Identification

Name
Vancomycin
Accession Number
DB00512  (APRD01287, EXPT03217)
Type
Small Molecule
Groups
Approved
Description

Antibacterial obtained from Streptomyces orientalis. It is a glycopeptide related to ristocetin that inhibits bacterial cell wall assembly and is toxic to kidneys and the inner ear.

As of January 29 2018, CutisPharma's Firvanq is the only FDA approved vancomycin oral liquid treatment option available for the the treatment of Clostridium difficile associated diarrhea and enterocolitis caused by Staphylococcus aureus, including methicillin-resistant strains [LP1196]. Such an oral liquid formulation is expected to make Clostridium difficile associated diarrhea therapy more accessible in comparison to previously available specialty compounding products [LP1196].

Structure
Thumb
Synonyms
  • (1S,2R,18R,22S,25R,28R,40S)-22-(2-amino-2-oxoethyl)-48-[2-O-(3-amino-2,3,6-trideoxy-3-methyl-α-L-lyxo-hexopyranosyl)-β-D-glucopyranosyloxy]-5,15-dichloro-2,18,32,35,37-pentahydroxy-19-[(N-methyl-D-leucyl)amino]-20,23,26,42,44-pentaoxo-7,13-dioxa-21,24,27,41,43-pentaazaoctacyclo[26.14.2.23,6.214,17.18,12.129,33.010,25.034,39]pentaconta-3,5,8(48),9,11,14,16,29(45),30,32,34,36,38,46,49-pentadecaene-40-carboxylic acid
  • (2.2Sp,3.5Sa,2.6Sp)-O4.2,C3.4:C5.4,O4.6:C3.5,C2.7-tricyclo[N-methyl-D-leucyl-3-chloro-(R)-β-hydroxy-D-tyrosyl-L-asparaginyl-D-2-(4-{[2-O-(3-amino-2,3,6-trideoxy-3-C-methyl-α-L-lyxo-hexopyranosyl)-β-D-glucopyranosyl]oxy}phenyl)glycyl-D-2-(4-hydroxyphenyl)glycyl-3-chloro-(R)-β-hydroxy-L-tyrosyl-L-2-(3,5-dihydroxyphenyl)glycine]
  • Vancomicina
  • Vancomycine
  • Vancomycinum
Product Ingredients
IngredientUNIICASInChI Key
Vancomycin hydrochloride71WO621TJD1404-93-9LCTORFDMHNKUSG-XTTLPDOESA-N
Product Images
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
FirvanqKitOralCutis Pharma, Inc.2018-01-26Not applicableUs
FirvanqKitOralCutis Pharma, Inc.2018-01-26Not applicableUs
FirvanqKitOralCutis Pharma, Inc.2018-01-26Not applicableUs
FirvanqKitOralCutis Pharma, Inc.2018-01-26Not applicableUs
Sterile Vancomycin HCl 5.0gm/vialPowder, for solution5 gIntravenousLyphomed, Division Of Fujisawa Canada Inc.1992-12-311996-09-10Canada
Sterile Vancomycin HCl USP 1.0gm/vialPowder, for solution1 gIntravenousLyphomed, Division Of Fujisawa Canada Inc.1992-12-311996-09-10Canada
Sterile Vancomycin HCl USP 500mg/vialPowder, for solution500 mgIntravenousLyphomed, Division Of Fujisawa Canada Inc.1992-12-311996-09-10Canada
Sterile Vancomycin Hydrochloride, USPPowder, for solution1 gIntravenousPartners Health Care, Inc.1987-12-312008-02-15Canada
Sterile Vancomycin Hydrochloride, USPPowder, for solution500 mgIntravenousPartners Health Care, Inc.1959-12-312008-02-15Canada
VancocinCapsule250 mgOralMerus Labs International Inc.1989-12-31Not applicableCanada
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Jamp-vancomycinPowder, for solution500 mgIntravenousJamp Pharma Corporation2014-09-22Not applicableCanada
Jamp-vancomycinCapsule250 mgOralJamp Pharma Corporation2014-03-26Not applicableCanada
Jamp-vancomycinPowder, for solution5 gIntravenousJamp Pharma Corporation2014-09-22Not applicableCanada
Jamp-vancomycinCapsule125 mgOralJamp Pharma Corporation2014-03-26Not applicableCanada
Jamp-vancomycinPowder, for solution1 gIntravenousJamp Pharma Corporation2014-09-22Not applicableCanada
Jamp-vancomycinPowder, for solution10 gIntravenousJamp Pharma Corporation2014-06-06Not applicableCanada
Mylan-vancomycin Hydrochloride for Injection, USPPowder, for solution500 mgIntravenousMylan PharmaceuticalsNot applicableNot applicableCanada
Mylan-vancomycin Hydrochloride for Injection, USPPowder, for solution5 gIntravenousMylan PharmaceuticalsNot applicableNot applicableCanada
Mylan-vancomycin Hydrochloride for Injection, USPPowder, for solution1 gIntravenousMylan PharmaceuticalsNot applicableNot applicableCanada
Mylan-vancomycin Hydrochloride for Injection, USPPowder, for solution10 gIntravenousMylan PharmaceuticalsNot applicableNot applicableCanada
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing End
Vancomycin HClVancomycin hydrochloride (4.2 mg/mL)Injection, solutionIntravenousCantrell Drug Company2013-05-01Not applicableUs
Vancomycin HClVancomycin hydrochloride (6 mg/mL)Injection, solutionIntravenousCantrell Drug Company2012-05-25Not applicableUs
Vancomycin HClVancomycin hydrochloride (5 mg/mL)Injection, solutionIntravenousCantrell Drug Company2012-05-25Not applicableUs
International/Other Brands
COVANC (Nucleus) / Vancocin / Vancoled
Categories
UNII
6Q205EH1VU
CAS number
1404-90-6
Weight
Average: 1449.254
Monoisotopic: 1447.430199787
Chemical Formula
C66H75Cl2N9O24
InChI Key
MYPYJXKWCTUITO-LYRMYLQWSA-N
InChI
InChI=1S/C66H75Cl2N9O24/c1-23(2)12-34(71-5)58(88)76-49-51(83)26-7-10-38(32(67)14-26)97-40-16-28-17-41(55(40)101-65-56(54(86)53(85)42(22-78)99-65)100-44-21-66(4,70)57(87)24(3)96-44)98-39-11-8-27(15-33(39)68)52(84)50-63(93)75-48(64(94)95)31-18-29(79)19-37(81)45(31)30-13-25(6-9-36(30)80)46(60(90)77-50)74-61(91)47(28)73-59(89)35(20-43(69)82)72-62(49)92/h6-11,13-19,23-24,34-35,42,44,46-54,56-57,65,71,78-81,83-87H,12,20-22,70H2,1-5H3,(H2,69,82)(H,72,92)(H,73,89)(H,74,91)(H,75,93)(H,76,88)(H,77,90)(H,94,95)/t24-,34+,35-,42+,44-,46+,47+,48-,49+,50-,51+,52+,53+,54-,56+,57+,65-,66-/m0/s1
IUPAC Name
(1S,2R,18R,19R,22S,25R,28R,40S)-48-{[(2S,3R,4S,5S,6R)-3-{[(2S,4S,5S,6S)-4-amino-5-hydroxy-4,6-dimethyloxan-2-yl]oxy}-4,5-dihydroxy-6-(hydroxymethyl)oxan-2-yl]oxy}-22-(carbamoylmethyl)-5,47-dichloro-2,18,32,35,37-pentahydroxy-19-[(2R)-4-methyl-2-(methylamino)pentanamido]-20,23,26,42,44-pentaoxo-7,13-dioxa-21,24,27,41,43-pentaazaoctacyclo[26.14.2.2³,⁶.2¹⁴,¹⁷.1⁸,¹².1²⁹,³³.0¹⁰,²⁵.0³⁴,³⁹]pentaconta-3,5,8,10,12(48),14,16,29(45),30,32,34,36,38,46,49-pentadecaene-40-carboxylic acid
SMILES
CN[C@H](CC(C)C)C(=O)N[C@@H]1[C@H](O)C2=CC=C(OC3=C(O[C@@H]4O[C@H](CO)[C@@H](O)[C@H](O)[C@H]4O[C@H]4C[C@](C)(N)[C@H](O)[C@H](C)O4)C4=CC(=C3)[C@@H](NC(=O)[C@H](CC(N)=O)NC1=O)C(=O)N[C@@H]1C3=CC(=C(O)C=C3)C3=C(O)C=C(O)C=C3[C@H](NC(=O)[C@@H](NC1=O)[C@H](O)C1=CC(Cl)=C(O4)C=C1)C(O)=O)C(Cl)=C2

Pharmacology

Indication

A variety of dosage forms (for example, oral, injections, etc.) exist for the treatment of serious or severe infections caused by susceptible strains of methicillin-resistant (beta-lactam-resistant) staphylococci [FDA Label].

