VANCOMYCIN HYDROCHLORIDE

First approved in 1958

Details

Stereochemistry	ABSOLUTE
Molecular Formula	C66H75Cl2N9O24.ClH
Molecular Weight	1485.715
Optical Activity	UNSPECIFIED
Defined Stereocenters	18 / 18
E/Z Centers	0
Charge	0

SHOW SMILES / InChI

Structure Search

SMILES

Cl.[H][C@@]2(O[C@H]1C[C@](C)(N)[C@H](O)[C@H](C)O1)[C@@H](O)[C@H](O)[C@@H](CO)O[C@H]2OC3=C4OC5=CC=C(C=C5Cl)[C@@H](O)[C@@H](NC(=O)[C@@H](CC(C)C)NC)C(=O)N[C@@H](CC(N)=O)C(=O)N[C@@H]6C(C=C3OC7=C(Cl)C=C(C=C7)[C@@H](O)[C@@H]8NC(=O)[C@H](NC6=O)C9=CC(=C(O)C=C9)C%10=C(C=C(O)C=C%10O)[C@H](NC8=O)C(O)=O)=C4

InChI

InChIKey=LCTORFDMHNKUSG-XTTLPDOESA-N

InChI=1S/C66H75Cl2N9O24.ClH/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);1H/t24-,34+,35-,42+,44-,46+,47+,48-,49+,50-,51+,52+,53+,54-,56+,57+,65-,66-;/m0./s1

HIDE SMILES / InChI

Description
Sources: https://www.drugbank.ca/drugs/DB00512
Curator's Comment: Description was created based on several sources, including http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/062911s035lbl.pdf

Vancomycin is a branched tricyclic glycosylated nonribosomal peptide produced by the fermentation of the Actinobacteria species Amycolatopsis orientalis (formerly Nocardia orientalis). Vancomycin became available for clinical use >50 years ago. It is often reserved as the "drug of last resort", used only after treatment with other antibiotics had 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. The bactericidal action of vancomycin results primarily from inhibition of cell-wall biosynthesis. Specifically, vancomycin prevents the 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.

CNS Activity

Originator

Approval Year

Targets

Primary Target	Pharmacology	Condition	Potency
Enterococcus faecalis 3 Target ID: CHEMBL362 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/062911s035lbl.pdf	Inhibitor 8297
Staphylococcus aureus 67 Target ID: CHEMBL352 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/062911s035lbl.pdf \| https://www.ncbi.nlm.nih.gov/pubmed/21353963	Inhibitor 8297
Streptococcus pneumoniae 25 Target ID: CHEMBL347 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/062911s035lbl.pdf	Inhibitor 8297

