Vancoplus is recommended twice daily not less than three days by slow intravenous infusion over 60 minutes. It is not to be diluted with calcium containing solutions
Vancoplus dose adjustment is not needed for patients with hepatic dysfunction.
Renal dysfunction: The major route of elimination of active components of Vancoplus component i.e., vancomycin and ceftriaxone is through kidneys. Approximately, 50-60 % of ceftriaxone and 90% of vancomycin is eliminated in urine and the rest is excreted via the bile into the faeces. In general, renal impairment decreases the clearance of the drug and thus increasing the accumulation of drugs which are primarily eliminated by kidneys. Therefore; less dosage is needed for achieving the same therapeutic effect.
Special patient groups
Elderly: These dosages do not require modification in elderly patients provided that renal and hepatic functions are satisfactory. However, dosage reduction may be necessary to a greater extent than expected because of decreasing renal function and auditory function should be monitored.
Patients with impaired renal function: Dosage adjustments must be made to avoid toxic serum levels. In premature infants and the elderly, greater dosage reductions than expected may be necessary because of decreased renal function. Regular monitoring of serum levels is advised in such patients, as accumulation has been reported, especially after prolonged therapy.
Patients with hepatic impairment: No dosage adjustment is required provided renal function. If the patient has hepatic and renal impairment together than the dose will be adjusted.
Dosage adjustments in patients with both hepatic dysfunction and significant renal disease, caution should be exercised and the Vancoplus dosage should be adjusted.
One should not administer a double dose to make up for a missed one.
- Vancoplus is recommended by slow intravenous infusion over 60 minutes and it should not be diluted with calcium containing solutions.
- In critically ill conditions, for the indications where the amount of infusion cannot be higher, Vancoplus 1.5 g can be diluted in minimum 100ml of the infusion. Similarly for Vancoplus 3 g can be diluted in minimum 200 mL of the infusion. Once reconstituted, Vancoplus should be used immediately. The color may get darkened during storage but it does not affect the efficacy of product if stored up to 24 h at refrigerated condition and up to 12 h at room temperature.
In the case of over dosage of Vancoplus, nausea, vomiting, diarrhoea can occur. Supportive care is advised, with maintenance of glomerular filtration. Ceftriaxone and vancomycin are poorly removed from the blood by hemodialysis or peritoneal dialysis. Haemoperfusion with Amberlite resin XAD-4 has been reported to be of limited benefit for vancomycin removal. Hemofiltration effectively removes vancomycin from the blood.