Additionally, a unique FDA approved oral liquid treatment is also available and indicated for the treatment of Clostridium difficile associated diarrhea and enterocolitis caused by Staphylococcus aureus, including methicillin-resistant strains [9].

Associated Conditions
Pharmacodynamics

Vancomycin is a branched tricyclic glycosylated nonribosomal peptide produced by the fermentation of the Actinobacteria species Amycolatopsis orientalis (formerly Nocardia orientalis) [10]. It is often reserved as the "drug of last resort", used only after treatment with other antibiotics has failed. Vancomycin has been shown to be active against most strains of the following microorganisms, both in vitro and in clinical infections: Listeria monocytogenes, Streptococcus pyogenes, Streptococcus pneumoniae (including penicillin-resistant strains), Streptococcus agalactiae, Actinomyces species, and Lactobacillus species. The combination of vancomycin and an aminoglycoside acts synergistically in vitro against many strains of Staphylococcus aureus, Streptococcus bovis, enterococci, and the viridans group streptococci [FDA Label].

Mechanism of action

The bactericidal action of vancomycin results primarily from inhibition of cell-wall biosynthesis. Specifically, vancomycin prevents incorporation of N-acetylmuramic acid (NAM)- and N-acetylglucosamine (NAG)-peptide subunits from being incorporated into the peptidoglycan matrix; which forms the major structural component of Gram-positive cell walls. The large hydrophilic molecule is able to form hydrogen bond interactions with the terminal D-alanyl-D-alanine moieties of the NAM/NAG-peptides. Normally this is a five-point interaction. This binding of vancomycin to the D-Ala-D-Ala prevents the incorporation of the NAM/NAG-peptide subunits into the peptidoglycan matrix. In addition, vancomycin alters bacterial-cell-membrane permeability and RNA synthesis. There is no cross-resistance between vancomycin and other antibiotics. Vancomycin is not active in vitro against gram-negative bacilli, mycobacteria, or fungi. [10]

TargetActionsOrganism
AD-Ala-D-Ala moiety of NAM/NAG peptide subunits of peptidoglycan
ligand
Gram-positive bacteria
Absorption

Poorly absorbed from gastrointestinal tract, however systemic absorption (up to 60%) may occur following intraperitoneal administration [FDA Label].

Volume of distribution

The volume of distribution, as discussed in the literature, varies between 0.4-1 L/kg [6].

Protein binding

Approximately 50% serum protein bound [7].

Metabolism

Since almost 75-80% of the drug is excreted unchanged in the urine after the first 24 hours following administration, there is seemingly no apparent metabolism of the drug [FDA Label]. The concentration of vancomycin in the liver tissue and bile 24 hours after administration has also been reported at or below detection limits as well [8].

Route of elimination

In the first 24 hours, about 75-80% of an administered dose of vancomycin is excreted in urine by glomerular filtration [FDA Label].

Half life

Half-life in normal renal patients is approximately 6 hours (range 4 to 11 hours). In anephric patients, the average half-life of elimination is 7.5 days [FDA Label].

Clearance

The mean plasma clearance of vancomycin is about 0.058 L/kg/h [FDA Label].

Toxicity

The oral LD50 in mice is 5000 mg/kg. The median lethal intravenous dose is 319 mg/kg in rats and 400 mg/kg in mice. [FDA Label]

Conversely, the most common adverse effects associated with vancomycin appear to be nausea, abdominal pain, and hypokalemia [FDA Label]. In particular, incidences of hypokalemia, urinary tracy infection, peripheral edema, insomnia, constipation, anemia, depression, vomiting, and hypotension are higher among subjects >65 years of than in those that are 65 years old or younger [FDA Label].

Additionally, nephrotoxicity involving reports of renal failure, renal impairment, elevated blood creatinine, and others has also occurred with vancomycin therapy during studies, and can occur during or after completion of a course of therapy [FDA Label]. Risk of such nephrotoxicity is increased in patients greater than 65 years of age [FDA Label].

Ototoxicity has also occurred in patients receiving vancomycin treatment, and it can be transient or permanent. This effect has been reported primarily in patients who have been given excessive intravenous doses, who have kidney dysfunction, who have an underlying hearing loss, or who are receiving concomitant therapy with another ototoxic agent like an aminoglycoside [FDA Label]. Potentially related adverse effects like vertigo, dizziness, and tinnitus have also been reported [FDA Label].

Neutropenia, often beginning one week or more after onset of intravenous vancomycin therapy or after a total dose of more than 25 mg has been observed for several dozen patients as well. This neutropenia however, appears to be promptly reversible when the vancomycin treatment is discontinued. Alternatively, thrombocytopenia has also been reported [FDA Label].

Additionally, a condition has been reported that is described as being similar to IV-induced symptoms involving symptoms consistent with anaphylactoid reactions, including hypotension, wheezing, dyspnea, urticaria, pruritus, flushing of the upper body (in what is known as the so-called 'Red Man Syndrome'), pain and muscle spasm of the chest and back. Although on average such reactions usually resolve within 20 minutes, they are just as likely to persist for hours [FDA Label].

In a controlled clinical study, the potential ototoxic and nephrotoxic effects of vancomycin on infants were assessed when the drug was given intravenously to pregnant women for serious staphylococcal infections complicating intravenous drug abuse. The results obtained demonstrated that vancomycin was found in cord blood but that no sensorineural hearing loss or nephrotoxicity attributable to vancomycin was noted. Ultimately however, because the number of subjects treated in this study was limited and vancomycin was administered only in the second and third trimesters, it is not formally known whether vancomycin causes fetal harm. Subsequently, vancomycin should be given to a pregnant woman only if clearly needed [FDA Label].

Although it is known that vancomycin is excreted in human milk based on information obtained from the intravenous administration of the medication, it is not known if vancomycin is excreted into human milk after oral administration. However, because of the overall potential for adverse events, caution must be exercised when vancomycin is given to a nursing woman and a decision must be made whether to discontinue nursing or discontinue the drug, taking into consideration the importance of the drug to the mother [FDA Label].

The safety and effectiveness in pediatric patients have not been formally established [FDA Label].

Patients older than 65 years of age may take longer to respond to therapy compared to patients aged 65 year or younger. Vancomycin treatment in patients aged older than 65 years subsequently should not be discontinued or switched to an alternative treatment prematurely [FDA Label].

Furthermore, clinical studies have demonstrated that geriatric patients are at increased risk of developing nephrotoxicity following treatment with oral vancomycin, which can occur during or after completion of therapy. In patients aged older than 65 years, including those with normal renal function prior to treatment, renal function should be monitored during and following treatment with vancomycin to detect any potential vancomycin induced nephrotoxicity [FDA Label].