Conditions

Condition	Modality	Targets	Highest Phase	Product
Severe infections caused by susceptible strains of methicillin-resistant staphylococci 2 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/062911s035lbl.pdf	Curative		Approved 8429	VANCOMYCIN HYDROCHLORIDE Approved Use Vancomycin hydrochloride is indicated for the treatment of serious or severe infections caused by susceptible strains of methicillin-resistant (beta-lactam-resistant) staphylococci. It is indicated for penicillin-allergic patients, for patients who cannot receive or who have failed to respond to other drugs, including the penicillins or cephalosporins, and for infections caused by vancomycin-susceptible organisms that are resistant to other antimicrobial drugs. Vancomycin is indicated for initial therapy when methicillin-resistant staphylococci are suspected, but after susceptibility data are available, therapy should be adjusted accordingly. Vancomycin hydrochloride is effective in the treatment of staphylococcal endocarditis. It’s effectiveness has been documented in other infections due to staphylococci, including septicemia, bone infections, lower respiratory tract infections, skin, and skin structure infections. When staphylococcal infections are localized and purulent, antibiotics are used as adjuncts to appropriate surgical measures. Vancomycin hydrochloride has been reported to be effective alone or in combination with an aminoglycoside for endocarditis caused by Streptococcus viridans or S. bovis. For endocarditis caused by enterococci (e.g., E. faecalis), vancomycin hydrochloride has been reported to be effective only in combination with an aminoglycoside. Vancomycin hydrochloride has been reported to be effective for the treatment of diphtheroid endocarditis. Vancomycin hydrochloride has been used successfully in combination with either rifampin, an aminoglycoside, or both in early-onset prosthetic valve endocarditis caused by S. epidermidis or diphtheroids. Specimens for bacteriologic cultures should be obtained in order to isolate and identify causative organisms and to determine their susceptibilities to vancomycin hydrochloride. To reduce the development of drug-resistant bacteria and maintain the effectiveness of vancomycin and other antibacterial drugs, vancomycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. Launch Date 1964
Bacterial endocarditis 30 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/062911s035lbl.pdf	Curative		Approved 8429	VANCOMYCIN HYDROCHLORIDE Approved Use Vancomycin hydrochloride is indicated for the treatment of serious or severe infections caused by susceptible strains of methicillin-resistant (beta-lactam-resistant) staphylococci. It is indicated for penicillin-allergic patients, for patients who cannot receive or who have failed to respond to other drugs, including the penicillins or cephalosporins, and for infections caused by vancomycin-susceptible organisms that are resistant to other antimicrobial drugs. Vancomycin is indicated for initial therapy when methicillin-resistant staphylococci are suspected, but after susceptibility data are available, therapy should be adjusted accordingly. Vancomycin hydrochloride is effective in the treatment of staphylococcal endocarditis. It’s effectiveness has been documented in other infections due to staphylococci, including septicemia, bone infections, lower respiratory tract infections, skin, and skin structure infections. When staphylococcal infections are localized and purulent, antibiotics are used as adjuncts to appropriate surgical measures. Vancomycin hydrochloride has been reported to be effective alone or in combination with an aminoglycoside for endocarditis caused by Streptococcus viridans or S. bovis. For endocarditis caused by enterococci (e.g., E. faecalis), vancomycin hydrochloride has been reported to be effective only in combination with an aminoglycoside. Vancomycin hydrochloride has been reported to be effective for the treatment of diphtheroid endocarditis. Vancomycin hydrochloride has been used successfully in combination with either rifampin, an aminoglycoside, or both in early-onset prosthetic valve endocarditis caused by S. epidermidis or diphtheroids. Specimens for bacteriologic cultures should be obtained in order to isolate and identify causative organisms and to determine their susceptibilities to vancomycin hydrochloride. To reduce the development of drug-resistant bacteria and maintain the effectiveness of vancomycin and other antibacterial drugs, vancomycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. Launch Date 1964

C_max

Value	Dose	Analyte	Population
65.7 μg/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3579256/	1000 mg 2 times / day steady-state, intravenous dose: 1000 mg route of administration: Intravenous experiment type: STEADY-STATE co-administered:	VANCOMYCIN serum	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN
40.3 μg/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3579256/	500 mg 4 times / day steady-state, intravenous dose: 500 mg route of administration: Intravenous experiment type: STEADY-STATE co-administered:	VANCOMYCIN serum	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN
19.1 mg/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/20015925/	986.1 mg 2 times / day multiple, intravenous dose: 986.1 mg route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
27.2 mg/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/20015925/	1000 mg 2 times / day multiple, intravenous dose: 1000 mg route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
35.4 mg/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10442692/	10 mg/kg bw 3 times / day steady-state, intravenous dose: 10 mg/kg bw route of administration: Intravenous experiment type: STEADY-STATE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN
40.94 μg/mL EXPERIMENT https://www.ijccm.org/doi/IJCCM/pdf/10.5005/jp-journals-10071-23275	20 mg/kg 3 times / day steady-state, intravenous dose: 20 mg/kg route of administration: Intravenous experiment type: STEADY-STATE co-administered:	VANCOMYCIN plasma	Homo sapiens population: UNHEALTHY age: CHILD sex: FEMALE / MALE food status: UNKNOWN
21.1 mg/L EXPERIMENT https://ejhp.bmj.com/content/ejhpharm/27/e1/e25.full.pdf	10 mg/kg bw 3 times / day multiple, intravenous dose: 10 mg/kg bw route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: NEWBORN sex: FEMALE / MALE food status: UNKNOWN
29.4 mg/L EXPERIMENT https://ejhp.bmj.com/content/ejhpharm/27/e1/e25.full.pdf	10 mg/kg bw 3 times / day multiple, intravenous dose: 10 mg/kg bw route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: NEWBORN sex: FEMALE / MALE food status: UNKNOWN
49 μg/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/062911s035lbl.pdf	500 mg 4 times / day multiple, intravenous dose: 500 mg route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN plasma	Homo sapiens population: UNKNOWN age: UNKNOWN sex: UNKNOWN food status: UNKNOWN
63 μg/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/062911s035lbl.pdf	1 g 1 times / day multiple, intravenous dose: 1 g route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN plasma	Homo sapiens population: UNKNOWN age: UNKNOWN sex: UNKNOWN food status: UNKNOWN

