Vancomycin

Vancomycin is an antibiotic which, when administered orally, kills diarrhea-causing Clostridium difficile (C diff) bacteria in the intestines.

Overview

As an antibiotic, vancomycin works by killing C diff bacteria and preventing their growth in the intestines. C diff is a kind of bacteria that infects the intestines, causing severe diarrhea in the patient. Oral Vancomycin is also used for the treatment of Entorocolitis (staph infections caused by certain bacteria such as Staphylococcus aureus).

Vancomycin is typically not absorbed in the body, and cannot treat viral infections (flu, colds, etc.), nor can it be used to treat bacterial infections in other parts of the body. An intravenous form of vancomycin is instead used for fighting severe infections in other parts of the body.

Conditions treated:

  • Clostridium difficile infection
  • Entorocolitis (Staphylococcal Bacteria infections)

Type of medicine:

  • Antibiotic

Vancomycin side effects

Patients may experience some abdominal pain or stomach ache while under treatment with this medication. These symptoms are not uncommon and are usually no cause for alarm. The patient should immediately notify their healthcare professional if they develop a fever, chills, or difficulty hearing. In case of an allergic reaction to the medicine (which is not very likely), the patient must get emergency medical help. The following are the symptoms to watch out for: rash, swelling, itching, dizziness and difficulty with breathing. Patients are advised to contact a doctor if they notice any other effects not mentioned.

Not all of the side effects listed are likely to be experienced, but when any of them occur, the patient is advised to get medical attention as soon as possible.

Common side effects:

  • Nausea
  • Vomiting
  • Bloating of the face, hands, arms, lower legs, or feet
  • Convulsions
  • Bladder pain
  • Decreased urine
  • Bloody or cloudy urine
  • Difficult, or painful urination
  • Frequent urge to urinate
  • Fever
  • Loss of appetite
  • Irregular heartbeat
  • Dry mouth
  • Increased thirst
  • Mood changes
  • Muscle cramps or pain
  • Lower back or side pain
  • Rapid weight gain
  • Unusual fatigue or weakness
  • Shortness of breath
  • Numbness or tingling in the hands, feet, or lips
  • Unusual weight gain or loss
  • Less common:
  • Changes in urination frequency or amount of urine
  • Difficulty breathing
  • Weakness
  • Drowsiness
  • Rare
  • Hives
  • Scaling or welting of the skin
  • Redness or other discoloration of the skin
  • Skin rash
  • Incidence not known:
  • Blurred vision
  • Chills
  • Black, tarry stools
  • Loosening, peeling, or blistering of the skin
  • Bleeding gums
  • Confusion
  • Continuing ringing or buzzing in the ears
  • Cough
  • Diarrhea
  • Difficulty with swallowing
  • Faintness, Dizziness, or lightheadedness when getting up suddenly from a lying or sitting position
  • Fast heartbeat
  • Feeling of constant movement of self of self or surroundings
  • Feeling of fullness in the ears
  • Hearing loss
  • Itching
  • Joint or muscle pain
  • Loss of balance
  • Lower back or side pain
  • Pale skin
  • Pinpoint red spots on the skin
  • Puffiness/swelling of the eyelids or around the eyes, tongue, lips, or face
  • Sore throat
  • Red skin lesions, often with a purple center
  • Spinning sensations
  • Troubled breathing with exertion
  • Tightness in the chest
  • Red, irritated eyes
  • Ringing or buzzing in the ears
  • Ulcers, sore, or white spots in the mouth or lips
  • Unusual bleeding or bruising
  • Sweating
  • Patients should seek advice from their doctor on the various ways to reduce or prevent these side effects.
  • Common:
  • Abdominal pain or stomach ache
  • Passing gas
  • Excess gas in stomach or intestines
  • Headache
  • Bitter or unpleasant taste
  • Mouth irritation
  • Back pain
  • Incidence not known:
  • Depression
  • Trouble sleeping
  • Difficulty having a bowel movement (stool)

Some patients may also experience other side effects not listed here. It is recommended to check with one's doctor as soon as possible if any other side effects are experienced.

