9 mins read

Vancomycin is an antibiotic used to treat a variety of infections caused by certain bacteria. Common side effects include nausea, stomach pain, and low potassium levels when taken by mouth. When getting it intravenously (IV), common side effects include kidney problems, hearing loss, and infusion reactions. Serious side effects are less common but can include serious skin reactions or a type of diarrhea that is difficult to treat. Notify your health care provider right away if you develop a rash, skin peeling, or watery or bloody diarrhea.

Vancomycin comes in several formulations including oral capsules, oral liquid, and injection.

Uses

What is vancomycin used for?

Vancomycin is an antibiotic that is commonly used for the following infections or conditions caused by certain bacteria.

  • Sepsis, which is a condition where your body has a severe response to infection
  • Antibiotic-associated diarrhea, which is also known as C. diff
  • Enterocolitis, which is a condition where your intestines are inflamed
  • Endocarditis, which is an infection of the inner lining of your heart and surface of its valves
  • Skin infections
  • Bone infections
  • Lung infections, such as bronchitis and pneumonia

Vancomycin may not be appropriate for some of the infections listed above, depending on which germs are causing the infection. Bacteria in some locations may have developed resistance to vancomycin, which will make it not work as well.

Vancomycin may also be used for other conditions as determined by your health care provider.

How does vancomycin work (mechanism of action)?

Vancomycin kills certain types of bacteria by blocking their ability to build a cell wall, weakening their cell membrane, and disrupting their ability to create proteins that they need to grow and multiply.

How is vancomycin supplied (dosage forms)?

Brands and other names

  • Firvanq Kit
  • Vancocin
  • Vancoled
  • Vancor

Dosage forms and strengths

  • 125 mg oral capsules
  • 250 mg oral capsules
  • 25 mg/mL kit for oral solution
  • 50 mg/ml kit for oral solution

Vancomycin is also available in injectable forms.

How should I store vancomycin?

Oral Capsule. Vancomycin capsules should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). The medicine can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Oral Liquid. Vancomycin liquid should be stored in the refrigerator between 36 F to 46 F (2 C to 8 C). Do not freeze. Keep the medicine container tightly closed when you are not using it. Protect the medicine from light.

Injection. Injectable vancomycin is usually given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of vancomycin?

The most common side effects of vancomycin are listed below. These side effects may vary depending on the infection being treated and the dosage form being used. Tell your health care provider if you have any of these side effects that bother you.

  • Nausea
  • Stomach pain
  • Low potassium levels (hypokalemia)
  • Kidney damage (see below)
  • Hearing loss (see below)
  • Low neutrophil levels (neutropenia) (see below)
  • Allergic reactions (see below)
  • Infusion reactions (see below)

There may be other side effects of vancomycin that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of vancomycin?

While less common, the most serious side effects of vancomycin are described below, along with what to do if they happen.

Severe Allergic Reactions. Vancomycin can cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for drug reaction with eosinophilia and systemic symptoms. It is also sometimes called multiorgan hypersensitivity. This is a reaction that can affect multiple parts of the body, including your liver, kidneys, and heart. Stop taking the medicine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Dark colored urine
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Kidney Damage. Kidney damage can happen when taking vancomycin. Call your health care provider right away if you have any of the following symptoms of kidney damage.

  • Reduced need to pee
  • Swelling in your feet, ankles, or legs
  • Weakness or unusual tiredness
  • Difficulty catching your breath or chest pain/pressure
  • Confusion
  • Nausea
  • Seizures

Hearing Loss. Vancomycin may be associated with hearing loss, which is also called ototoxicity. Tell your health care provider right away if you have hearing loss or if you hear a ringing or roaring sound in your ears.

Severe Skin Reactions. Vancomycin can cause severe skin reactions, called Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), acute generalized exanthematous pustulosis (AGEP), and linear IgA bullous dermatosis (LABD), some of which can lead to death if not treated. Stop vancomycin and get emergency help if you have any of the following symptoms.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes
  • Small, pus-filled bumps on the skin surrounded by redness

Low Neutrophil Levels (Neutropenia). Vancomycin may cause low levels of a type of white blood cell (called neutrophils), which is known as neutropenia. Neutrophils help prevent infection. Having a low level of neutrophils may increase your risk of infection. Tell your health care provider right away if you have any of the following symptoms of low neutrophil levels.

  • Fever, chills, or sweats
  • Tiredness
  • Sore throat, cough, or shortness of breath
  • Mouth or throat sores
  • Swollen lymph nodes

Infusion Reactions. Intravenous (IV) vancomycin can cause reactions that can be serious when it is given to you. Your infusion may be slowed down or you may be changed to a different medicine if you experience this reaction. You will be monitored while you are receiving vancomycin. Tell your health care provider right away if you have any of the following symptoms when you receive the medicine.