AUC

Value	Dose	Analyte	Population
227 μg × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3579256/	1000 mg 2 times / day steady-state, intravenous dose: 1000 mg route of administration: Intravenous experiment type: STEADY-STATE co-administered:	VANCOMYCIN serum	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN
116 μg × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3579256/	500 mg 4 times / day steady-state, intravenous dose: 500 mg route of administration: Intravenous experiment type: STEADY-STATE co-administered:	VANCOMYCIN serum	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN
135 mg × h/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3415206/	10.5 mg/kg bw 2 times / day multiple, intravenous dose: 10.5 mg/kg bw route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
264 mg × h/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3415206/	11.6 mg/kg bw 2 times / day multiple, intravenous dose: 11.6 mg/kg bw route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
451 mg × h/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3415206/	11 mg/kg bw 2 times / day multiple, intravenous dose: 11 mg/kg bw route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
124.15 μg × h/mL EXPERIMENT https://www.ijccm.org/doi/IJCCM/pdf/10.5005/jp-journals-10071-23275	20 mg/kg 3 times / day steady-state, intravenous dose: 20 mg/kg route of administration: Intravenous experiment type: STEADY-STATE co-administered:	VANCOMYCIN plasma	Homo sapiens population: UNHEALTHY age: CHILD sex: FEMALE / MALE food status: UNKNOWN

T_1/2

Value	Dose	Analyte	Population
7.7 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3579256/	1000 mg 2 times / day steady-state, intravenous dose: 1000 mg route of administration: Intravenous experiment type: STEADY-STATE co-administered:	VANCOMYCIN serum	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN
8.1 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3579256/	500 mg 4 times / day steady-state, intravenous dose: 500 mg route of administration: Intravenous experiment type: STEADY-STATE co-administered:	VANCOMYCIN serum	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN
5.2 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3415206/	10.5 mg/kg bw 2 times / day multiple, intravenous dose: 10.5 mg/kg bw route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
10.5 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3415206/	11.6 mg/kg bw 2 times / day multiple, intravenous dose: 11.6 mg/kg bw route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
19.9 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3415206/	11 mg/kg bw 2 times / day multiple, intravenous dose: 11 mg/kg bw route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
8.6 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/20015925/	986.1 mg 2 times / day multiple, intravenous dose: 986.1 mg route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
5.4 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/20015925/	1000 mg 2 times / day multiple, intravenous dose: 1000 mg route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
409 min EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10442692/	10 mg/kg bw 3 times / day steady-state, intravenous dose: 10 mg/kg bw route of administration: Intravenous experiment type: STEADY-STATE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN
224 min EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10442692/	10 mg/kg bw single, intravenous dose: 10 mg/kg bw route of administration: Intravenous experiment type: SINGLE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN
4.82 h EXPERIMENT https://www.ijccm.org/doi/IJCCM/pdf/10.5005/jp-journals-10071-23275	20 mg/kg 3 times / day steady-state, intravenous dose: 20 mg/kg route of administration: Intravenous experiment type: STEADY-STATE co-administered:	VANCOMYCIN plasma	Homo sapiens population: UNHEALTHY age: CHILD sex: FEMALE / MALE food status: UNKNOWN
5.5 h EXPERIMENT https://ejhp.bmj.com/content/ejhpharm/27/e1/e25.full.pdf	10 mg/kg bw 3 times / day multiple, intravenous dose: 10 mg/kg bw route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: NEWBORN sex: FEMALE / MALE food status: UNKNOWN
13.7 h EXPERIMENT https://ejhp.bmj.com/content/ejhpharm/27/e1/e25.full.pdf	10 mg/kg bw 3 times / day multiple, intravenous dose: 10 mg/kg bw route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: NEWBORN sex: FEMALE / MALE food status: UNKNOWN