Dosage

Vancomycin should be taken orally as directed, usually three to four times a day for seven to 10 days. To improve the taste, the patient may dilute the oral solution in about ounce of water. Dosages should be taken at evenly-spaced intervals throughout the day for best results. This ensures that the level of medication in the blood remains constant. Do not stop taking the medication without your physician’s approval—take it for the full duration prescribed. If therapy is stopped too soon, a re-infection could occur.

Dosing for this medication varies from patient to patient. It's important that the patient follows their doctor’s instructions or the directions provided on the label. The information provided below indicates only the average or usual doses for Vancomycin. One should not change dose if it’s different, unless instructed by their doctor.

Vancomycin dosages (capsules or oral solution):

To treat C. difficile-associated diarrhea:

Adults—125 milligrams (mg) orally four times a day for 10 days.

Children—Dosage depends on body weight and should be determined by the healthcare professional. The typical dose is 40 mg per kg of body weight. This is divided into three to four doses and taken for between seven and 10 days. Total daily dose usually does not exceed 2000 mg per day.

To treat Staphylococcal enterocolitis:

Adults—500 mg to 2000 mg orally, divided into three to four doses for seven to 10 days.

Children— Dosage depends on body weight and should be determined by the healthcare professional. The typical dose is 40 mg per kg of body weight. This is divided into three to four doses and taken for between seven and 10 days. Total daily dose usually does not exceed 2000 mg per day.

How to take vancomycin:

The amount of medication taken depends on the potency of the medicine. In addition to the number of doses per day, the intervals allowed between those doses, and the duration of treatment all depend on what medical condition you are using the medicine for.

The patient should take his or her medication exactly as their doctor prescribed. It's also important to read the prescription label carefully and follow all the directions given. Patients must not alter doses by taking either smaller or larger quantities, or by using the medicine longer than prescribed. Taking larger doses will not make the drug more effective, and may actually cause fatal side effects.

As with other prescription drugs, patients should also use this medication for the full duration as prescribed by their healthcare professional. This is the case even when symptoms show improvement before the infection is fully cleared. Skipping doses may increase the chances of further infection, which may be resistant to the antibiotic. Vancomycin does not treat viral infections.

It is also important to note that vancomycin could potentially cause temporary or permanent hearing loss. If a patient starts experiencing hearing problems or ringing in your ears, they should stop using the medication at once and contact their healthcare professional. Hearing may have to be tested on an ongoing basis so as to ascertain that the medication is not causing any problems. Patients should, therefore, visit their healthcare professionals regularly for testing.

Missed dose:

If the patient missed a dose, they must take it as soon as they remember. However, they should skip that dose if the next scheduled dose is too close at that moment. It is not advised to attempt to make up for the missed dose by ingesting extra medicine.

What to do in case of an overdose:

In case of an overdose, call your nearest poison control center immediately. The national poison hotline for US residents is 1-800-222-1222. Those in Canada can call their local poison center directly. It's very important that emergency medical attention is sought as soon as an overdose is suspected.

What to avoid:

Patients should follow their healthcare professional’s instructions concerning beverages, foods or activities to avoid.

Drug Interactions

Although there are medications that should not be used together, there may be cases where they may be used together even if some interaction is expected. In such cases, the doctor may alter the dosage, or advise certain precautions. When taking vancomycin, it’s absolutely vital for a patient to inform their doctor whether they are also using any of the drugs highlighted below. The interactions given here have been chosen based on how significant they’re likely to be when used together with vancomycin. The list may not be all-inclusive.

Using vancomycin with any of these medicines is not recommended, except under special circumstances as determined by the doctor. The patient is strongly advised to talk to their healthcare provider about all of his/her medical conditions, allergies, and all the medicines they use. This information is vital to the doctor as they prepare the patient's prescription. If the doctor has to prescribe both medications together, they may change dosages or the frequency of taking one or both medicines:

  • Gentamicin
  • Cholera Vaccine, Live
  • Piperacillin
  • Amikacin
  • Tobramycin

Using vancomycin together with any of the following may increase the risk of some side effects occurring, even though the combination might be the best therapy for a patient. If the doctor has to prescribe both medications together, they may change dosages or the frequency of taking one or both medicines:

  • Succinylcholine
  • Warfarin

Other interactions

It may be necessary to avoid consuming certain foods, beverages or substances around the time of taking certain medications, as unpleasant interactions may occur. Using tobacco or alcohol in particular with certain medicines may cause interactions. Have a talk with your doctor about the use of alcohol, tobacco, or certain foods.

