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VANCOMYCIN PIL NEW 13 27 9 2018.Indd CLINICAL PHARMACOLOGY or less against most (>90%) strains of other listed microorganisms; CONTRAINDICATIONS observation of the patient is essential. If superinfection occurs during administration of vancomycin. Because the number of patients Vancomycin is poorly absorbed after oral administration. however, the safety and effectiveness of vancomycin in treating Vancomycin hydrochloride is contraindicated in patients with known therapy, appropriate measures should be taken. In rare instances, treated in this study was limited and vancomycin was administered clinical infections due to these microorganisms have not been hypersensitivity to this antibiotic. there have been reports of pseudomembranous colitis due to C. only in the second and third trimesters, it is not known whether In subjects with normal kidney function, multiple intravenous established in adequate and well-controlled clinical trials. difficile developing in patients who received intravenous vancomycin vancomycin causes fetal harm. Vancomycin should be given to a 2503-A dosing of 1 g of vancomycin (15 mg/kg) infused over 60 minutes WARNINGS hydrochloride for injection. pregnant woman only if clearly needed. produces mean plasma concentrations of approximately 63 mcg/ Aerobic gram-positive microorganisms Infusion Reactions Serial tests of auditory function may be helpful in order to minimize mL immediately after the completion of infusion, mean plasma Listeria monocytogenes Nursing Mothers concentrations of approximately 23 mcg/mL 2 hours after infusion, Rapid bolus administration (e.g., over several minutes) may be the risk of ototoxicity. Streptococcus pyogenes Vancomycin hydrochloride for injection is excreted in human milk. and mean plasma concentrations of approximately 8 mcg/mL 11 associated with exaggerated hypotension including shock and Streptococcus pneumoniae (including penicillin-resistant strains) Reversible neutropenia has been reported in patients receiving Caution should be exercised when vancomycin hydrochloride hours after the end of the infusion. rarely cardiac arrest. vancomycin hydrochloride for injection (see ADVERSE Rx only Streptococcus agalactiae for injection is administered to a nursing woman. Because of the Multiple dosing of 500 mg infused over 30 minutes produces mean ). Patients who will undergo prolonged therapy with Vancomycin hydrochloride for injection should be administered REACTIONS potential for adverse events, a decision should be made whether to plasma concentrations of about 49 mcg/mL at the completion of vancomycin hydrochloride for injection or those who are receiving in a diluted solution over a period of not less than 60 minutes to discontinue nursing or to discontinue the drug, taking into account infusion, mean plasma concentrations of about 19 mcg/mL 2 hours Anaerobic gram-positive microorganisms concomitant drugs that may cause neutropenia should have periodic avoid rapid-infusion-related reactions. Stopping the infusion usually the importance of the drug to the mother. Vancomycin Hydrochloride for after infusion, and mean plasma concentrations of about 10 mcg/mL Actinomyces species results in a prompt cessation of these reactions. monitoring of the leukocyte count. 6 hours after infusion. The plasma concentrations during multiple Lactobacillus species Vancomycin hydrochloride for injection is irritating to tissue and must Injection, USP dosing are similar to those after a single dose. Nephrotoxicity Pediatric Use Susceptibility Testing be given by a secure IV route of administration. Pain, tenderness, In pediatric patients, it may be appropriate to confirm desired For Intravenous Use The mean elimination half-life of vancomycin from plasma is 4 to 6 Systemic vancomycin exposure may result in acute kidney injury and necrosis occur with intramuscular (IM) injection of vancomycin For specific information regarding susceptibility test interpretive vancomycin serum concentrations. Concomitant administration hours in subjects with normal renal function. In the first 24 hours, (AKI). The risk of AKI increases as systemic exposure/serum levels hydrochloride for injection or with inadvertent extravasation. criteria and associated test methods and quality control standards of vancomycin and anesthetic agents has been associated with To reduce the development of drug-resistant bacteria and maintain about 75% of an administered dose of vancomycin is excreted in increase. Monitor renal function in all patients, especially patients Thrombophlebitis may occur, the frequency and severity of which recognized by FDA for this drug, please see: https://www.fda.gov/ erythema and histamine-like flushing in pediatric patients (see the effectiveness of Vancomycin Hydrochloride for Injection, USP urine by