F_unbound

Value	Dose	Analyte	Population
69.8% EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3415206/	10.5 mg/kg bw 2 times / day multiple, intravenous dose: 10.5 mg/kg bw route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
70.2% EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3415206/	11.6 mg/kg bw 2 times / day multiple, intravenous dose: 11.6 mg/kg bw route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
69.1% EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3415206/	11 mg/kg bw 2 times / day multiple, intravenous dose: 11 mg/kg bw route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
45% DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/062911s035lbl.pdf	1 g 1 times / day multiple, intravenous dose: 1 g route of administration: Intravenous experiment type: MULTIPLE co-administered:	VANCOMYCIN plasma	Homo sapiens population: UNKNOWN age: UNKNOWN sex: UNKNOWN food status: UNKNOWN

Doses

Dose	Population	Adverse events
1 g 6 times / day multiple, intravenous Overdose Dose: 1 g, 6 times / day Route: intravenous Route: multiple Dose: 1 g, 6 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/3239947	unhealthy, 54 n = 1 Health Status: unhealthy Condition: Staphylococcus epidermidis infection Age Group: 54 Sex: M Population Size: 1 Sources: https://pubmed.ncbi.nlm.nih.gov/3239947	Disc. AE: Acute renal failure... AEs leading to discontinuation/dose reduction: Acute renal failure Sources: https://pubmed.ncbi.nlm.nih.gov/3239947
15 mg/kg 2 times / day multiple, intravenous Recommended Dose: 15 mg/kg, 2 times / day Route: intravenous Route: multiple Dose: 15 mg/kg, 2 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/22247123 Page: p.5	unhealthy, 61.6 n = 587 Health Status: unhealthy Condition: Staphylococcus aureus nosocomial pneumonia Age Group: 61.6 Sex: M+F Population Size: 587 Sources: https://pubmed.ncbi.nlm.nih.gov/22247123 Page: p.5	Disc. AE: Acute renal failure, Infection staphylococcal... AEs leading to discontinuation/dose reduction: Acute renal failure (0.34%) Infection staphylococcal (0.17%) Respiratory failure (0.17%) Sepsis (0.17%) Intracranial hemorrhage (0.17%) Hypersensitivity (0.17%) Renal failure (0.17%) Sources: https://pubmed.ncbi.nlm.nih.gov/22247123 Page: p.5