Affected organisms
  • Enteric bacteria and other eubacteria
  • Corynebacterium diphtheriae
  • Treponema pallidum
  • Streptococcus pyogenes
  • Chlamydia pneumoniae
  • Chlamydia trachomatis
  • Mycoplasma pneumoniae
  • Neisseria gonorrhoeae
  • Legionella pneumophila
  • Bordetella pertussis
  • Chlamydia psittaci
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
DrugInteractionDrug group
(4R)-limoneneThe serum concentration of Vancomycin can be increased when it is combined with (4R)-limonene.Investigational
AceclofenacThe serum concentration of Vancomycin can be increased when it is combined with Aceclofenac.Approved, Investigational
AcemetacinThe serum concentration of Vancomycin can be increased when it is combined with Acemetacin.Approved, Experimental, Investigational
Acetylsalicylic acidThe serum concentration of Vancomycin can be increased when it is combined with Acetylsalicylic acid.Approved, Vet Approved
AdapaleneThe serum concentration of Vancomycin can be increased when it is combined with Adapalene.Approved
AlclofenacThe serum concentration of Vancomycin can be increased when it is combined with Alclofenac.Approved, Withdrawn
AlcuroniumVancomycin may increase the neuromuscular blocking activities of Alcuronium.Experimental
AlminoprofenThe serum concentration of Vancomycin can be increased when it is combined with Alminoprofen.Experimental
AmikacinVancomycin may increase the nephrotoxic activities of Amikacin.Approved, Investigational, Vet Approved
AndrographolideThe serum concentration of Vancomycin can be increased when it is combined with Andrographolide.Investigational
AnisodamineThe serum concentration of Vancomycin can be increased when it is combined with Anisodamine.Investigational
AntipyrineThe serum concentration of Vancomycin can be increased when it is combined with Antipyrine.Approved, Investigational
ApocyninThe serum concentration of Vancomycin can be increased when it is combined with Apocynin.Investigational
ApramycinVancomycin may increase the nephrotoxic activities of Apramycin.Experimental, Vet Approved
ApremilastThe serum concentration of Vancomycin can be increased when it is combined with Apremilast.Approved, Investigational
ArbekacinVancomycin may increase the nephrotoxic activities of Arbekacin.Approved, Investigational
AtracuriumVancomycin may increase the neuromuscular blocking activities of Atracurium.Approved, Experimental, Investigational
Atracurium besylateVancomycin may increase the neuromuscular blocking activities of Atracurium besylate.Approved
AzapropazoneThe serum concentration of Vancomycin can be increased when it is combined with Azapropazone.Withdrawn
AzelastineThe serum concentration of Vancomycin can be increased when it is combined with Azelastine.Approved
BalsalazideThe serum concentration of Vancomycin can be increased when it is combined with Balsalazide.Approved, Investigational
BCG vaccineThe therapeutic efficacy of BCG vaccine can be decreased when used in combination with Vancomycin.Investigational
BekanamycinVancomycin may increase the nephrotoxic activities of Bekanamycin.Experimental
BendazacThe serum concentration of Vancomycin can be increased when it is combined with Bendazac.Experimental
BenorilateThe serum concentration of Vancomycin can be increased when it is combined with Benorilate.Experimental
BenoxaprofenThe serum concentration of Vancomycin can be increased when it is combined with Benoxaprofen.Withdrawn
BenzydamineThe serum concentration of Vancomycin can be increased when it is combined with Benzydamine.Approved
BevoniumThe serum concentration of Vancomycin can be increased when it is combined with Bevonium.Experimental
BromfenacThe serum concentration of Vancomycin can be increased when it is combined with Bromfenac.Approved
BucillamineThe serum concentration of Vancomycin can be increased when it is combined with Bucillamine.Investigational
BufexamacThe serum concentration of Vancomycin can be increased when it is combined with Bufexamac.Approved, Experimental
BumadizoneThe serum concentration of Vancomycin can be increased when it is combined with Bumadizone.Experimental
Carbaspirin calciumThe serum concentration of Vancomycin can be increased when it is combined with Carbaspirin calcium.Experimental, Investigational
CarprofenThe serum concentration of Vancomycin can be increased when it is combined with Carprofen.Approved, Vet Approved, Withdrawn
CastanospermineThe serum concentration of Vancomycin can be increased when it is combined with Castanospermine.Experimental
CelecoxibThe serum concentration of Vancomycin can be increased when it is combined with Celecoxib.Approved, Investigational
ChloroquineThe serum concentration of Vancomycin can be increased when it is combined with Chloroquine.Approved, Investigational, Vet Approved
CholestyramineThe therapeutic efficacy of Vancomycin can be decreased when used in combination with Cholestyramine.Approved, Investigational
Choline magnesium trisalicylateThe serum concentration of Vancomycin can be increased when it is combined with Choline magnesium trisalicylate.Approved
CisatracuriumVancomycin may increase the neuromuscular blocking activities of Cisatracurium.Approved
ClonixinThe serum concentration of Vancomycin can be increased when it is combined with Clonixin.Approved
ColesevelamThe therapeutic efficacy of Vancomycin can be decreased when used in combination with Colesevelam.Approved
ColestipolThe therapeutic efficacy of Vancomycin can be decreased when used in combination with Colestipol.Approved
ColistimethateVancomycin may increase the nephrotoxic activities of Colistimethate.Approved, Vet Approved
CurcuminThe serum concentration of Vancomycin can be increased when it is combined with Curcumin.Approved, Investigational
DecamethoniumVancomycin may increase the neuromuscular blocking activities of Decamethonium.Approved
DibekacinVancomycin may increase the nephrotoxic activities of Dibekacin.Experimental
DiclofenacThe serum concentration of Vancomycin can be increased when it is combined with Diclofenac.Approved, Vet Approved
DifenpiramideThe serum concentration of Vancomycin can be increased when it is combined with Difenpiramide.Experimental
DiflunisalThe serum concentration of Vancomycin can be increased when it is combined with Diflunisal.Approved, Investigational
DihydrostreptomycinVancomycin may increase the nephrotoxic activities of Dihydrostreptomycin.Investigational, Vet Approved
Domoic AcidVancomycin may increase the neuromuscular blocking activities of Domoic Acid.Experimental
Doxacurium chlorideVancomycin may increase the neuromuscular blocking activities of Doxacurium chloride.Approved
DroxicamThe serum concentration of Vancomycin can be increased when it is combined with Droxicam.Withdrawn
DuvelisibThe serum concentration of Vancomycin can be increased when it is combined with Duvelisib.Investigational
E-6201The serum concentration of Vancomycin can be increased when it is combined with E-6201.Investigational
EpirizoleThe serum concentration of Vancomycin can be increased when it is combined with Epirizole.Approved
EtanerceptThe serum concentration of Vancomycin can be increased when it is combined with Etanercept.Approved, Investigational
EthenzamideThe serum concentration of Vancomycin can be increased when it is combined with Ethenzamide.Experimental
EtodolacThe serum concentration of Vancomycin can be increased when it is combined with Etodolac.Approved, Investigational, Vet Approved
EtofenamateThe serum concentration of Vancomycin can be increased when it is combined with Etofenamate.Approved, Investigational
EtoricoxibThe serum concentration of Vancomycin can be increased when it is combined with Etoricoxib.Approved, Investigational
