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vancomycine

J - Antiinfectives For Systemic Use -> J01 - Antibacterials For Systemic Use -> J01X - Other Antibacterials -> J01XA - Glycopeptide Antibacterials -> J01XA01 - Vancomycin
Administration category: Free Medicine group: antibacterial

Safety margins

≥ 18 years
Weight ROA Dosage
ROA:
po
Dosage:
min. 125mg 4 dd to max. 500mg 4 dd
Comments:

per os alleen bij pseudomembraneuze colitis

Standard dosages

≥ 18 years
Weight ROA Load Dosage
ROA:
iv
Load:
20mg/kg
Dosage:
15mg/kg 2 dd
Comments:

Intermitterend: start 12 uur na oplaaddosering 2dd 15 mg/kg (of 1000 mg 2dd). Doseren op geleide van spiegels.

Weight ROA Load Dosage
ROA:
iv
Load:
20mg/kg
Dosage:
30mg/kg continuous per 24 hours
Comments:

Continu infuus: start direct na oplaaddosering met 30 mg/kg/dag. Doseren op geleide van spiegels.

Kidney function

≥ 18 years
ROA GFR Dosage Interval Comments
ROA: iv
GFR:
30 - 50
Dosage:
standaard oplaaddosis 20 mg/kg
Comments:
Intermitterend: (MZH: 2dd 750 mg) dosering aanpassen op geleide van spiegels; continu infuus: 20 mg/kg/dag. Doseren op geleide van spiegels
GFR:
10 - 30
Dosage:
standaard oplaaddosis 20 mg/kg
Comments:
Intermitterend: (MZH: 2dd 500 mg) dosering aanpassen op geleide van spiegels; continu infuus: 10 mg/kg/dag. Doseren op geleide van spiegels
GFR:
<10
Dosage:
standaard oplaaddosis 20 mg/kg
Comments:
Intermitterend: (MZH: 1dd 500 mg) dosering aanpassen op geleide van spiegels; continu infuus: 10 mg/kg/dag. Doseren op geleide van spiegels
Renal elimination: 80%

Renal function-replacement therapy

CAPD: 15 mg/kg i.v. elke 4-7 dagen

Hemo dialysis: <70 kg: 1000 mg oplaaddosis gevolgd door 500 mg onderhoudsdosis. (3x/week na dialyse) 70-100 kg: 1250 mg oplaadosis gevolgd door 750 mg onderhoudsdosis. (3x/week ND) >100 kg: 1500 mg oplaaddosis gevolgd door 1000 mg onderhoudsdosis. (3x/week ND)

CAV / VVHD: oplaaddosis 20 mg/kg, vervolgdosering 15 mg/kg, verder op geleide spiegels

Interactions

Interaction with (ATC): Expected effect:
Interaction with (ATC):
J01G - Aminoglycoside Antibacterials
Expected effect:
toename nefrotoxiciteit

Pregnancy

Due to the expiration of the alphanumeric classification for use in pregnancy and lactation, reference is made to the current, online information of the Teratology Information Service (TIS) of LAREB:

For individual advice, consult an expert on site.

General comments

TDM Alert
Metadata

Swab vid: M-500563.1
Updated: 10/16/2021 - 11:39
Status: Published

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