Description⁵

• Vancomycin vials available as 500mg or 1000mg.
• The vials contain vancomycin as a white powder for reconstitution. The solution is pH 2.5 – 4.5 when reconstituted with water, and has an osmolality at 5mg/ml of 249 mOsmol/kg (in dextrose 5%)and 291 mOsmol/kg (in sodium chloride 0.9%).

• The maintenance dose is charted on the drug chart as mg/dose.

Administration^3,5,8,9

1. Use appropriate powder space and reconstitute vial with Water for Injection to give a solution of 50mg/ml.
2. Then further dilute this solution to 5 mg/ml with sodium chloride 0.9% or glucose 5%.
3. For fluid restricted patients a solution of 10mg/ml can be used, but this must be infused via a central line. The higher concentration increases the risk of infusion-related adverse events
4. Each dose must be administered over at least one hour, preferably 2 hours. Can be infused through a 0.2 micron filter.
5. As vancomycin is irritant to the tissues, avoid intramuscular injection and extravasation when given intravenously.
6. Flush line with sodium chloride 0.9% before and after infusion.
7. Incompatible with: blood or blood products, cefotaxime, cefoxitin, ceftazidime, cefuroxime, heparin.

Observation and Documentation

• Monitor renal output. Take serum trough levels as advised (see Special Considerations).
• Monitor for adverse effects.
• Notify medical staff of potential drug interactions.

Storage

• Unopened - store at room temperature <25°C
• After reconstitution: discard remaining contents immediately after use. Do not store reconstituted vials.

References