AEs

AE	Significance	Dose	Population
Acute renal failure	Disc. AE	1 g 6 times / day multiple, intravenous Overdose Dose: 1 g, 6 times / day Route: intravenous Route: multiple Dose: 1 g, 6 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/3239947	unhealthy, 54 n = 1 Health Status: unhealthy Condition: Staphylococcus epidermidis infection Age Group: 54 Sex: M Population Size: 1 Sources: https://pubmed.ncbi.nlm.nih.gov/3239947
Hypersensitivity	0.17% Disc. AE	15 mg/kg 2 times / day multiple, intravenous Recommended Dose: 15 mg/kg, 2 times / day Route: intravenous Route: multiple Dose: 15 mg/kg, 2 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/22247123 Page: p.5	unhealthy, 61.6 n = 587 Health Status: unhealthy Condition: Staphylococcus aureus nosocomial pneumonia Age Group: 61.6 Sex: M+F Population Size: 587 Sources: https://pubmed.ncbi.nlm.nih.gov/22247123 Page: p.5
Infection staphylococcal	0.17% Disc. AE	15 mg/kg 2 times / day multiple, intravenous Recommended Dose: 15 mg/kg, 2 times / day Route: intravenous Route: multiple Dose: 15 mg/kg, 2 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/22247123 Page: p.5	unhealthy, 61.6 n = 587 Health Status: unhealthy Condition: Staphylococcus aureus nosocomial pneumonia Age Group: 61.6 Sex: M+F Population Size: 587 Sources: https://pubmed.ncbi.nlm.nih.gov/22247123 Page: p.5
Intracranial hemorrhage	0.17% Disc. AE	15 mg/kg 2 times / day multiple, intravenous Recommended Dose: 15 mg/kg, 2 times / day Route: intravenous Route: multiple Dose: 15 mg/kg, 2 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/22247123 Page: p.5	unhealthy, 61.6 n = 587 Health Status: unhealthy Condition: Staphylococcus aureus nosocomial pneumonia Age Group: 61.6 Sex: M+F Population Size: 587 Sources: https://pubmed.ncbi.nlm.nih.gov/22247123 Page: p.5
Renal failure	0.17% Disc. AE	15 mg/kg 2 times / day multiple, intravenous Recommended Dose: 15 mg/kg, 2 times / day Route: intravenous Route: multiple Dose: 15 mg/kg, 2 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/22247123 Page: p.5	unhealthy, 61.6 n = 587 Health Status: unhealthy Condition: Staphylococcus aureus nosocomial pneumonia Age Group: 61.6 Sex: M+F Population Size: 587 Sources: https://pubmed.ncbi.nlm.nih.gov/22247123 Page: p.5
Respiratory failure	0.17% Disc. AE	15 mg/kg 2 times / day multiple, intravenous Recommended Dose: 15 mg/kg, 2 times / day Route: intravenous Route: multiple Dose: 15 mg/kg, 2 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/22247123 Page: p.5	unhealthy, 61.6 n = 587 Health Status: unhealthy Condition: Staphylococcus aureus nosocomial pneumonia Age Group: 61.6 Sex: M+F Population Size: 587 Sources: https://pubmed.ncbi.nlm.nih.gov/22247123 Page: p.5
Sepsis	0.17% Disc. AE	15 mg/kg 2 times / day multiple, intravenous Recommended Dose: 15 mg/kg, 2 times / day Route: intravenous Route: multiple Dose: 15 mg/kg, 2 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/22247123 Page: p.5	unhealthy, 61.6 n = 587 Health Status: unhealthy Condition: Staphylococcus aureus nosocomial pneumonia Age Group: 61.6 Sex: M+F Population Size: 587 Sources: https://pubmed.ncbi.nlm.nih.gov/22247123 Page: p.5
Acute renal failure	0.34% Disc. AE	15 mg/kg 2 times / day multiple, intravenous Recommended Dose: 15 mg/kg, 2 times / day Route: intravenous Route: multiple Dose: 15 mg/kg, 2 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/22247123 Page: p.5	unhealthy, 61.6 n = 587 Health Status: unhealthy Condition: Staphylococcus aureus nosocomial pneumonia Age Group: 61.6 Sex: M+F Population Size: 587 Sources: https://pubmed.ncbi.nlm.nih.gov/22247123 Page: p.5

