (1000 mg).

Renal Dosing (Kidney Impairment)

Dosage adjustments are crucial for patients with kidney problems to prevent serious side effects. Your doctor will monitor your kidney function and vancomycin levels in your blood.

• Patient on Intermittent Hemodialysis:
  • Loading dose: 15-25 mg/kg on Day 1.
  • Maintenance dose: 5-10 mg/kg after each dialysis session.
• Anuric Patient (no kidney function) on Dialysis:
  • Initially: 15 mg/kg.
  • Maintenance: 1.9 mg/kg every 24 hours.
• Creatinine Clearance (CrCl) Dosage Recommendations:
  • CrCl < 20 mL/min: Longer dosing intervals are needed; dosage will be determined by monitoring vancomycin levels in your blood.
  • CrCl 20-49 mL/min: Initially, 15-20 mg/kg per dose (typically 750-1500 mg) every 24 hours.
  • CrCl > 50 mL/min: Initially, 15-20 mg/kg per dose (typically 750-1500 mg) every 8-12 hours.

How Vancocin CP Is Administered

Vancocin CP is given as an intravenous infusion.

IV Preparation

• To prepare the initial solution: Add 10 mL of Sterile Water for Injection (SWI) to a 500 mg vial, or 20 mL of SWI to a 1-gram vial. This creates a 50 mg/mL solution.
• Further Dilution: This initial solution must be further diluted before infusion:
  • For a 500 mg dose, dilute with at least 100 mL of diluent (Normal Saline or 5% Dextrose in Water).
  • For a 1 gram dose, dilute with at least 200 mL of diluent (Normal Saline or 5% Dextrose in Water).
• For Continuous Infusion: Dilute in enough fluid to allow infusion over 24 hours.

IV Administration

• Intermittent Infusion (preferred): Administer over 60 minutes. The infusion rate should not exceed 10 mg per minute.
• Continuous Infusion: Administer over 24 hours.

Important: Rapid or bolus (quick) administration must be avoided as it can cause a sudden drop in blood pressure (hypotension).

Important Warnings and Precautions

Do Not Use Vancocin CP If:

• You have a known hypersensitivity (allergy) to vancomycin.
• You have a history of impaired hearing.
• It is not given as an intramuscular (IM) injection.

Special Considerations:

• Allergic Reactions: Use with caution if you have a history of allergic reactions to teicoplanin (another antibiotic).
• Hearing Loss: Use with caution if you have previous hearing loss.
• Inflammatory Bowel Disease: Use with caution.
• Kidney Impairment: Requires careful monitoring and dosage adjustment.
• Elderly Patients: Dosage adjustments are needed due to potential age-related decline in kidney function.
• Pregnancy and Lactation:
  • Pregnancy: Use during pregnancy should be carefully considered by your doctor, weighing benefits against risks.
  • Lactation (Breastfeeding): Vancomycin can pass into breast milk; therefore, it is not recommended for breastfeeding mothers.
• Monitoring: Your doctor will regularly perform:
  • Serial tests of your auditory function (hearing).
  • Vancomycin concentrations in your blood to ensure levels are safe and effective.
  • Periodic urinalysis and kidney function tests.
  • Leukocyte count (white blood cell count) during prolonged therapy.

Possible Drug Interactions

Tell your doctor about all medications you are taking, including over-the-counter drugs and herbal supplements, as Vancocin CP can interact with them.

• General Anesthetics: May increase the adverse effects of vancomycin.
• Increased Risk of Toxicity: Increased risk of ototoxicity (damage to the ear leading to hearing problems) and nephrotoxicity (kidney damage) when taken with:
  • Aminoglycosides (e.g., gentamicin, tobramycin)
  • Polymyxins
  • Ciclosporin
  • Cisplatin
  • Loop diuretics (e.g., furosemide)
• Neuromuscular Blockade: Increased potential for muscle weakness or paralysis when taken with neuromuscular blocking agents like suxamethonium or vecuronium.

Possible Side Effects

Like all medicines, Vancocin CP can cause side effects. Some are common and mild, while others can be serious. If you experience any severe or concerning side effects, contact your doctor immediately.

• Very Common (>10%):
  • Erythematous rash on face and upper body (Red Neck or Red Man Syndrome): This is related to the infusion rate and can be managed by slowing down the infusion.
  • Hypotension (low blood pressure) accompanied by flushing.
• Common (1-10%): Chills, drug fever, eosinophilia (increase in a type of white blood cell), rash, reversible neutropenia (temporary low white blood cell count), phlebitis (vein inflammation at injection site).
• Less Common (<1%):
  • Nephrotoxicity (kidney damage): Especially with large doses.
  • Ototoxicity (hearing damage).
  • Stevens-Johnson syndrome (a severe skin reaction).
  • Thrombocytopenia (low platelet count).
  • Vasculitis (inflammation of blood vessels).

Potentially Fatal Side Effects:

• Stevens-Johnson syndrome and toxic epidermal necrolysis (TEN): These are severe, life-threatening skin reactions.
• Blood dyscrasias: Serious blood disorders such as severe neutropenia (very low white blood cell count) or thrombocytopenia (very low platelet count).

How Vancocin CP Works

Vancomycin works by binding strongly to a specific part of the bacterial cell wall precursor (D-alanyl-D-alanine). This action blocks the formation of the bacterial cell wall (glycopeptide polymerization), leading to immediate inhibition of cell wall synthesis. This also causes secondary damage to the bacterial cell’s cytoplasmic membrane, ultimately killing the bacteria. It is particularly effective against Gram-positive bacteria.

Note: This information about Vancocin CP 500mg Injection, manufactured by Astra Zeneca (generic name: Vancomycin), is available in Nepal. This drug index information is for general knowledge only and is not intended for diagnosis, medical advice, or treatment. It should never replace the professional judgment of a healthcare provider. Always consult your doctor or pharmacist for medical advice specific to your condition.