Antimicrobials
Vancomycin PO

Vancomycin PO

N/A
None
See below under General Info

Spectrum of Activity

Dosing

General Information

Hospital Formulary Status Yes (PO solid, PO soln compounded from IV)

In-Hospital Cost will be updated

PharmaCare Formulary Status Yes (PO solid)

Special Authority Yes (125mg, 250mg PO solid) (See below under Restricted Use Criteria)

PharmaCare Coverage 125mg PO - $5.5944/cap 250mg PO - $11.1888/cap

Outpatient Cost 125mg PO - $5.62-9.56/cap 250mg PO - $11.25-11.83/cap

Only indication is in the therapy of C. difficile infection, particularly recurrent or severe disease

Possibility of accumulation in severe renal dysfunction.

Consider checking a vancomycin level in dialysis patients.

Special Authority Status: Yes (125mg PO solid, 250mg PO solid)

Special Authority Category: Limited Coverage Drugs

Special Authority Criteria: For the treatment of symptomatic C. Difficile Infection, when:

  • patient is allergic, resistant, or intolerant to metronidazole OR
  • patient has failed to respond to 4–6 days of oral metronidazole at doses of 500mg TID OR
  • patient has symptoms of moderate to severe disease or is experiencing a second disease recurrence* OR
  • patient was initiated on vancomycin as an inpatient (e.g. in a hospital setting, nursing home, or long-term care facility) and requires continuation of vancomycin to complete their full course of therapy

*Vancomycin capsules are a full benefit for patients registered with the Palliative program

Special Authority Approval Period: Initial: up to 14 days. Second or further recurrence: up to 14 days

Special Authority Practitioner Exemptions: None

Special Authority Special Notes:

  • prescribers may submit written requests via the Special Authority fax line at any time
  • coverage decision should be provided within one business day
  • urgent Special Authority requests can be made if the patient meets any of the criteria
  • refer to the BC Special Authority Program Website for more info

Hypokalemia (PO)

  • more common in older patients (>65 years old)
  • may occur 2-7 days after initiation
  • co-administration with amphotericin B increases risk

Gastrointestinal (PO)

  • common sx: abdominal pain and nausea
  • uncommon sx: vomiting, diarrhea and flatulence
  • unique sx of oral solution: dysgeusia
  • usually temporary

Other

  • peripheral edema (6%)
  • fatigue (5%)
  • headache (7%)
  • back pain (6%)
  • UTI (8%)
  • fever (9%)

Antimicrobial class: Glycopeptide

Pregnancy category: B

No oral absorption. May increase vancomycin resistant enterococci colonization in the gut.

Average serum half life: 0.0 hr

Urine penetration: None

Lung penetration: None

CSF penetration: None

Biliary penetration: None