Overview

CYP3A4	CYP2C9	CYP2D6	hERG

OverviewOther

Other Inhibitor	Other Substrate	Other Inducer
P-gp 1461 OAT1 599 OAT3 642

Drug as perpetrator

Target	Modality	Activity
OAT1 603	inhibitor 3277 Sources: https://www.karger.com/Article/FullText/513742 Page: 8.0	likely
OAT3 644	inhibitor 3277 Sources: https://www.karger.com/Article/FullText/513742 Page: 8.0	likely
P-gp 1650	inhibitor 3277 Sources: https://www.sciencedirect.com/science/article/abs/pii/S0378427417302096 Page: 22.0	yes

Sourcing

Vendor/Aggregator	ID	URL
AbMole Bioscience	M4862	http://www.abmole.com/products/vancomycin-hcl.html
Achemtek	0102-023992	http://www.achemtek.com/1404-90-6
Ambeed	A606050	https://www.ambeed.com/products/1404-90-6.html
Aurora Fine Chemicals LLC	A24.069.278	http://online.aurorafinechemicals.com/info?ID=A24.069.278
BLD Pharm	BD156341	http://www.bldpharm.com/products/1404-90-6.html
Chem Scene	CS-3242	http://www.chemscene.com/1404-90-6.html
ChemMol	49429832	http://www.chemmol.com/chemmol/49429832.html
Chemspace	CSSB02125554663	https://chem-space.com/CSSB02125554663
DC Chemicals	DC24146	http://www.dcchemicals.com/product_show-DC24146.html
Lab Network	LN01342348	https://labnetwork.com/frontend-app/p/#!/moleculedetails/LN01342348
MedChem Express	HY-B0671	https://www.medchemexpress.com/vancomycin.html
MolPort	MolPort-001-794-649	https://www.molport.com/shop/molecule-link/MolPort-001-794-649
MuseChem	I001555	https://www.musechem.com/product/I001555.html
OChem	8516	http://www.ocheminc.com/index.php?act=psearch&pid=404V906
Selleck Chemicals	S5784	http://www.selleckchem.com/products/vancomycin.html
THE BioTek	bt-242503	https://www.thebiotek.com/product/peptides/bt-242503
eNovation Chemicals	D541301	https://www.enovationchem.com/ProductDetails.asp?ProductID=D541301
eNovation Chemicals	D592870	https://www.enovationchem.com/ProductDetails.asp?ProductID=D592870
eNovation Chemicals	D678922	https://www.enovationchem.com/ProductDetails.asp?ProductID=D678922
iChemical	EBD2126820	http://www.ichemical.com/products/1404-90-6.html?utm_source=PubChem&utm_medium=website&utm_campaign=product%20catalogs

