藥劑部參考美國 Johns Hopkins 大學研究團隊所建立的 NxP (Nephrotoxic Potential) 專家共識分級清單，本品具「顯著以上腎毒性風險」，被認定具中度至高度腎損傷潛勢，特別是同時合併其他腎毒性藥物、脫水、高齡或既有腎功能異常的患者族群，應更加注意。

Treatment of patients with infections caused by staphylococcal species and streptococcal species; used orally for staphylococcal enterocolitis or for antibiotic-associated pseudomembranous colitis produced by C. difficile.
葡萄球菌感染所致之心內膜炎、骨髓炎、肺炎、敗血病、軟組織感染、腸炎、梭狀桿菌感染所致之假膜性結腸炎

Vancomycin is a tricyclic glycopeptides antibiotic. It inhibits bacterial cell wall synthesis by blocking glycopeptide polymerization through binding tightly to D-alanyl-D-alanine portion of cell wall precursor

Absorption: Oral: Poor; Intraperitoneal: ~38%; Distribution: Vd: 0.4-1 L/kg; Distributes widely in body tissue and fluids, except for CSF, CSF:blood level ratio: Normal meninges: Nil; Inflamed meninges: 20% to 30%; Excretion: I.V.: Urine (80% to 90% as unchanged drug); Oral: Primarily feces; Elimination Half-life: Adults: 5-11 hrs, significantly prolonged with renal impairment; CVVHD clears vancomycin from the circulation while conventional hemodialysis does not.

Hypersensitivity to vancomycin or any component of the formulation; avoid in patients with previous severe hearing loss.

B (oral)
C (injection)

Enters breast milk/not recommended

Ototoxicity, nephrotoxicity, rapid infusion may develop anaphylactoid reactions, including red man syndrome, hypotension, urticaria; reversible neutropenia.

Adults: 2-3 g/day (or 30-60 mg/kg/day) in divided doses every 8-12 hours; Note: Dose requires adjustment in renal impairment. Each gram should be administered over a period of at least 60 minutes.
Older infants and children: IV 40mg/kg/day in 2-4 divided doses.
In neonates: an initial dose of 15mg/kg is suggested followed by 10mg/kg every 12 hours in the first week of life and every 8 hours thereafter up to the age of one month.

口服給予 :
對於C. difficile引起之偽膜性結腸炎每日劑量為500mg-2g，分成3-4次投與7-10天。小孩子的每日劑量為40mg/kg，分3-4次投與。每日劑量不可超過2g。可將適當劑量用水稀釋到30mL給病人喝，一般矯味糖漿可加入此溶液以改善口服的味道，此溶液也可藉由鼻胃管投與。【文字內容來自仿單】

General dosing:
Infants, Children, and Adolescents:
IV: Initial: 45 to 60 mg/kg/day divided every 6 to 8 hours; dose and frequency should be individualized based on serum concentrations.
Note: Based on adult data, an AUC24 target of 400 mg•hour/L is recommended in patients with serious methicillin-resistant S. aureus (MRSA) infections; specific dosing recommendations may be higher when targeting this range.

Dose requires adjustment in renal impairment.
ESRD患者之使用劑量：第一天loading dose: 15 mg/kg, 第四天：15 mg/kg，之後每7天給15 mg/kg

Initial or dose adjustment in patients with preexisting liver cirrhosis:
Child-Turcotte-Pugh class A:
Initial: No dosage adjustment necessary.

Child-Turcotte-Pugh class B and C:
Initial: No dosage adjustment necessary. Use caution as creatinine-based equations may overestimate kidney function in these patients; consider a conservative starting dose. If concurrent kidney dysfunction exists, an empiric reduction in dose or frequency (in addition to kidney impairment dosing adjustments) may be necessary to achieve clinical goals.

溶解後的溶液，可在冷藏保存內14天。進一步稀釋的注射液在室溫下可安定24小時，冷藏中可安定96小時。