Evening primrose oilThe serum concentration of Vancomycin can be increased when it is combined with Evening primrose oil.Investigational, Nutraceutical
ExisulindThe serum concentration of Vancomycin can be increased when it is combined with Exisulind.Investigational
FelbinacThe serum concentration of Vancomycin can be increased when it is combined with Felbinac.Experimental
FenbufenThe serum concentration of Vancomycin can be increased when it is combined with Fenbufen.Approved
FenoprofenThe serum concentration of Vancomycin can be increased when it is combined with Fenoprofen.Approved
FentiazacThe serum concentration of Vancomycin can be increased when it is combined with Fentiazac.Experimental
FeprazoneThe serum concentration of Vancomycin can be increased when it is combined with Feprazone.Experimental
Ferulic acidThe serum concentration of Vancomycin can be increased when it is combined with Ferulic acid.Experimental
FloctafenineThe serum concentration of Vancomycin can be increased when it is combined with Floctafenine.Approved, Withdrawn
FlunixinThe serum concentration of Vancomycin can be increased when it is combined with Flunixin.Vet Approved
FlunoxaprofenThe serum concentration of Vancomycin can be increased when it is combined with Flunoxaprofen.Experimental
FlurbiprofenThe serum concentration of Vancomycin can be increased when it is combined with Flurbiprofen.Approved, Investigational
FramycetinVancomycin may increase the nephrotoxic activities of Framycetin.Approved
GallamineVancomycin may increase the neuromuscular blocking activities of Gallamine.Experimental
Gallamine TriethiodideVancomycin may increase the neuromuscular blocking activities of Gallamine Triethiodide.Approved
GeneticinVancomycin may increase the nephrotoxic activities of Geneticin.Experimental
GentamicinVancomycin may increase the nephrotoxic activities of Gentamicin.Approved, Vet Approved
GENTAMICIN C1AVancomycin may increase the nephrotoxic activities of GENTAMICIN C1A.Experimental
GuacetisalThe serum concentration of Vancomycin can be increased when it is combined with Guacetisal.Experimental
HigenamineThe serum concentration of Vancomycin can be increased when it is combined with Higenamine.Investigational
Hygromycin BVancomycin may increase the nephrotoxic activities of Hygromycin B.Vet Approved
IbuprofenThe serum concentration of Vancomycin can be increased when it is combined with Ibuprofen.Approved
IbuproxamThe serum concentration of Vancomycin can be increased when it is combined with Ibuproxam.Withdrawn
IcatibantThe serum concentration of Vancomycin can be increased when it is combined with Icatibant.Approved, Investigational
Imidazole salicylateThe serum concentration of Vancomycin can be increased when it is combined with Imidazole salicylate.Experimental
IndobufenThe serum concentration of Vancomycin can be increased when it is combined with Indobufen.Investigational
IndomethacinThe serum concentration of Vancomycin can be increased when it is combined with Indomethacin.Approved, Investigational
IndoprofenThe serum concentration of Vancomycin can be increased when it is combined with Indoprofen.Withdrawn
IsepamicinVancomycin may increase the nephrotoxic activities of Isepamicin.Experimental
IsoxicamThe serum concentration of Vancomycin can be increased when it is combined with Isoxicam.Withdrawn
KanamycinVancomycin may increase the nephrotoxic activities of Kanamycin.Approved, Investigational, Vet Approved
KebuzoneThe serum concentration of Vancomycin can be increased when it is combined with Kebuzone.Experimental
KetoprofenThe serum concentration of Vancomycin can be increased when it is combined with Ketoprofen.Approved, Vet Approved
KetorolacThe serum concentration of Vancomycin can be increased when it is combined with Ketorolac.Approved
LeflunomideThe serum concentration of Vancomycin can be increased when it is combined with Leflunomide.Approved, Investigational
LisofyllineThe serum concentration of Vancomycin can be increased when it is combined with Lisofylline.Investigational
LonazolacThe serum concentration of Vancomycin can be increased when it is combined with Lonazolac.Experimental
LornoxicamThe serum concentration of Vancomycin can be increased when it is combined with Lornoxicam.Approved, Investigational
LoxoprofenThe serum concentration of Vancomycin can be increased when it is combined with Loxoprofen.Approved, Investigational
LumiracoxibThe serum concentration of Vancomycin can be increased when it is combined with Lumiracoxib.Approved, Investigational
Magnesium salicylateThe serum concentration of Vancomycin can be increased when it is combined with Magnesium salicylate.Approved
MasoprocolThe serum concentration of Vancomycin can be increased when it is combined with Masoprocol.Approved, Investigational
Meclofenamic acidThe serum concentration of Vancomycin can be increased when it is combined with Meclofenamic acid.Approved, Vet Approved
Mefenamic acidThe serum concentration of Vancomycin can be increased when it is combined with Mefenamic acid.Approved
MeloxicamThe serum concentration of Vancomycin can be increased when it is combined with Meloxicam.Approved, Vet Approved
MesalazineThe serum concentration of Vancomycin can be increased when it is combined with Mesalazine.Approved
MetamizoleThe serum concentration of Vancomycin can be increased when it is combined with Metamizole.Approved, Investigational, Withdrawn
MetocurineVancomycin may increase the neuromuscular blocking activities of Metocurine.Approved
Metocurine IodideVancomycin may increase the neuromuscular blocking activities of Metocurine Iodide.Approved, Withdrawn
MicronomicinVancomycin may increase the nephrotoxic activities of Micronomicin.Experimental
MivacuriumVancomycin may increase the neuromuscular blocking activities of Mivacurium.Approved
MizoribineThe serum concentration of Vancomycin can be increased when it is combined with Mizoribine.Investigational
MofebutazoneThe serum concentration of Vancomycin can be increased when it is combined with Mofebutazone.Experimental
Mycophenolate mofetilThe serum concentration of Vancomycin can be increased when it is combined with Mycophenolate mofetil.Approved, Investigational
Mycophenolic acidThe serum concentration of Vancomycin can be increased when it is combined with Mycophenolic acid.Approved
NabumetoneThe serum concentration of Vancomycin can be increased when it is combined with Nabumetone.Approved
NafamostatThe serum concentration of Vancomycin can be increased when it is combined with Nafamostat.Approved, Investigational
NaftifineThe serum concentration of Vancomycin can be increased when it is combined with Naftifine.Approved
NaproxenThe serum concentration of Vancomycin can be increased when it is combined with Naproxen.Approved, Vet Approved
NeamineVancomycin may increase the nephrotoxic activities of Neamine.Experimental
NeomycinVancomycin may increase the nephrotoxic activities of Neomycin.Approved, Vet Approved
NeosaxitoxinVancomycin may increase the neuromuscular blocking activities of Neosaxitoxin.Investigational
NepafenacThe serum concentration of Vancomycin can be increased when it is combined with Nepafenac.Approved, Investigational
NetilmicinVancomycin may increase the nephrotoxic activities of Netilmicin.Approved, Investigational
NifenazoneThe serum concentration of Vancomycin can be increased when it is combined with Nifenazone.Experimental
Niflumic AcidThe serum concentration of Vancomycin can be increased when it is combined with Niflumic Acid.Approved
NimesulideThe serum concentration of Vancomycin can be increased when it is combined with Nimesulide.Approved, Investigational, Withdrawn
