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Vancogen
Last reviewed: 03.07.2025
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A glycopeptidic antibiotic for intravenous infusions, used only in inpatient departments of medical institutions. It is intended for the treatment of severe infections, the active component is vancomycin hydrochloride (produced by Amycolatopsis orientalis).
Indications Vancogen
Severe clinical cases of infectious diseases caused by microorganisms sensitized to the active ingredient, due to the lack of effectiveness of penicillin, cephalosporin and other antibacterial drugs or hypersensitivity to them in the patient; bacterial sepsis; bacterial inflammation of the endocardium; preoperative antibiotic therapy for heart valve replacement; inflammation (abscess) of the lung; infectious and inflammatory diseases of the bones, bone marrow and central nervous system; enterocolitis.
Release form
Dry substance for infusion solution, packaged in vials containing 500 and 1000 mg of active substance.
Pharmacodynamics
The bactericidal effect is based on inhibition of the biosynthesis of the bacterial cell membrane and reduction of its strength. Vancomycin hydrochloride modifies the synthesis of the ribonucleic acid molecule of the pathogenic microorganism.
The active ingredient is active against gram-positive microbes: staphylococci, in particular, golden and epidermal (methicillin-resistant strains inclusive), streptococci - ß-hemolytic group A and group B, pneumococci (penicillin-resistant strains inclusive), green streptococci, enterococci, listeria, diphtheria bacilli, clostridia, actinomycetes.
Suppresses the activity of most microorganisms sensitive to vancomycin hydrochloride with a minimum serum level of this drug up to 5 mcg/ml. For tolerant Staphylococcus aureus, a concentration of the drug from 10 mcg/ml to 20 mcg/ml is lethal.
Pharmacokinetics
The active ingredient is practically not absorbed in the gastrointestinal tract, which is why intravenous continuous (over the course of an hour) drip infusions of vancomycin hydrochloride are used.
The highest post-infusion serum concentration is directly proportional to the administered dosage: drip infusion of 500 mg of the antibiotic leads to a serum concentration of approximately 33 mcg/ml (1000 ml - 63 mcg/ml). After 12 hours, the residual level of the drug is from 5 to 10 mcg/ml. It binds to albumin by 55%.
The active ingredient penetrates well into interstitial fluids - joint, pleural, pericardial and others. It overcomes the blood-brain barrier only in case of inflammation of the membranes of the brain.
Approximately three-quarters of the administered amount of this substance is eliminated with the urinary organs through the glomerular filter during the first day; in individuals over 18 years of age without renal pathologies, the half-life of vancomycin hydrochloride is from four to six hours. In the presence of anuria, this time period is extended to 7.5 days.
Dosing and administration
Childhood age of the patient
The recommended dosage is 10 mg per kilogram of the child's body weight, administered intravenously over an hour every six hours.
Treatment of newborns begins with a dosage of 15 mg per kilogram of the child's weight, then the dosage is reduced to 10 mg per kilogram of weight every 12 hours during the first seven days after birth. From the eighth day to one month of age, 10 mg per kilogram of weight is administered every eight hours. It is administered by drip over the course of an hour.
Vancogen Dosage Regimens in the Neonatal Period
Age since pregnancy start¹ (weeks) |
Chronological age (days) |
Whey Creatinine² (mg/dl) |
Dosage (mg/kg) |
Less than 30 |
No more than seven |
The data is not informative³ |
15 in a day |
From the eighth day of life |
No more than 1.2 |
10 in 12 hours |
|
30-36 |
No more than 14 |
The data is not informative³ |
10 in 12 hours |
Over 14 |
Not more than 0.6 |
10 in 8 hours |
|
Over 14 |
0.7-1.2 |
10 in 12 hours |
|
More than 36 |
No more than seven |
The data is not informative³ |
10 in 12 hours |
From the eighth day of life |
Not more than 0.6 |
10 in 8 hours |
|
From the eighth day of life |
0.7-1.2 |
10 in 12 hours |
¹ – age of intrauterine development plus chronological age;
² – if the serum creatinine level is more than 1.2 mg/dl, the drug is dosed at 15 mg/kg daily;
³ – such patients need to regularly monitor the serum level of the active ingredient of the drug.
Dosage for patients over 18 years of age
The recommended dosage of the drug for people over 18 years of age without renal pathologies is 2000 mg per day. It can be administered four times at 500 mg or twice at 1000 mg, maintaining equal time intervals. Drip injection of Vancogen is performed at a rate of 10 mg / min.
For elderly and/or overweight patients, the dosage of the drug may be adjusted depending on the plasma content of the active ingredient.
For patients with pathological processes in the kidneys, Vancogen is dosed individually, based on serum creatinine levels.