  • Redness of the face, neck, or upper body
  • Dizziness or lightheadedness
  • Weakness or unusual tiredness
  • Wheezing, trouble breathing, or shortness of breath
  • Chest pain or pressure
  • Muscle pain
  • Itching or skin rash, usually on the upper body
  • Low blood pressure or a fast heart rate

Vein Swelling. Vancomycin for injection can cause phlebitis, which is vein inflammation, because it is irritating to the tissues surrounding your veins. The medicine is given through a vein with secure access to your bloodstream to reduce the risk of phlebitis. Tell your health care provider if you have any of the following symptoms of phlebitis.

  • Redness or tenderness near the site of infusion
  • Itching or swelling of the skin near the vein
  • Throbbing or burning of the area near the vein

Antibiotic-Associated Diarrhea. An overgrowth of germs called Clostridioides difficile, or C. diff, can happen in your gut with many types of antibiotics, including vancomycin. This can cause a condition known as antibiotic-associated diarrhea and can happen even up to two months after stopping the antibiotic. Call your health care provider right away if you have any of the following symptoms of this condition.

  • Watery diarrhea
  • Diarrhea that does not go away
  • Blood in your stool (poop)
  • Severe stomach cramps
  • Fever that starts after you start or finish the medicine

Warnings & Precautions

Who should not use vancomycin?

Allergies to Ingredients. People who are allergic to any of the following should not take vancomycin.

  • Firvanq Kit
  • Vancocin
  • Vancoled
  • Vancomycin
  • Vancor
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific vancomycin products they stock.

What should I know about vancomycin before using it?

Do not take vancomycin unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share vancomycin with other people, even if they have the same condition as you. It may harm them.

Keep vancomycin out of the reach of children. Since liquid vancomycin should be kept in a refrigerator, take special precautions to keep it away from children who also use the refrigerator.

If you are taking liquid vancomycin, shake the medicine container well before measuring your dose and use an accurate measuring device. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device. Throw away any unused liquid vancomycin after 14 days or if the medicine appears cloudy or seems to have particles or clumps in it.

People who are 65 and older can be at greater risk for some side effects from vancomycin. Talk to your health care provider about your risks if you are in this age group.

What should I tell my health care provider before using vancomycin?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if vancomycin is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Kidney problems
  • Any inflammatory condition of the intestines, including colitis
  • Hearing loss
  • Dehydration
  • Low neutrophil levels (neutropenia)
  • Any condition requiring restricted sodium intake, such as heart failure

Other Medicines and Supplements. Vancomycin may interact with other medicines and supplements. Before using vancomycin, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how vancomycin could affect pregnancy or harm an unborn baby. Tell your health care provider if you are or plan to become pregnant. Your health care provider will advise you if you should be treated with vancomycin while you are pregnant or trying to get pregnant.

Breastfeeding. It is not known if oral vancomycin passes into breast milk. Vancomycin for injection passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will advise you if you should be treated with vancomycin while breastfeeding.

Ingredient Allergies. Some vancomycin products should not be used in people who have an allergy to polysorbate 80, corn, or corn products. Tell your health care provider if you have an allergy to any of these ingredients before you are treated with vancomycin.

Interactions

Does vancomycin interact with foods or drinks?

There are no known interactions between vancomycin and foods or drinks.

There are no known interactions between vancomycin and alcohol, but heavy drinking can slow your immune response and make it harder for your body to fight infections.

Does vancomycin interact with other medicines (drug interactions)?

There are no known interactions between oral vancomycin and other medicines. Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using vancomycin for injection.

  • Piperacillin-tazobactam (Zosyn), which is an antibiotic used to treat bacterial infections
  • Amphotericin B (Abelcet, AmBisome), which is a medicine used to treat fungal infections
  • An aminoglycoside, such as amikacin or gentamicin, which is a medicine given by injection to treat infections
  • Any medicine with bacitracin, colistin, or polymyxin B in it, which are antibiotics used to treat bacterial infections
  • Cisplatin, which is a medicine used to treat some cancers

This may not be a complete list of medicines that can interact with vancomycin. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much vancomycin?

If you or someone else has used too much vancomycin, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of vancomycin?

Oral Capsule or Liquid. If you miss a dose of oral vancomycin, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses. It is important to complete your prescribed course of oral vancomycin, even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to vancomycin or other similar medicines.

Injection. Vancomycin for injection is usually given by a health care provider in a hospital or clinic. Your health care provider will make sure you are receiving vancomycin for injection as scheduled. If you miss an appointment to get your vancomycin dose, call to make another appointment as soon as possible.

Look up another drug