NitroaspirinThe serum concentration of Vancomycin can be increased when it is combined with Nitroaspirin.Investigational
OlopatadineThe serum concentration of Vancomycin can be increased when it is combined with Olopatadine.Approved
OlsalazineThe serum concentration of Vancomycin can be increased when it is combined with Olsalazine.Approved
OrgoteinThe serum concentration of Vancomycin can be increased when it is combined with Orgotein.Vet Approved
OxaprozinThe serum concentration of Vancomycin can be increased when it is combined with Oxaprozin.Approved
OxyphenbutazoneThe serum concentration of Vancomycin can be increased when it is combined with Oxyphenbutazone.Approved, Withdrawn
PalmidrolThe serum concentration of Vancomycin can be increased when it is combined with Palmidrol.Experimental, Nutraceutical
PancuroniumVancomycin may increase the neuromuscular blocking activities of Pancuronium.Approved
ParecoxibThe serum concentration of Vancomycin can be increased when it is combined with Parecoxib.Approved
ParomomycinVancomycin may increase the nephrotoxic activities of Paromomycin.Approved, Investigational
ParthenolideThe serum concentration of Vancomycin can be increased when it is combined with Parthenolide.Approved, Investigational
PhenylbutazoneThe serum concentration of Vancomycin can be increased when it is combined with Phenylbutazone.Approved, Vet Approved
Picosulfuric acidThe therapeutic efficacy of Picosulfuric acid can be decreased when used in combination with Vancomycin.Approved
PimecrolimusThe serum concentration of Vancomycin can be increased when it is combined with Pimecrolimus.Approved, Investigational
PipecuroniumVancomycin may increase the neuromuscular blocking activities of Pipecuronium.Approved
PiperacillinPiperacillin may increase the nephrotoxic activities of Vancomycin.Approved
PirfenidoneThe serum concentration of Vancomycin can be increased when it is combined with Pirfenidone.Approved, Investigational
PiroxicamThe serum concentration of Vancomycin can be increased when it is combined with Piroxicam.Approved, Investigational
PirprofenThe serum concentration of Vancomycin can be increased when it is combined with Pirprofen.Experimental
PlazomicinVancomycin may increase the nephrotoxic activities of Plazomicin.Investigational
PranoprofenThe serum concentration of Vancomycin can be increased when it is combined with Pranoprofen.Experimental, Investigational
ProglumetacinThe serum concentration of Vancomycin can be increased when it is combined with Proglumetacin.Experimental
PropacetamolThe serum concentration of Vancomycin can be increased when it is combined with Propacetamol.Approved, Investigational
PropyphenazoneThe serum concentration of Vancomycin can be increased when it is combined with Propyphenazone.Experimental
ProquazoneThe serum concentration of Vancomycin can be increased when it is combined with Proquazone.Experimental
PTC299The serum concentration of Vancomycin can be increased when it is combined with PTC299.Investigational
PuromycinVancomycin may increase the nephrotoxic activities of Puromycin.Experimental
PyrantelVancomycin may increase the neuromuscular blocking activities of Pyrantel.Approved, Vet Approved
RapacuroniumVancomycin may increase the neuromuscular blocking activities of Rapacuronium.Withdrawn
ResveratrolThe serum concentration of Vancomycin can be increased when it is combined with Resveratrol.Approved, Experimental, Investigational
RibostamycinVancomycin may increase the nephrotoxic activities of Ribostamycin.Approved, Investigational
RocuroniumVancomycin may increase the neuromuscular blocking activities of Rocuronium.Approved
RofecoxibThe serum concentration of Vancomycin can be increased when it is combined with Rofecoxib.Approved, Investigational, Withdrawn
SalicylamideThe serum concentration of Vancomycin can be increased when it is combined with Salicylamide.Approved
Salicylic acidThe serum concentration of Vancomycin can be increased when it is combined with Salicylic acid.Approved, Investigational, Vet Approved
SalsalateThe serum concentration of Vancomycin can be increased when it is combined with Salsalate.Approved
SemapimodThe serum concentration of Vancomycin can be increased when it is combined with Semapimod.Investigational
SeratrodastThe serum concentration of Vancomycin can be increased when it is combined with Seratrodast.Approved
SerrapeptaseThe serum concentration of Vancomycin can be increased when it is combined with Serrapeptase.Investigational
SisomicinVancomycin may increase the nephrotoxic activities of Sisomicin.Investigational
SRT501The serum concentration of Vancomycin can be increased when it is combined with SRT501.Investigational
StreptomycinVancomycin may increase the nephrotoxic activities of Streptomycin.Approved, Vet Approved
SuccinylcholineVancomycin may increase the neuromuscular blocking activities of Succinylcholine.Approved
SulfasalazineThe serum concentration of Vancomycin can be increased when it is combined with Sulfasalazine.Approved
SulindacThe serum concentration of Vancomycin can be increased when it is combined with Sulindac.Approved, Investigational
SuprofenThe serum concentration of Vancomycin can be increased when it is combined with Suprofen.Approved, Withdrawn
SuxibuzoneThe serum concentration of Vancomycin can be increased when it is combined with Suxibuzone.Experimental
TarenflurbilThe serum concentration of Vancomycin can be increased when it is combined with Tarenflurbil.Investigational
TenidapThe serum concentration of Vancomycin can be increased when it is combined with Tenidap.Experimental
TenoxicamThe serum concentration of Vancomycin can be increased when it is combined with Tenoxicam.Approved
TepoxalinThe serum concentration of Vancomycin can be increased when it is combined with Tepoxalin.Vet Approved
TeriflunomideThe serum concentration of Vancomycin can be increased when it is combined with Teriflunomide.Approved
Tiaprofenic acidThe serum concentration of Vancomycin can be increased when it is combined with Tiaprofenic acid.Approved
TinoridineThe serum concentration of Vancomycin can be increased when it is combined with Tinoridine.Investigational
TobramycinVancomycin may increase the nephrotoxic activities of Tobramycin.Approved, Investigational
Tolfenamic AcidThe serum concentration of Vancomycin can be increased when it is combined with Tolfenamic Acid.Approved, Investigational
TolmetinThe serum concentration of Vancomycin can be increased when it is combined with Tolmetin.Approved
TranilastThe serum concentration of Vancomycin can be increased when it is combined with Tranilast.Approved, Investigational
TribenosideThe serum concentration of Vancomycin can be increased when it is combined with Tribenoside.Experimental
TriptolideThe serum concentration of Vancomycin can be increased when it is combined with Triptolide.Investigational
TubocurarineVancomycin may increase the neuromuscular blocking activities of Tubocurarine.Approved
ValdecoxibThe serum concentration of Vancomycin can be increased when it is combined with Valdecoxib.Approved, Investigational, Withdrawn
VecuroniumVancomycin may increase the neuromuscular blocking activities of Vecuronium.Approved
ZaltoprofenThe serum concentration of Vancomycin can be increased when it is combined with Zaltoprofen.Approved, Investigational
ZileutonThe serum concentration of Vancomycin can be increased when it is combined with Zileuton.Approved, Investigational, Withdrawn
ZomepiracThe serum concentration of Vancomycin can be increased when it is combined with Zomepirac.Withdrawn
Food Interactions
Not Available