Vancogen Dosage in Individuals with Renal Dysfunction
Creatinine clearance (ml/min) |
Vancogen dosage (mg/24 h) |
100 |
1545 |
90 |
1390 |
80 |
1235 |
70 |
1080 |
60 |
925 |
50 |
770 |
40 |
620 |
30 |
465 |
20 |
310 |
10 |
155 |
The above calculations are not applicable to individuals with no urine output in the bladder. They are recommended to start therapy with a dosage of 15 mg per kilogram of body weight to accelerate the creation of optimal concentrations of vancomycin hydrochloride in the blood plasma. The dosage that maintains the serum level of its content is determined at the rate of 1.9 mg per kilogram of body weight per day. For patients with severe renal dysfunction, intravenous drip infusion of maintenance doses of Vancogen (250-1000 mg) is recommended once at intervals of several days, with anuria - 1000 mg once at intervals of seven to ten days.
Preparation and use
Intravenous infusions: To obtain a composition with a vancomycin hydrochloride density of 50 mg/ml, add 10 ml of water for injection to a vial with 500 ml of the active ingredient; with 1000 ml - 20 ml. This composition must be diluted with a glucose solution for infusions (5%) or isotonic (0.9% NaCl) to obtain a density of the active substance of 5 mg/ml: a composition with 500 mg of the active ingredient is diluted in 100 ml of 5% glucose solution for infusions (isotonic, 0.9% NaCl), with 1000 mg - in 200 ml. If necessary, ready-made infusion solutions can be kept at a temperature of 2-8 ° C (in the refrigerator), but not more than 24 hours.
Antibiotic-associated pseudomembranous colitis caused by Peptoclostridium difficile or staphylococcal enterocolitis require oral administration of the drug. Adult dosage is 500-1000 mg per day. The calculation for children is based on 40 mg per kilogram of the child's weight per day. A single dosage is calculated by dividing into three or four doses. Duration of treatment is from a week to ten days.
The oral solution is prepared by dissolving the powder from the bottle in 30 ml of water. The resulting solution can be combined with liquid syrups or food flavorings to improve the taste.
[ 1 ]
Use Vancogen during pregnancy
This medicine is not recommended for use during pregnancy, with the exception of vital cases. The active ingredient is found in breast milk, therefore, breastfeeding is interrupted during the therapeutic course of vancomycin.
Contraindications
Cochlear neuritis, hearing loss; renal pathologies; first three months of pregnancy, sensitization to the ingredients of the solution.
Side effects Vancogen
Short-term intravenous injection of the drug is associated with the risk of anaphylaxis, a rush of blood to the upper body, combined with rashes on the face, neck, arms, legs, and spasmodic contractions of the chest and back muscles. As a rule, such phenomena last no more than a third of an hour, but not always. Rarely, such phenomena occur even at the recommended infusion rate.
The greatest danger is the drug's side effects on the hearing organs and kidney function. The appearance of symptoms of hearing loss, such as tinnitus, is a signal to stop treatment with Vancogen due to the possibility of irreversible changes in the hearing organs.
Severe renal dysfunction as a result of drug therapy is rarely detected. It is manifested by an increase in the concentration of plasma creatinine and azotemia. It develops more often with high-dose therapy. There are isolated cases of interstitial nephritis with the combined use of aminoglycoside antibacterial agents or with renal failure in the patient. Discontinuation of administration leads to restoration of normal renal function.
Reversible disorders of hematopoiesis may be observed in the form of a decrease in the number of neutrophils, leukocytes, platelets, and an increase in the number of eosinophils.
Skin reactions may include urticaria, malignant exudative erythema, Lyell's syndrome, and vasculitis.
Dyspeptic disorders and uncontrollable diarrhea can be considered as a symptom of the development of superinfection.
Overdose
The symptoms of drug overdose are expressed in the aggravation of side effects. Its administration is stopped and therapeutic measures are carried out according to the symptoms.
Recommended measures: fluid administration and determination of serum density of the active substance. Hemofiltration is preferable for elimination of excess drug. It is more effective than hemodialysis in this case.
Interactions with other drugs
The combined use of Vancogen with drugs that may have a toxic effect on the central nervous system and/or urinary organs (uregit, cisplatin, aminoglycoside antibacterial agents, muscle relaxants) may mutually increase intoxication.
Combination with ototoxic drugs may mutually enhance the negative impact on the hearing organs.
Combination with antihistamines may camouflage the signs of Vancogen ototoxicity (tinnitus).
Concomitant use with anesthetics increases the possibility of developing arterial hypotension, skin and anaphylactoid reactions.
Vancomycin hydrochloride in solution has a pronounced acidity, which cannot be neglected when mixing with other substances is necessary.
Cross-resistance of Vancogen with other antibacterial drugs is not known.
Combined use with chloramphenicol, synthetic steroid hormones, methicillin, euphyllin, cephalosporin antibiotics, heparin derivatives, phenobarbital.
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Storage conditions
Shelf life
Shelf life is 3 years.
The prepared solution for infusions is suitable for use within 24 hours from the moment of preparation, provided that it is stored at a temperature of 2-8°C.
Attention!
To simplify the perception of information, this instruction for use of the drug "Vancogen" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.