Vancomycin (Vancomycin Hydrochloride) - Side Effects and Adverse Reactions

ADVERSE REACTIONS

Infusion-Related Events

During or soon after rapid infusion of vancomycin, patients may develop anaphylactoid reactions, including hypotension (see ANIMAL PHARMACOLOGY), wheezing, dyspnea, urticaria, or pruritus. Rapid infusion may also cause flushing of the upper body (“red neck”) or pain and muscle spasm of the chest and back. These reactions usually resolve within 20 minutes but may persist for several hours. Such events are infrequent if vancomycin is given by a slow infusion over 60 minutes. In studies of normal volunteers, infusion-related events did not occur when vancomycin was administered at a rate of 10 mg/min or less.

Nephrotoxicity

Renal failure, principally manifested by increased serum creatinine or BUN concentrations, especially in patients administered large doses of vancomycin, has been reported rarely. Cases of interstitial nephritis have also been reported rarely. Most of these have occurred in patients who were given aminoglycosides concomitantly or who had preexisting kidney dysfunction. When vancomycin was discontinued, azotemia resolved in most patients.

Gastrointestinal

Onset of pseudomembranous colitis symptoms may occur during or after antibiotic treatment (see WARNINGS).

Ototoxicity

A few dozen cases of hearing loss associated with vancomycin have been reported. Most of these patients had kidney dysfunction or a preexisting hearing loss or were receiving concomitant treatment with an ototoxic drug. Vertigo, dizziness, and tinnitus have been reported rarely.

Hematopoietic

Reversible neutropenia, usually starting 1 week or more after onset of therapy with vancomycin or after a total dosage of more than 25 g, has been reported for several dozen patients. Neutropenia appears to be promptly reversible when vancomycin is discontinued.

Thrombocytopenia has rarely been reported. Although a causal relationship has not been established, reversible agranulocytosis (granulocytes <500/mm3) has been reported rarely.

Phlebitis

Inflammation at the injection site has been reported.

Miscellaneous

Infrequently, patients have been reported to have had anaphylaxis, drug fever, nausea, chills, eosinophilia, rashes including exfoliative dermatitis, linear IgA bullous dermatosis, Stevens-Johnson syndrome, and vasculitis in association with administration of vancomycin.

Chemical peritonitis has been reported following intraperitoneal administration of vancomycin (see PRECAUTIONS).

REPORTS OF SUSPECTED VANCOMYCIN SIDE EFFECTS / ADVERSE REACTIONS

Possible Vancomycin side effects / adverse reactions in 66 year old female

Reported by a health professional (non-physician/pharmacist) from Korea, Republic of on 2011-10-03

Patient: 66 year old female

Reactions: Bronchopulmonary Aspergillosis, Hypotension

Adverse event resulted in: death

Suspect drug(s):
Itraconazole
    Indication: Aspergillosis

Vancomycin
    Indication: Aspergillosis

Voriconazole
    Indication: Aspergillosis

Azithromycin
    Indication: Aspergillosis

Adalimumab
    Indication: Rheumatoid Arthritis

Ceftriaxone
    Indication: Aspergillosis

Other drugs received by patient: Prednisolone; Celecoxib; Methotrexate

Possible Vancomycin side effects / adverse reactions in 88 year old female

Reported by a health professional (non-physician/pharmacist) from Denmark on 2011-10-03

Patient: 88 year old female

Reactions: Face Oedema

Suspect drug(s):
Kadian
    Dosage: sc
    Indication: Product Used FOR Unknown Indication

Vancomycin
    Dosage: iv
    Indication: Product Used FOR Unknown Indication

Metoclopramide
    Dosage: sc
    Indication: Product Used FOR Unknown Indication

Metronidazole
    Dosage: iv
    Indication: Product Used FOR Unknown Indication

Ciprofloxacin
    Dosage: iv
    Indication: Product Used FOR Unknown Indication

Other drugs received by patient: Trospium Chloride; Polyethylene Glycol; Simvastatin; Cetirizine HCL; Amitriptyline HCL; Lidocaine; Propylthiouracil

Possible Vancomycin side effects / adverse reactions in 88 year old female

Reported by a health professional (non-physician/pharmacist) from United Kingdom on 2011-10-03

Patient: 88 year old female

Reactions: Face Oedema

Suspect drug(s):
Morphine Sulfate
    Indication: Product Used FOR Unknown Indication

Vancomycin
    Indication: Product Used FOR Unknown Indication

Metoclopramide
    Indication: Product Used FOR Unknown Indication

Metronidazole IN Plastic Container
    Indication: Product Used FOR Unknown Indication

Ciprofloxacin IN Dextrose
    Indication: Product Used FOR Unknown Indication

Other drugs received by patient: Amitriptyline HCL; Lidocaine; Trospium Chloride; Cetirizine HCL; Polyethylene Glycol; Simvastatin; Propylthiouracil