References

Synthesis Reference

Boger DL. Vancomycin, teicoplanin, and ramoplanin: synthetic and mechanistic studies. Med Res Rev. 2001 Sep;21(5):356-81. Pubmed

General References
  1. Levine DP: Vancomycin: a history. Clin Infect Dis. 2006 Jan 1;42 Suppl 1:S5-12. [PubMed:16323120]
  2. Small PM, Chambers HF: Vancomycin for Staphylococcus aureus endocarditis in intravenous drug users. Antimicrob Agents Chemother. 1990 Jun;34(6):1227-31. [PubMed:2393284]
  3. Gonzalez C, Rubio M, Romero-Vivas J, Gonzalez M, Picazo JJ: Bacteremic pneumonia due to Staphylococcus aureus: A comparison of disease caused by methicillin-resistant and methicillin-susceptible organisms. Clin Infect Dis. 1999 Nov;29(5):1171-7. [PubMed:10524959]
  4. Sivagnanam S, Deleu D: Red man syndrome. Crit Care. 2003 Apr;7(2):119-20. Epub 2002 Dec 23. [PubMed:12720556]
  5. Cantu TG, Yamanaka-Yuen NA, Lietman PS: Serum vancomycin concentrations: reappraisal of their clinical value. Clin Infect Dis. 1994 Apr;18(4):533-43. [PubMed:8038306]
  6. Rybak MJ: The pharmacokinetic and pharmacodynamic properties of vancomycin. Clin Infect Dis. 2006 Jan 1;42 Suppl 1:S35-9. doi: 10.1086/491712. [PubMed:16323118]
  7. Butterfield JM, Patel N, Pai MP, Rosano TG, Drusano GL, Lodise TP: Refining vancomycin protein binding estimates: identification of clinical factors that influence protein binding. Antimicrob Agents Chemother. 2011 Sep;55(9):4277-82. doi: 10.1128/AAC.01674-10. Epub 2011 Jun 13. [PubMed:21670191]
  8. Matzke GR, Zhanel GG, Guay DR: Clinical pharmacokinetics of vancomycin. Clin Pharmacokinet. 1986 Jul-Aug;11(4):257-82. doi: 10.2165/00003088-198611040-00001. [PubMed:3530582]
  9. CutisPharma Announces FDA Approval of Firvanq (vancomycin) for Treatment of Clostridium Difficile Associated Diarrhea and Staphylococcus Aureus Colitis [Link]
  10. Wikipedia Page on Vancomycin [Link]
External Links
Human Metabolome Database
HMDB0014653
KEGG Drug
D00212
KEGG Compound
C06689
PubChem Compound
14969
PubChem Substance
46505261
ChemSpider
14253
BindingDB
50335519
ChEBI
28001
ChEMBL
CHEMBL262777
Therapeutic Targets Database
DAP001330
PharmGKB
PA451850
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Vancomycin
ATC Codes
A07AA09 — VancomycinJ01XA01 — Vancomycin
AHFS Codes
  • 08:12.28.16 — Glycopeptides
FDA label
Download (57.8 KB)
MSDS
Download (73 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
0CompletedBasic ScienceBMI >30 kg/m2 / Bone destruction / Diabetes Mellitus (DM) / Inflammatory Reaction1
0CompletedTreatmentBacterial Resistance / Respiratory Failure / Respiratory Tract Infections (RTI)1
0Enrolling by InvitationBasic ScienceDietary Modifications / Nutrition1
0RecruitingTreatmentEarly Stage Non-small Cell Lung Cancer1
1CompletedBasic ScienceSimvastatin Pharmacokinetics and Gut Microbiome1
1CompletedSupportive CareCritical Illness / Methicillin-Resistant Staphylococcus Aureus (MRSA) / Sepsis1
1CompletedTreatmentBiliary Atresia / Primary Sclerosing Cholangitis (PSC)1
1CompletedTreatmentCystic Fibrosis (CF) / Healthy Volunteers1
1CompletedTreatmentPrimary Sclerosing Cholangitis (PSC)1
1RecruitingTreatmentBiliary Atresia / Primary Sclerosing Cholangitis (PSC)1
1RecruitingTreatmentClostridium Difficile Infection (CDI)1
1RecruitingTreatmentDialysis therapy / Pediatric Continuous Renal Replacement Therapy / Renal Failure1
1TerminatedPreventionSurgical Site Infections1
1Unknown StatusTreatmentCystic Fibrosis (CF) / Methicillin-Resistant Staphylococcus Aureus (MRSA)1
1WithdrawnPreventionNeurosurgery1
1, 2CompletedTreatmentAutism Spectrum Conditions/Disorders / Gastrointestinal Problems1
1, 2Not Yet RecruitingPreventionElective Craniotomy-candidated Patients1
2Active Not RecruitingTreatmentChronic Constipation / Slow Transit Constipation1
2CompletedTreatmentBacteremia1
2CompletedTreatmentBacterial Infections1
2CompletedTreatmentBacterial Infections / Infection NOS1
2CompletedTreatmentClostridium Difficile Infection (CDI)2
2CompletedTreatmentClostridium Difficile Infection (CDI) / Diarrhea1
2CompletedTreatmentClostridium Difficile / Pseudomembranous Colitis1
2CompletedTreatmentModerate Clostridium Difficile Infection1
2CompletedTreatmentOsteomyelitis1
2CompletedTreatmentRecurrent C. Difficile Infection1
2CompletedTreatmentSkin and Subcutaneous Tissue Bacterial Infections1
2CompletedTreatmentSoft Tissues Infections1
2CompletedTreatmentStaphylococcal Skin Infections1
2Enrolling by InvitationPreventionInfection NOS1
2Not Yet RecruitingPreventionClostridium Difficile Infection (CDI) / Clostridium difficile infection recurrence1
2Not Yet RecruitingTreatmentCrohn's Disease (CD)1
2Not Yet RecruitingTreatmentEnd Stage Renal Disease (ESRD)1
2RecruitingTreatmentAutism Spectrum Conditions/Disorders / Gastrointestinal Disorders1
2RecruitingTreatmentClostridium Difficile1
2RecruitingTreatmentCrohn's Disease (CD)1
2RecruitingTreatmentLate Onset Neonatal Sepsis1
2RecruitingTreatmentMethicillin-Resistant Staphylococcus Aureus (MRSA) / Pneumonia, Staphylococcal1
2RecruitingTreatmentPre-Diabetic1
2TerminatedTreatmentBacteremia Due to Staphylococcus Aureus1
2TerminatedTreatmentEndocarditis, Bacterial / Infective Endocarditis1
2TerminatedTreatmentHealth-Care-Associated Pneumonia / Pneumonia, Hospital-Acquired / Ventilator-Associated Pneumonia (VAP)1
2TerminatedTreatmentInfected Spacers / Prosthetic Joint Infections of Hip / Prosthetic Joint Infections of Knee1
2TerminatedTreatmentNeoplasms / Neutropenia, Febrile1
2TerminatedTreatmentOsteomyelitis1
2Unknown StatusPreventionWound Infections1
2Unknown StatusTreatmentHip Prosthetic Joint Infection1
2, 3CompletedTreatmentArthropathy of Knee Joint / Revision, Knee Joint1
2, 3Not Yet RecruitingPreventionArthropathy of Knee Joint1
2, 3Not Yet RecruitingTreatmentClostridium Difficile Infection (CDI)1
2, 3RecruitingTreatmentClostridium Difficile1
2, 3TerminatedTreatmentClostridium Difficile Infection (CDI)1
2, 3TerminatedTreatmentClostridium difficile infection recurrence / Laboratory Confirmed Clostridium Difficile Infection1
3Active Not RecruitingTreatmentBacteremia1
3Active Not RecruitingTreatmentPrimary Sclerosing Cholangitis (PSC)1
3CompletedSupportive CareBone Marrow Suppression / Fever, Sweats, and Hot Flashes / Infection NOS / Leukemias / Malignant Lymphomas / Multiple Myeloma and Plasma Cell Neoplasm / Myelodysplastic Syndromes / Unspecified Adult Solid Tumor, Protocol Specific / Unspecified Childhood Solid Tumor, Protocol Specific1
3CompletedTreatmentAbscesses / Cellulitis / Surgical Site Infections / Wound Infections2
3CompletedTreatmentAbscesses / Cellulitis / Systemic Inflammation / Wound Infections2
3CompletedTreatmentAcute Hematogenous Osteomyelitis1
3CompletedTreatmentBacteremia / Bacterial Infections / Infections, Gram-Positive Bacterial1
3CompletedTreatmentBacterial Infections1
3CompletedTreatmentClostridium Difficile1
3CompletedTreatmentClostridium Difficile Infection (CDI)4
3CompletedTreatmentClostridium Difficile-Associated Diarrhea (CDAD)1
3CompletedTreatmentClostridium Infections / Diarrhea2
3CompletedTreatmentComplicated Skin and Soft Tissue Infection1
3CompletedTreatmentInfection caused by staphylococci1
3CompletedTreatmentInfection caused by staphylococci / Meningitis / Pneumonia / Sepsis1
3CompletedTreatmentInfectious / Skin Diseases1
3CompletedTreatmentNeutropenia, Febrile1
3CompletedTreatmentNosocomial Neonatal Sepsis1
3CompletedTreatmentPneumonia, Bacterial2
3CompletedTreatmentSkin Diseases, Bacterial / Skin Diseases, Infectious / Staphylococcal Skin Infections1
3CompletedTreatmentSkin Structures and Soft Tissue Infections2