PubMed

Title	Date	PubMed
Liver abscess caused by Clostridium difficile.	2001	11234983
Emergence of methicillin-resistant Staphylococcus aureus with intermediate glycopeptide resistance: clinical significance and treatment options.	2001	11217866
Intraabdominal vancomycin-resistant enterococcus infections: the new threat.	2001 Apr	11276278
Dietary habits and gastrointestinal colonization by antibiotic resistant microorganisms.	2001 Apr	11266432
A modified population analysis profile (PAP) method to detect hetero-resistance to vancomycin in Staphylococcus aureus in a UK hospital.	2001 Apr	11266410
Is vancomycin resistance in enterococci predictive of inferior outcome of enterococcal bacteremia?	2001 Apr 1	11264043
[Subacute infectious endocarditis due to the agent of cat scratch fever: Bartonella henselae].	2001 Feb	11265556
[Antibiotic resistance of Staphylococcus aureus in urban experience: 6 month study in Aquitaine].	2001 Feb	11265221
Use of vancomycin silica stationary phase in packed capillary electrochromatography I. Enantiomer separation of basic compounds.	2001 Feb	11258766
Synthesis of variously oxidized abietane diterpenes and their antibacterial activities against MRSA and VRE.	2001 Feb	11249127
Antimicrobial resistance: steps to reduce the problem with emphasis on antibiotic utilization the Rapid City experience.	2001 Feb	11236710
Reality check: should we try to detect and isolate vancomycin-resistant enterococci patients?	2001 Feb	11232874
Does the empiric use of vancomycin in pediatrics increase the risk for Gram-negative bacteremia?	2001 Feb	11224837
Septic sacroiliitis with hematogenous spread to a total knee arthroplasty.	2001 Feb	11222898
Treatment of methicillin-resistant Staphylococcus epidermidis infection following repair of an ulnar fracture and humeroradial joint luxation in a horse.	2001 Feb 15	11229509
New sensitive assay of vancomycin in human plasma using high-performance liquid chromatography and electrochemical detection.	2001 Feb 25	11236095
Clostridium difficile--Associated diarrhea: A review.	2001 Feb 26	11252111
VanA-type vancomycin-resistant enterococci (VRE) remain prevalent in poultry carcasses 3 years after avoparcin was banned.	2001 Feb 28	11252515
Physiological function of exopolysaccharides produced by Lactococcus lactis.	2001 Feb 28	11252513
Prevalence of glycopeptide and aminoglycoside resistance in Enterococcus and Listeria spp. in low microbial load diets of neutropenic hospital patients.	2001 Feb 28	11252510
Cresol red thallium acetate sucrose inulin (CTSI) agar for the selective recovery of Carnobacterium spp.	2001 Feb 28	11252499
Aerobic bacterial and fungal infections in peripheral blood stem cell transplants.	2001 Jan	11281391
[Pneumococcal antibiotic resistance in 1999. Results from 19 registries for 1999].	2001 Jan	11242764
Drug therapy for methicillin-resistant Staphylococcus aureus.	2001 Jan	11227621
Quinupristin/dalfopristin: a therapeutic review.	2001 Jan	11219478
[Detection of mupirocin resistant staphylococci from patients treated with mupirocin].	2001 Jan	11218388
High-performance liquid chromatographic and capillary electrophoretic enantioseparation of plant growth regulators and related indole compounds using macrocyclic antibiotics as chiral selectors.	2001 Jan 12	11215905
First glycopeptide-resistant Enterococcus faecium isolate from blood culture in Ankara, Turkey.	2001 Jan-Feb	11266313
[Drug resistance of Staphylococcus aureus strains, isolated from children with intestinal dysbacteriosis].	2001 Jan-Feb	11236517
Antimicrobial resistance of Enterococci in Lebanon.	2001 Mar	11282266
In vitro activity of mezlocillin, meropenem, aztreonam, vancomycin, teicoplanin, ribostamycin and fusidic acid against Borrelia burgdorferi.	2001 Mar	11282265
Antibiotic resistance rates and macrolide resistance phenotypes of viridans group streptococci from the oropharynx of healthy Greek children.	2001 Mar	11282264
Invasive pneumococcal disease.	2001 Mar	11280137
Comparison of two sampling methods for the detection of gram-positive and gram-negative bacteria in the environment: moistened swabs versus Rodac plates.	2001 Mar	11279821
Optimization of the resistance of arterial allografts to infection: comparative study with synthetic prostheses.	2001 Mar	11265083
Characterization of dextran-producing Leuconostoc strains.	2001 Mar	11264750
Comparison of length of hospital stay for patients with known or suspected methicillin-resistant Staphylococcus species infections treated with linezolid or vancomycin: a randomized, multicenter trial.	2001 Mar	11256381
Effects of adjunctive treatment with combined cytokines in a neutropenic mouse model of multidrug-resistant Enterococcus faecalis septicemia.	2001 Mar	11253851
Chryseobacterium (Flavobacterium) meningosepticum outbreak associated with colonization of water taps in a neonatal intensive care unit.	2001 Mar	11247678
Vancomycin prophylaxis and emerging resistance: are ophthalmologists the villains? The heroes?	2001 Mar	11239872
The effect of topical povidone-iodine, intraocular vancomycin, or both on aqueous humor cultures at the time of cataract surgery.	2001 Mar	11239859
Formation and efficacy of vancomycin group glycopeptide antibiotic stereoisomers studied by capillary electrophoresis and bioaffinity mass spectrometry.	2001 Mar	11237332
Chryseobacterium in burn wounds.	2001 Mar	11226658
Daptomycin for line-related Leuconostoc bacteraemia.	2001 Mar	11222577
Bacteraemia due to vancomycin-resistant enterococci in Slovakia.	2001 Mar	11222576
Efficacy of linezolid in a staphylococcal endocarditis rabbit model.	2001 Mar	11222569
Effectiveness of gloves in the prevention of hand carriage of vancomycin-resistant enterococcus species by health care workers after patient care.	2001 Mar 1	11229854
Penicillin-resistant Streptococcus pneumoniae endocarditis: a case report and review.	2001 Mar 15	11247720
Enterococcal vanB resistance locus in anaerobic bacteria in human faeces.	2001 Mar 17	11265957
Variant esp gene as a marker of a distinct genetic lineage of vancomycin-resistant Enterococcus faecium spreading in hospitals.	2001 Mar 17	11265956

