Vanko

Vanco is a glycopeptide that is used for injection.

Indications Vanko

It is indicated for the elimination of infectious processes caused by gram-positive bacteria sensitive to drugs. In addition, it is intended for people with a history of intolerance to cephalosporins and penicillins. It promotes the treatment of:

• sepsis, endocarditis, and osteomyelitis;
• infectious processes in the central nervous system;
• infectious processes in the lower respiratory tract (such as pneumonia);
• infectious processes in soft tissues and skin;
• staphylococcal food poisoning (oral use);
• pseudomembranous colitis (oral administration).

Prevents the development of endocarditis in people with penicillin intolerance, as well as infections in the oral cavity and ENT organs after surgical operations.

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Release form

It is available in powder form – in 500 mg vials.

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Pharmacodynamics

Vancomycin is an antibiotic from the glycopeptide category. The bactericidal properties of the drug are due to the suppression of the processes of binding of the cell walls of pathogenic microbes.

It is active against gram-positive microorganisms: staphylococci (including Staphylococcus aureus and Staphylococcus epidermidis, as well as methicillin strains), streptococci (including pneumococcus, Streptococcus pyogenes and Streptococcus agalactiae), fecal enterococci, clostridia (including Clostridium difficile) and diphtheria corynebacterium.

Inactive against fungi, gram-negative microbes, and mycobacteria.

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Pharmacokinetics

When vancomycin is administered in an amount of 1 g, its values in the blood plasma are approximately 63 mg/l (at the moment after the infusion), and then 23 mg/l (after 2 hours) and 8 mg/l (after 11 hours). About 55% of the substance is synthesized with plasma protein.

The overwhelming concentration of the component is observed in the peritoneal, serous, pleural, and also synovial and pericardial fluids. In addition, in the muscle and valves of the heart, as well as in the urine. Vancomycin weakly penetrates the membrane of the brain (if it is in a normal state, in case of inflammation the substance easily penetrates through it).

The half-life is 4-6 hours in people with normal kidney function. About 75% of the dose is excreted in the urine by glomerular filtration in the first 24 hours. A small portion of the substance is excreted in the bile.

In people with renal dysfunction, excretion of the component is delayed. In patients with anuria, the average half-life is 7.5 days.

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Dosing and administration

The drug is administered intravenously. It is used to eliminate life-threatening infectious processes. It is prohibited to administer Vanco in the form of a bolus injection or intramuscularly, since this procedure is very painful, and in addition, it can cause necrosis at the injection site.

The body's reactions to the administration of drugs depend on the rate of administration, as well as the concentration of the solution used. Adults require a concentration of no more than 5 mg/ml with a rate of administration of no more than 10 mg/minute. For some patients who need to limit fluid intake, a concentration of no more than 10 mg/ml should be used, and the rate should be no more than 10 mg/minute. High concentrations of drugs increase the likelihood of adverse reactions.

For children aged 12 years and over and adults: the standard intravenous dosage is 2 mg per day (500 mg every 6 hours or 1 g every 12 hours). The solution is administered for at least 1 hour.

For newborns under 7 days: the initial dosage is 15 mg/kg, then 10 mg/kg every 12 hours. For newborns over 7 days and up to 1 month – the first dosage is also 15 mg/kg, then 10 mg/kg every 8 hours.

For children over 1 month and up to 12 years old – 40 mg/kg per day in separate doses (10 mg/kg), which should be administered every 6 hours.

The concentration of the injection solution of the drug in children should be no more than 2.5-5 mg/ml. The administration of the solution lasts at least 1 hour.

Children may be administered no more than 15 mg/kg at a time. No more than 60 mg/kg may be administered per day (total amount – no more than 2 g).

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Use Vanko during pregnancy

There is no information on the safety of using the drug in pregnant women. It is prohibited to use in the 1st trimester. The drug can be prescribed in the 2nd-3rd trimesters, but only if there are vital indications, when the possible benefit to the woman will be higher than the risk of developing negative consequences for the fetus. During the intake, it is necessary to monitor the serum concentration of vancomycin.

