vancomycin hydrochloride at a glance
Medicine class
Glycopeptide antibiotic
Main routes
Slow intravenous infusion for systemic infection; oral treatment for C. difficile infection
Monitoring
Intravenous treatment commonly requires kidney-function tests and measurement of blood concentrations
Capsules
Swallow whole with water; unsuitable for people who cannot safely swallow capsules
What is vancomycin hydrochloride used for?
Oral treatment acts within the bowel; intravenous treatment is for susceptible systemic infections.
Oral treatment of Clostridioides difficile infection.
Intravenous treatment of complicated skin and soft-tissue, bone and joint, lung, heart-valve and associated bloodstream infections.
Perioperative antibacterial prophylaxis for people at high risk of bacterial endocarditis during major surgery.
How does vancomycin hydrochloride work?
Vancomycin binds to bacterial cell-wall building blocks, disrupting wall formation and killing dividing susceptible bacteria. Its activity is mainly against Gram-positive organisms. Oral treatment is poorly absorbed and acts predominantly inside the bowel.
vancomycin hydrochloride preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 500 mg, 1000 mg, 1 g
Capsule
Route: Oral
Strengths: 125 mg, 250 mg
How to take vancomycin hydrochloride
Use exactly as directed by the prescribing team. Intravenous treatment must be prepared, diluted and given slowly by a healthcare professional; it must not be injected into muscle.
Swallow hard capsules whole with plenty of water; do not open them.
If swallowing capsules is unsafe, tell the clinical team. A suitable oral preparation may be prepared from an appropriate licensed infusion product and given through an enteral tube.
Complete the prescribed antibiotic course unless a healthcare professional tells you to stop.
vancomycin hydrochloride side effects
Common or expected effects
- Infusion-site pain or inflammation of a vein.
- Flushing or redness of the face and upper body, particularly with rapid infusion.
- Itching, rash or hives.
- Kidney-function changes or raised liver enzymes on blood tests.
Get urgent medical advice
- Severe allergic reaction, including breathing difficulty, swelling, collapse or chest pain.
- Blistering, peeling or widespread febrile skin reactions.
- Significant kidney injury.
- New ringing in the ears, dizziness, balance disturbance or hearing loss.
- Severe or persistent diarrhoea, particularly with abdominal pain or blood.
- Blood-cell abnormalities, which may present with fever, infection, unusual bruising or profound tiredness.
vancomycin hydrochloride in pregnancy
Human pregnancy evidence is limited, although published reviews have not identified a clear signal of congenital harm. It crosses the placenta and should be used only when clinically needed after an individual risk-benefit assessment.
vancomycin hydrochloride while breastfeeding
Vancomycin is excreted into human milk. The decision to use it while breastfeeding should consider treatment need, route, infant age and health, and possible infant effects. Seek prescriber or specialist breastfeeding-medicines advice before stopping breastfeeding.
vancomycin hydrochloride interactions
Tell the prescribing team about all prescribed, non-prescribed and recently used medicines. Important interactions mainly increase kidney, hearing or infusion-related risks.
Aminoglycosides, such as gentamicin, amikacin or tobramycin
Combined use can increase kidney and hearing toxicity and may require closer monitoring.
Other nephrotoxic or ototoxic medicines, including amphotericin B, colistin, cisplatin and piperacillin/tazobactam
Concurrent or sequential exposure may increase kidney or hearing injury.
Common questions about vancomycin hydrochloride
Answers are fully visible for fast scanning and source review.
Can capsules treat a bloodstream infection?
No. Capsules act within the bowel and do not provide reliable systemic exposure; systemic infections require appropriate parenteral treatment selected by the clinical team.
Why are blood tests needed with intravenous treatment?
They assess kidney function and vancomycin exposure, helping limit accumulation and toxicity.
Can it damage the kidneys?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.