Patents

Sample Use Guides

In Vivo Use Guide

Patients with Normal Renal Function The usual daily intravenous dose is 2 g divided either as 500 mg every six hours or 1 g every 12 hours. Each Adults: dose should be administered at no more than 10 mg/min, or over a period of at least 60 minutes, whichever is longer. Other patient factors, such as age or obesity, may call for modification of the usual intravenous daily dose. The usual intravenous dosage of vancomycin is 10 mg/kg per dose given every six hours. Each Pediatric Patients: dose should be administered over a period of at least 60 minutes. Close monitoring of serum concentrations of vancomycin is recommended in these patients. In pediatric patients up to the age of 1 month, the total daily intravenous dosage may be lower. In Neonates: neonates, an initial dose of 15 mg/kg is suggested, followed by 10 mg/kg every 12 hours for neonates in the first week of life and every eight hours thereafter up to the age of one month. Each dose should be administered over 60 minutes. In premature infants, vancomycin clearance decreases as postconceptional age decreases. Therefore, longer dosing intervals may be necessary in premature infants. Close monitoring of serum concentrations of vancomycin is recommended in these patients.

Route of Administration: Intravenous

In Vitro Use Guide

Vancomycin was active against Staph. aureus and Staph. epidermidis, inhibiting 90% of strains at concentrations of 1.0 and 2.0 mg/l, respectively.

Name

Type

Language

VANCOMYCIN HYDROCHLORIDE

Common Name

English

NSC-757377

Code

English

Vancomycin monohydrochloride

Common Name

English

Vancomycin hydrochloride [WHO-DD]

Common Name

English

VANCOMYCIN HYDROCHLORIDE [MART.]

Common Name

English

VANCOCIN HYDROCHLORIDE

Brand Name

English

FIRVANQ

Brand Name

English

VANCOMYCIN HYDROCHLORIDE [ORANGE BOOK]

Common Name

English

VANCOMYCIN MONOHYDROCHLORIDE [MI]

Common Name

English

VANCOMYCIN HYDROCHLORIDE [USP MONOGRAPH]

Common Name

English

VANCOMYCIN HCL

Common Name

English

VANCOMYCIN HYDROCHLORIDE [EP MONOGRAPH]

Common Name

English

VANCOMYCIN HYDROCHLORIDE [VANDF]

Common Name

English

VANCOMYCIN HYDROCHLORIDE [USP-RS]

Common Name

English

VANCOMYCIN (AS HYDROCHLORIDE)

Common Name

English

VANCOMYCIN HYDROCHLORIDE [JAN]

Common Name

English

VANCOMYCIN, MONOHYDROCHLORIDE

Common Name

English

Classification Tree Code System Code

FDA ORPHAN DRUG

536416