Vancomycin
Trade name
DBL Vancomycin, Vancocin CP, Vancomycin (Alphapharm), Vancomycin (AN), Vancomycin (Juno)
Presentation and preparation
|
Vial size
(powder volume) |
Fluid to add
|
Volume to add
|
Resulting concentration
|
|---|---|---|---|
| 500 mg (negligible) |
Water for injections | 10 mL | 50 mg/mL |
| 1 g (negligible) |
Water for injections | 20 mL | 50 mg/mL |
Reconstitute to 50 mg/mL.
IV administration
Do not administer without further dilution.
Doses greater than 500 mg: maximum rate 10 mg/minute.
Maximum concentration if necessary: 10 mg/mL, and infuse via a central line. Risk of infusion reactions is increased with higher concentrations.
Patients with a history of red man syndrome should receive their doses over 90 – 120 minutes. Infusion concentration should be reduced, if possible.
Neonates and infants less than 90 days old: Total daily dose may be given as a continuous infusion over 24 hours following an initial loading dose.
Loading dose: dilute to 5 mg/mL or weaker and give over 1 hour. Refer to local protocol.
Other routes of administration
IM: Contraindicated.
SC: Not recommended.
Compatible IV fluids
Glucose 5%
Sodium chloride 0.9%
Vancomycin 5 mg/mL or weaker:
Glucose 5% and sodium chloride 0.9%
Glucose 10%
Hartmann's
Y-site only:
Plasma-Lyte 148
Potassium chloride 20 mmol/L
Additional information
Extravasation risk: pH 2.5 – 4.5.
Observe closely for anaphylactic reactions.
Rapid infusion may cause red man syndrome; symptoms include flushing or rash on the upper body and neck, muscle spasm of the chest and back.
If this occurs:
- cease infusion and inform medical staff
- check dosage and infusion rate
- wait for symptoms to resolve
- reduce infusion concentration, if possible
- resume infusion at a slower rate
- report and document adverse reaction
Therapeutic Drug Monitoring required; refer to local guidelines.
Protect from light during storage.