3CompletedTreatmentSkin and Subcutaneous Tissue Bacterial Infections / Skin Structures and Soft Tissue Infections1
3CompletedTreatmentSkin and Subcutaneous Tissue Bacterial Infections1
3CompletedTreatmentStaphylococcal Skin Infections2
3Not Yet RecruitingTreatmentCataract operation / Endophthalmitis / Intracameral Antibiotics / Moxifloxacin / Phacoemulsification / Vancomycin1
3Not Yet RecruitingTreatmentChronic Rhinosinusitis (Diagnosis)1
3Not Yet RecruitingTreatmentClostridium Difficile1
3RecruitingPreventionGeneral Surgery / Infection NOS / Nervous System Diseases1
3RecruitingTreatmentClostridium Difficile1
3RecruitingTreatmentClostridium Difficile Infection (CDI)1
3RecruitingTreatmentConjunctivitis, Bacterial1
3RecruitingTreatmentSkin Diseases, Bacterial / Skin Diseases, Infectious1
3RecruitingTreatmentStaphylococcus Aureus Infections1
3TerminatedTreatmentBacteremia / Infections, Gram-Positive Bacterial1
3TerminatedTreatmentClostridium Infections1
3TerminatedTreatmentComplicated Skin and Soft Tissue Infection1
3TerminatedTreatmentDiabetic Foot1
3TerminatedTreatmentSkin Diseases, Infectious / Soft Tissues Infections1
4Active Not RecruitingBasic ScienceInflammatory Bowel Diseases (IBD) / Primary Sclerosing Cholangitis (PSC)1
4Active Not RecruitingPreventionArrythmias1
4Active Not RecruitingPreventionCalcium Nephrolithiasis / Urinary Tract Infections (UTIs)1
4CompletedNot AvailableComplicated Skin and Structure Infection / Hospital-acquired bacterial pneumonia1
4CompletedNot AvailableStaphylococcus Aureus1
4CompletedBasic ScienceCellulitis1
4CompletedPreventionAortic Valve Disorder / Congenital Heart Disease (CHD)1
4CompletedPreventionClostridium Difficile Infection (CDI) / Prophylaxis / Vancomycin1
4CompletedPreventionMRSA Infections1
4CompletedTreatmentBacteremia1
4CompletedTreatmentCellulitis1
4CompletedTreatmentCellulitis / Skin-structure infections1
4CompletedTreatmentClostridium Difficile1
4CompletedTreatmentCoronary Artery Disease1
4CompletedTreatmentExtracorporeal Membrane Oxygenation1
4CompletedTreatmentInfection NOS / Neutropenia, Febrile1
4CompletedTreatmentInfection NOS / Pneumonia1
4CompletedTreatmentInfective Endocarditis1
4CompletedTreatmentMethicillin Resistant Staphylococcus Aureus (MRSA)1
4CompletedTreatmentMethicillin Resistant Staphylococcus Aureus (MRSA) / Skin/Soft Tissue Infections1
4CompletedTreatmentSkin Diseases, Infectious / Staphylococcal Skin Infections1
4CompletedTreatmentStaphylococcal Skin Infections1
4CompletedTreatmentSurgical Site Infections / Vancomycin1
4CompletedTreatmentVentilator-Associated Pneumonia (VAP)1
4Enrolling by InvitationOtherClostridium Difficile Infection (CDI) / Diarrhea1
4Enrolling by InvitationPreventionClostridium Difficile Infection (CDI)1
4Enrolling by InvitationPreventionFractures, Open / Infection, Postoperative Wound1
4Not Yet RecruitingBasic ScienceMicrobial Colonization1
4Not Yet RecruitingBasic ScienceRabies Human1
4Not Yet RecruitingPreventionCarpal Tunnel Syndrome (CTS)1
4Not Yet RecruitingPreventionSurgical Site Infections2
4Not Yet RecruitingTreatmentClostridium Difficile Infection (CDI)1
4Not Yet RecruitingTreatmentFevers / Neutropenia, Febrile1
4RecruitingBasic ScienceNeonatal Infections1
4RecruitingPreventionClostridium Difficile Infection (CDI)2
4RecruitingPreventionSpinal Fusion Acquired1
4RecruitingPreventionSurgical Site Infections1
4RecruitingTreatmentAsthma Bronchial1
4RecruitingTreatmentBlood Stream Infections / Endocarditis / MRSA1
4RecruitingTreatmentBone Infection / Joint Infections / Osteomyelitis / Prosthetic Joint Infection / Septic Arthritis1
4RecruitingTreatmentClostridium Difficile Infection (CDI)1
4RecruitingTreatmentClostridium / Difficile / Fidaxomicin / Vancomycin1
4RecruitingTreatmentPrimary Sclerosing Cholangitis (PSC)1
4TerminatedNot AvailableBacteremia / Pneumonia1
4TerminatedHealth Services ResearchComplicated Skin or Skin Structure Infection1
4TerminatedPreventionAcute Bacterial Skin and Skin Structure Infections / Bacteremia / Endocarditis / Health Care Associated Pneumonia / Osteomyelitis/Septic Arthritis1
4TerminatedPreventionInfection caused by staphylococci / Methicillin-Resistant Staphylococcus Aureus (MRSA)1
4TerminatedTreatmentBacteremia1
4TerminatedTreatmentClostridium Difficile1
4TerminatedTreatmentClostridium Difficile / Spinal Cord Injuries (SCI)1
4TerminatedTreatmentDiabetic Foot1
4TerminatedTreatmentImpaired Renal Function / S. Aureus Bacteremia / Skin and Subcutaneous Tissue Bacterial Infections1
4Unknown StatusPreventionClostridium Difficile Infection (CDI)1
4Unknown StatusTreatmentClostridium Difficile Infection (CDI)1
4Unknown StatusTreatmentLiver Cirrhosis1
Not AvailableActive Not RecruitingTreatmentClostridium Difficile Infection (CDI)1
Not AvailableCompletedNot AvailableAcinetobacter Infections1
Not AvailableCompletedNot AvailableAllogenic Blood Stem Cell Transplantation / Neutropenia, Febrile1
Not AvailableCompletedNot AvailableC. Difficile / Diarrhea / Enterocolitis1
Not AvailableCompletedNot AvailableEnd Stage Renal Disease (ESRD) / Infection NOS1
Not AvailableCompletedNot AvailableMethicillin-Resistant Staphylococcus Aureus (MRSA) / Pneumonia, Hospital-Acquired1
Not AvailableCompletedNot AvailableOsteomyelitis1
Not AvailableCompletedNot AvailablePeriodontal Diseases / Psoriatic Arthritis / Rheumatoid Arthritis1
Not AvailableCompletedNot AvailablePneumonia1
Not AvailableCompletedBasic ScienceEndotoxaemia1
Not AvailableCompletedBasic ScienceHealthy Volunteers / Sepsis1
Not AvailableCompletedOtherFlu caused by Influenza1
Not AvailableCompletedPreventionDental Decay1
Not AvailableCompletedPreventionProsthetic Joint Infection1
Not AvailableCompletedTreatmentAntibiotic Prophylaxis1
Not AvailableCompletedTreatmentClostridium Difficile Infection (CDI)1
Not AvailableCompletedTreatmentInfection caused by staphylococci1
Not AvailableCompletedTreatmentInfectious Diseases1
Not AvailableCompletedTreatmentPeritoneal Dialysis Associated Peritonitis1
Not AvailableCompletedTreatmentSkin and Soft Tissue Infections1
Not AvailableCompletedTreatmentUlcerative Colitis (UC)1
Not AvailableEnrolling by InvitationPreventionFractures, Closed / Infection NOS1
Not AvailableNot Yet RecruitingNot AvailableAcute Kidney Injury (AKI) / Adverse Effects / Cross-Sectional Study / Infection caused by staphylococci / Vancomycin1
Not AvailableNot Yet RecruitingNot AvailableAcute Kidney Insufficiency / Anti-Infective Agent Toxicity1
Not AvailableRecruitingNot AvailableCritical Illness / Infection NOS1
Not AvailableRecruitingPreventionAntibiotic Prophylaxis / Thoracic Surgery1
Not AvailableRecruitingPreventionPost- Orthotopic Liver Transplantation / Primary Sclerosing Cholangitis (PSC)1
Not AvailableRecruitingPreventionSurgical Site Infections1
Not AvailableRecruitingTreatmentBMI >30 kg/m2 / Infection NOS / Sepsis1
Not AvailableTerminatedTreatmentColitis1
Not AvailableTerminatedTreatmentInfection NOS2
Not AvailableUnknown StatusBasic ScienceBMI >30 kg/m2 / Insulin Resistance1
Not AvailableUnknown StatusPreventionInfection NOS1
Not AvailableUnknown StatusPreventionLow Back Pain (LBP)1
Not AvailableUnknown StatusTreatmentAcute Renal Failure (ARF) / Postoperative / Sepsis1
Not AvailableUnknown StatusTreatmentClostridium Difficile / Clostridium Difficile Infection (CDI)1
Not AvailableUnknown StatusTreatmentInfection NOS1
Not AvailableUnknown StatusTreatmentInfection, Postoperative Wound1
Not AvailableUnknown StatusTreatmentMethicillin-Resistant Staphylococcus Aureus (MRSA) / Osteomyelitis1
Not AvailableWithdrawnSupportive CareInfection NOS / Neutropenias / Unspecified Adult Solid Tumor, Protocol Specific / Unspecified Childhood Solid Tumor, Protocol Specific1