glomerular filtration. Mean plasma clearance is about 0.058 with underlying renal impairment, patients with co-morbidities that can be minimized by administering the drug slowly as a dilute STIC. PRECAUTIONS). and other antibacterial drugs, Vancomycin Hydrochloride for L/kg/h, and mean renal clearance is about 0.048 L/kg/h. Renal predispose to renal impairment, and patients receiving concomitant solution (2.5 to 5 g/L) and by rotation of venous access sites. Injection, USP should be used only to treat or prevent infections dysfunction slows excretion of vancomycin. In anephric patients, therapy with a drug known to be nephrotoxic. There have been reports that the frequency of infusion-related events Geriatric Use that are proven or strongly suspected to be caused by bacteria. the average half-life of elimination is 7.5 days. The distribution INDICATIONS AND USAGE Ototoxicity (including hypotension, flushing, erythema, urticaria, and pruritus) coefficient is from 0.3 to 0.43 L/kg. There is no apparent metabolism Vancomycin Hydrochloride for Injection, USP is indicated for the The natural decrement of glomerular filtration with increasing age increases with the concomitant administration of anesthetic agents. DESCRIPTION of the drug. About 60% of an intraperitoneal dose of vancomycin treatment of serious or severe infections caused by susceptible Ototoxicity has occurred in patients receiving vancomycin may lead to elevated vancomycin serum concentrations if dosage Infusion-related events may be minimized by the administration of is not adjusted. Vancomycin dosage schedules should be adjusted Vancomycin Hydrochloride for Injection, USP is a lyophilized for administered during peritoneal dialysis is absorbed systemically in strains of methicillin-resistant (β-lactam-resistant) staphylococci. It hydrochloride for injection. It may be transient or permanent. It has vancomycin as a 60-minute infusion prior to anesthetic induction. The preparing intravenous (IV) infusions, in vials each containing 6 hours. Serum concentrations of about 10 mcg/mL are achieved is indicated for penicillin-allergic patients, for patients who cannot been reported mostly in patients who have been given excessive in elderly patients (see DOSAGE AND ADMINISTRATION). safety and efficacy of vancomycin administered by the intrathecal the equivalent of 500 mg or 1 g vancomycin base. 500 mg of by intraperitoneal injection of 30 mg/kg of vancomycin. However, receive or who have failed to respond to other drugs, including doses, who have an underlying hearing loss, or who are receiving (intralumbar or intraventricular) route or by the intraperitoneal route the base are equivalent to 0.34 mmol. When reconstituted with the safety and efficacy of the intraperitoneal use of vancomycin has the penicillins or cephalosporins, and for infections caused by concomitant therapy with another ototoxic agent such as an Information for Patients have not been established by adequate and well controlled trials. Sterile Water for Injection to a concentration of 50 mg/mL pH not been established in adequate and well-controlled trials (see vancomycin-susceptible organisms that are resistant to other aminoglycoside. Vancomycin should be used with caution in patients Patients should be counseled that antibacterial drugs including of the solution is between 2.5 and 4.5. This product is oxygen PRECAUTIONS). antimicrobial drugs. Vancomycin Hydrochloride for Injection, USP is with renal insufficiency because the risk of toxicity is appreciably Reports have revealed that administration of sterile vancomycin by vancomycin hydrochloride for injection, should only be used to sensitive. Vancomycin Hydrochloride for Injection, USP should be indicated for initial therapy when methicillin-resistant staphylococci increased by high, prolonged blood concentrations. the intraperitoneal route during continuous ambulatory peritoneal treat bacterial infections. They do not treat viral infections (e.g., Total systemic and renal clearance of vancomycin may be reduced in administered intravenously in diluted solution (see DOSAGE AND are suspected, but after susceptibility data are available, therapy dialysis (CAPD) has resulted in a syndrome of chemical peritonitis. the common cold). When vancomycin hydrochloride for injection the elderly. Vancomycin is approximately 55% serum protein bound Dosage of vancomycin hydrochloride for injection must be adjusted ADMINISTRATION). AFTER RECONSTITUTION FURTHER should be adjusted accordingly. To date, this syndrome has ranged from cloudy dialysate alone to is prescribed to treat a bacterial infection, patients should be as measured by ultrafiltration at vancomycin serum concentrations for patients with renal dysfunction (see PRECAUTIONS and DILUTION IS REQUIRED BEFORE USE.
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