Other medical conditions

Having other medical issues may affect usage of this medicine. The patient should inform his or her doctor if they suffer from any other medical conditions, and in particular:

  • Hearing problems—using vancomycin may make hearing problems worse
  • Kidney disease
  • Bowel disorders—the risk of severe side effects may be higher with IBS, Cron’s disease and other bowel disorders.

Warnings

For any medication, it’s important to weigh the potential risks of taking it versus the good it can do. The doctor should help his or her patient make this decision. Here are some of the most important factors to consider:

Allergies

This medicine should not be used by a patient with a vancomycin allergy. The patient must inform their doctor if they have had any allergic reactions to this or other medicines. They should also tell them if they have other allergies, such as to animals, dyes, foods, preservatives etc.

Pediatric

No conclusive studies have been done to establish the relationship between age and vancomycin’s effects among children. The efficacy and safety of this medication have not been established.

Geriatric

To date, no studies have found geriatric-specific problems that would impact on the efficacy of vancomycin in the elderly. Elderly patients are however likely to have kidney problems, and this calls for caution or adjustments in doses for this medicine.

Additionally, to make sure vancomycin is safe, patients should tell their doctor if they have:

  • Hearing problems
  • Kidney disease
  • Intestinal disorders, e.g. ulcerative colitis, inflammatory bowel syndrome, or Crohn's disease

Is vancomycin safe for pregnant or breastfeeding mothers?

Vancomycin is classified by the FDA as a pregnancy category C medicine. This means use of vancomycin during pregnancy has not been sufficiently evaluated; it is therefore not known if vancomycin can cause harm to the unborn child. The patient must her doctor know if she is pregnant, or if she is planning to get pregnant while using this medicine. Due to lack of data on safety, vancomycin should be prescribed to pregnant mothers only when deemed absolutely necessary.

When administered intravenously, vancomycin will be excreted in breast milk. When taken orally, however, vancomycin levels in the blood are not significantly high, and it’s not yet known if it is also excreted in breast milk. Because safety data is unavailable, nursing mothers are advised to take vancomycin with caution. Patients may want to weigh the potential risks of taking the drug against its potential benefits.

This medicine must no be shared with anyone. This is because it has been specifically prescribed for one patient and their current condition. Unless directed by the doctor, the patient should not use the medication later to treat another infection. It is the doctor's responsibility to determine and prescribe the right medication in each case.

Storage

Vancomycin should be stored in the refrigerator. Warm temperatures must be avoided at all times. Unused medication Should be discarded after fourteen days.

Summary

Vancomycin, when taken orally, is used for the treatment of Clostridium difficile-associated diarrhea, which results from bacterial infection in the intestines. It is also used to treat staph infections caused by certain bacteria. It works by killing, as well as suppressing the growth of more bacteria. This medicine is only used for clearing bacterial infections in the gut only, and not any other parts of the body. The intravenous form of vancomycin is used for infections in other parts.

A common side effect of taking this medicine is abdominal pain, which is fairly common, and medical attention is usually not needed. Emergency help should be sought if the patient experiences other severe side effects.

Taking vancomycin requires following certain precautions. If the patient has an allergy of any kind, or if he or she suffers from any other medical problem, they should be sure to inform their doctor. Pregnant or nursing mothers should use vancomycin with caution as no safety data on the drug is available yet. It's also vital for the patient to let the doctor know if they are currently taking other medications. This is because certain medications when used together with vancomycin may cause interactions and aggravate some side effects.

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Last Reviewed:
December 24, 2017
Last Updated:
December 22, 2017
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