Pharmacoeconomics

Manufacturers
  • Viropharma inc
  • Lederle parenterals inc
  • Baxter healthcare corp
  • Baxter healthcare corp anesthesia and critical care
  • Akorn strides llc
  • App pharmaceuticals llc
  • Bioniche pharma usa llc
  • Hospira inc
  • Sandoz inc
  • Pharmacia and upjohn co
Packagers
  • ACS Dobfar SPA
  • Akorn Inc.
  • Amerisource Health Services Corp.
  • APP Pharmaceuticals
  • Baxter International Inc.
  • Cardinal Health
  • General Injectables and Vaccines Inc.
  • Generamedix Inc.
  • Hospira Inc.
  • Medisca Inc.
  • Mustafa Nevzat Ilac Sanayii AS
  • Neuman Distributors Inc.
  • Norwich Pharmaceuticals Inc.
  • Pharmedium
  • Sandoz
  • Strides Arcolab Limited
  • Viropharma Inc.
Dosage forms
FormRouteStrength
KitOral
CapsuleOral125 mg
CapsuleOral250 mg
Powder, for solutionIntravenous1.0 g
Injection, powder, lyophilized, for solutionIntravenous1 g/20mL
Injection, powder, lyophilized, for solutionIntravenous500 mg/10mL
PowderIntravenous1 g
Injection, powder, lyophilized, for solutionIntravenous10 g/100mL
Injection, solutionIntravenous4.2 mg/mL
Injection, solutionIntravenous5 mg/mL
Injection, solutionIntravenous6 mg/mL
CapsuleOral125 mg/1
CapsuleOral250 mg/1
InjectionIntravenous10 g/100mL
InjectionIntravenous5 g/100mL
Injection, powder, lyophilized, for solutionIntravenous1 g/8mL
Injection, powder, lyophilized, for solutionIntravenous1 g/250mL
Injection, powder, lyophilized, for solutionIntravenous1 g/1
Injection, powder, lyophilized, for solutionIntravenous10 g/1
Injection, powder, lyophilized, for solutionIntravenous100 g/1
Injection, powder, lyophilized, for solutionIntravenous100 mg/mL
Injection, powder, lyophilized, for solutionIntravenous5 g/1
Injection, powder, lyophilized, for solutionIntravenous5 g/100mL
Injection, powder, lyophilized, for solutionIntravenous500 mg/100mL
Injection, powder, lyophilized, for solutionIntravenous500 mg/1
Injection, powder, lyophilized, for solutionIntravenous500 mg/4mL
Injection, powder, lyophilized, for solutionIntravenous750 mg/1
Injection, powder, lyophilized, for solutionIntravenous750 mg/15mL
Injection, solutionIntravenous1 g/1
Injection, solutionIntravenous1 g/200mL
Injection, solutionIntravenous500 mg/100mL
Injection, solutionIntravenous500 mg/1
Injection, solutionIntravenous750 mg/150mL
Powder, for solutionIntravenous10 g
Powder, for solutionIntravenous1000 mg
Powder, for solutionIntravenous1 g
Powder, for solutionIntravenous5 g
Powder, for solutionIntravenous500 mg
Injection, powder, lyophilized, for solutionIntravenous10 g/80mL
Prices
Unit descriptionCostUnit
Vancocin HCl 20 250 mg capsule Box1019.87USD box
Vancomycin hcl powder85.68USD g
Pms-Vancomycin 1 g/vial61.98USD vial
Vancocin hcl 250 mg pulvule40.97USD each
Pms-Vancomycin 500 mg/vial32.62USD vial
Vancocin HCl 125 mg capsule27.66USD capsule
Vancocin hcl 125 mg pulvule22.22USD each
Vancomycin 1 gm vial7.0USD vial
Vancomycin hcl 750 mg vial5.72USD vial
Vancomycin 500 mg vial3.74USD vial
Vancomycin-ns 1.5 g/150 ml0.24USD ml
Vancomycin-ns 1.25 g/150 ml0.21USD ml
Vancomycin hcl 1 g/200 ml bag0.17USD ml
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Not Available

Properties

State
Solid
Experimental Properties
PropertyValueSource
logP-3.1Not Available
Predicted Properties
PropertyValueSource
Water Solubility0.225 mg/mLALOGPS
logP1.11ALOGPS
logP-4.4ChemAxon
logS-3.8ALOGPS
pKa (Strongest Acidic)2.99ChemAxon
pKa (Strongest Basic)9.93ChemAxon
Physiological Charge1ChemAxon
Hydrogen Acceptor Count24ChemAxon
Hydrogen Donor Count19ChemAxon
Polar Surface Area530.49 Å2ChemAxon
Rotatable Bond Count13ChemAxon
Refractivity346.61 m3·mol-1ChemAxon
Polarizability138.7 Å3ChemAxon
Number of Rings10ChemAxon
Bioavailability0ChemAxon
Rule of FiveNoChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleYesChemAxon
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption-0.7876
Blood Brain Barrier-0.991
Caco-2 permeable-0.7094
P-glycoprotein substrateSubstrate0.8562
P-glycoprotein inhibitor INon-inhibitor0.8781
P-glycoprotein inhibitor IINon-inhibitor0.9636
Renal organic cation transporterNon-inhibitor0.9503
CYP450 2C9 substrateNon-substrate0.8535
CYP450 2D6 substrateNon-substrate0.8323
CYP450 3A4 substrateSubstrate0.6686
CYP450 1A2 substrateNon-inhibitor0.9046
CYP450 2C9 inhibitorNon-inhibitor0.9071
CYP450 2D6 inhibitorNon-inhibitor0.9231
CYP450 2C19 inhibitorNon-inhibitor0.9026
CYP450 3A4 inhibitorNon-inhibitor0.8309
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.7268
Ames testNon AMES toxic0.5927
CarcinogenicityNon-carcinogens0.8826
BiodegradationNot ready biodegradable1.0
Rat acute toxicity2.5856 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9987
hERG inhibition (predictor II)Non-inhibitor0.8098
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available
MS/MS Spectrum - DI-ESI-Ion Trap , PositiveLC-MS/MSNot Available
MS/MS Spectrum - DI-ESI-Hybrid FT , PositiveLC-MS/MSNot Available

Taxonomy

Description
This compound belongs to the class of organic compounds known as cyclic peptides. These are compounds containing a cyclic moiety bearing a peptide backbone.
Kingdom
Organic compounds
Super Class
Organic acids and derivatives
Class
Carboxylic acids and derivatives
Sub Class
Amino acids, peptides, and analogues
Direct Parent
Cyclic peptides
Alternative Parents
Aminoglycosides / Phenolic glycosides / Diarylethers / Disaccharides / O-glycosyl compounds / Alpha amino acids and derivatives / 1-hydroxy-2-unsubstituted benzenoids / 1-hydroxy-4-unsubstituted benzenoids / Aryl chlorides / Oxanes
show 19 more
Substituents
Aminoglycoside core / Cyclic alpha peptide / Phenolic glycoside / O-glycosyl compound / Glycosyl compound / Disaccharide / Diaryl ether / Alpha-amino acid or derivatives / 1-hydroxy-4-unsubstituted benzenoid / 1-hydroxy-2-unsubstituted benzenoid
show 40 more
Molecular Framework
Aromatic heteropolycyclic compounds
External Descriptors
glycopeptide (CHEBI:28001)

Targets

1. D-Ala-D-Ala moiety of NAM/NAG peptide subunits of peptidoglycan
Kind
Group
Organism
Gram-positive bacteria
Pharmacological action
Yes
Actions
Ligand
References
  1. Reynolds PE: Structure, biochemistry and mechanism of action of glycopeptide antibiotics. Eur J Clin Microbiol Infect Dis. 1989 Nov;8(11):943-50. [PubMed:2532132]
  2. Reynolds PE, Somner EA: Comparison of the target sites and mechanisms of action of glycopeptide and lipoglycodepsipeptide antibiotics. Drugs Exp Clin Res. 1990;16(8):385-9. [PubMed:2151441]
  3. Boger DL: Vancomycin, teicoplanin, and ramoplanin: synthetic and mechanistic studies. Med Res Rev. 2001 Sep;21(5):356-81. [PubMed:11579438]

Carriers

Details
1. Serum albumin
Kind
Protein
Organism
Human
Pharmacological action
No
Actions
Substrate
General Function
Toxic substance binding
Specific Function
Serum albumin, the main protein of plasma, has a good binding capacity for water, Ca(2+), Na(+), K(+), fatty acids, hormones, bilirubin and drugs. Its main function is the regulation of the colloid...
Gene Name
ALB
Uniprot ID
P02768
Uniprot Name
Serum albumin
Molecular Weight
69365.94 Da
References
  1. Baneres-Roquet F, Gualtieri M, Villain-Guillot P, Pugniere M, Leonetti JP: Use of a surface plasmon resonance method to investigate antibiotic and plasma protein interactions. Antimicrob Agents Chemother. 2009 Apr;53(4):1528-31. doi: 10.1128/AAC.00971-08. Epub 2009 Jan 21. [PubMed:19164148]
Kind
Protein group
Organism
Human
Pharmacological action
No
Actions
Substrate
General Function
Not Available
Specific Function
Functions as transport protein in the blood stream. Binds various ligands in the interior of its beta-barrel domain. Also binds synthetic drugs and influences their distribution and availability in...

Components:
References
  1. Baneres-Roquet F, Gualtieri M, Villain-Guillot P, Pugniere M, Leonetti JP: Use of a surface plasmon resonance method to investigate antibiotic and plasma protein interactions. Antimicrob Agents Chemother. 2009 Apr;53(4):1528-31. doi: 10.1128/AAC.00971-08. Epub 2009 Jan 21. [PubMed:19164148]
3. Gamma Globulin
Kind
Protein group
Organism
Human
Pharmacological action
No
Actions
Substrate
References
  1. Baneres-Roquet F, Gualtieri M, Villain-Guillot P, Pugniere M, Leonetti JP: Use of a surface plasmon resonance method to investigate antibiotic and plasma protein interactions. Antimicrob Agents Chemother. 2009 Apr;53(4):1528-31. doi: 10.1128/AAC.00971-08. Epub 2009 Jan 21. [PubMed:19164148]

Drug created on June 13, 2005 07:24 / Updated on June 20, 2018 23:51