The medicine passes into breast milk, therefore breastfeeding should be avoided during treatment.

Contraindications

A contraindication is the patient's intolerance to vancomycin.

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Side effects Vanko

Most often, side effects to the use of drugs are pseudo-allergies and phlebitis, which develop due to rapid administration of the solution. In addition, the following negative effects may be observed:

• organs of the lymphatic and circulatory systems: eosinophilia, thrombocyto- or neutropenia, and agranulocytosis occasionally develop;
• immune system: intolerance reactions or anaphylaxis are occasionally observed;
• auditory organs: sometimes hearing deteriorates temporarily, in rare cases vertigo may develop or ringing or noises in the ears may appear. Ototoxic effects mainly develop as a result of using large doses of drugs or as a result of combined administration with other drugs with an ototoxic effect (also with hearing problems or with weakened renal function);
• cardiovascular system: mainly thrombophlebitis or decreased blood pressure; less frequently, vasculitis develops; isolated cases – cardiac arrest occurs (such symptoms usually occur due to rapid infusion);
• respiratory organs: mainly dyspnea develops;
• Digestive organs: occasionally – diarrhea, as well as vomiting along with nausea; pseudomembranous colitis develops occasionally;
• subcutaneous tissue and skin: mucous membranes often become inflamed, urticaria and itching appear, and exanthema develops; occasionally - foliaceous dermatitis, Lyell's or Stevens-Johnson syndromes, and in addition IgA bullous dermatitis;
• kidneys and urinary system: renal failure often develops, which manifests itself as an increase in the level of urea and creatinine in the serum; tubulointerstitial nephritis (especially in the case of a combination of drugs with aminoglycosides or with a history of renal dysfunction) or acute renal failure rarely occurs;
• General disorders, as well as local reactions: often there are spasms or pain in the muscles of the back and chest, as well as redness of the upper parts of the face and body; occasionally there are chills, drug-induced fever, as well as drug-induced rashes against the background of eosinophilia and systemic manifestations (DRESS syndrome). Also, occasionally, the growth of insensitive fungi or microbes begins, itching and inflammation at the injection site appear, as well as wheezing; isolated severe lacrimation occurs, which sometimes lasts up to 10 hours. As a result of accelerated infusion, anaphylaxis may occur. Such reactions, as a rule, pass after 20 minutes, but sometimes they can last for several hours. In case of slow administration of the drug, such effects are almost not observed. Due to incorrect (not intravenous) administration, inflammation, tissue necrosis, irritation, and pain may develop at the site of the procedure.

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Overdose

Overdose may increase side effects.

Treatment is required to maintain normal glomerular filtration. Dialysis will not remove the drug. Hemodialysis and hemofiltration using polysulfone membranes help to increase the clearance rate of vancomycin and reduce its blood levels. There is no specific antidote.

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Interactions with other drugs

As a result of combined or sequential administration of vancomycin with other drugs that have a nephro- or neurotoxic effect (among these are ethacrynic acid, gentamicin, Amphotericin B, and also kanamycin, streptomycin, amikacin and neomycin; also viomycin with tobramycin and colistin with bacitracin, and also polymyxin B with cisplatin), the nephro- or ototoxic effect of vancomycin may increase.

Since a synergistic effect develops in combination with gentamicin, it is necessary to limit the maximum dosage of Vanco to 500 mg every 8 hours.

Anesthetics in combination with vancomycin increase the likelihood of hypotension, and also provoke anaphylaxis, histamine-like flushes and the development of erythema.

If drugs are administered during surgery or immediately after it, the effect of muscle relaxants (for example, succinylcholine) may increase or be prolonged.

The combination of the drug with aminoglycosides has a synergistic effect in vitro on Staphylococcus aureus, non-enterococcal type D streptococci, and also on various types of Streptococcus species and enterococci.

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Storage conditions

The medicine should be kept in conditions standard for medicinal products, inaccessible to small children. Temperature – no more than 25°C.

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Shelf life

Vanco is permitted to be used for 3 years from the date of release of the drug.

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