Indications
Covan IV Infusion is used for:
Septicaemia, Soft tissue infections, Osteomyelitis, Enterocolitis, Colitis, Serious staphylococcal or other Gm +ve infections, Bacterial endocarditis
Adult Dose
Intravenous
Severe staphylococcal or other Gram-positive infections, Endocarditis
Adult: 500 mg 6 hrly, infused over at least 60 min or 1 g 12 hrly, infused over at least 100 min.
Elderly: Dosage adjustment needed.
Child Dose
Intravenous
Children
Severe staphylococcal or other Gram-positive infections, Endocarditis
<1 month: 15 mg/kg followed by 10 mg/kg IV q12hr for neonates in first week of life and q8hr thereafter up to 1 month of age; longer dosing intervals recommended in premature infants
>1 month: 10 mg/kg/day IV divided q6hr; individual dose not to exceed 1 g
Renal Dose
Renal impairment: Patient on intermittent haemodialysis: Loading dose: 15-25 mg/kg on day 1, followed by 5-10 mg/kg maintenance dose after each dialysis run. Anuric patient (w/o kidney function) on dialysis: Initially, 15 mg/kg. Maintenance: 1.9 mg/kg 24 hrly.
CrCl (ml/min) Dosage Recommendation
<20 Longer intervals; determine by serum concentration monitoring.
20-49 Initially, 15-20 mg/kg/dose (usual: 750-1,500 mg) 24 hrly.
>50 Initially, 15-20 mg/kg/dose (usual: 750-1,500 mg) 8-12 hrly.
Administration
IV Preparation
Add 10 mL of SWI to 500-mg vial and 20 mL of SWI to 1-g vial to yield 50 mg/mL solution; further dilution is required, depending on method of administration
Intermittent infusion: Dilute 500 mg with ?100 mL of diluent and 1 g with ?200 mL of diluent (NS or D5W)
Continuous infusion: Dilute in sufficient amount to permit infusion over 24 hours
IV Administration
Intermittent (preferred): Administer over 60 minutes; not to exceed 10 mg/min
Continuous: Administer over 24 hours
Contra Indications
Hypersensitivity to the drug; history of impaired hearing; IM administration.
Precautions
Patient w/ allergic reaction to teicoplanin, previous hearing loss, inflammatory bowel disease. Renal impairment. Elderly. Pregnancy and lactation. Monitoring Parameters Determine regularly serial tests of auditory function and serum or blood vancomycin concentrations during treatment. Periodic urinalysis and renal function tests. Monitor leukocyte count in prolonged therapy.
Lactation: Drug enters breast milk; not recommended
Pregnancy-Lactation
Pregnancy
Animal reproduction studies have not been conducted with vancomycin
Unknown whether vancomycin can affect reproduction capacity
In a controlled clinical study, potential ototoxic and nephrotoxic effects of vancomycin on infants were evaluated when administered to pregnant women for serious staphylococcal infections complicating IV drug abuse
Single-dose flexible bags only
This formulation is not recommended for use during pregnancy because it contains the excipients, PEG 400 and NADA, which caused fetal malformations in animal reproduction studies (see Contraindications)
Perform a pregnancy test in females of reproductive potential prior to prescribing this formulation
Lactation
Vancomycin is excreted in human milk
Exercise caution when vancomycin is administered to a nursing woman
Because of the potential for adverse events, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother
Interactions
General anaesth may enhance the adverse effects of vancomycin. Increased risk of ototoxicity and nephrotoxicity w/ aminoglycosides, polymyxins, ciclosporin, cisplatin and loop diuretics. Increased potential of neuromuscular blockade w/ suxamethonium or vecuronium.
Side Effects
Side effects of Vancomycin :
>10%
Erythematous rash on face and upper body (red neck or red man syndrome; related to infusion rate), Hypotension accompanied by flushing
1-10%
Chills, Drug fever, Eosinophilia, Rash, Reversible neutropenia, Phlebitis
<1%
Nephrotoxicity, Ototoxicity (especially with large doses), Stevens-Johnson syndrome, Thrombocytopenia, Vasculitis
Potentially Fatal: Stevens-Johnson syndrome; toxic epidermal necrolysis, blood dyscrasias such as neutropenia or thrombocytopenia.
Mode of Action
Vancomycin binds tightly to D-alanyl-D-alanine portion cell wall precursor causing blockage of glycopeptide polymerisation which produces immediate inhibition of cell wall synthesis and secondary damage to the cytoplasmic membrane.
Note
Covan 1gm IV Infusion generic name is Vancomycin. Covan 1gm IV Infusion is manufactured by Renata LimitedCovan is availble in all over Bangladesh.
Mes BD drug index information on Covan IV Infusion is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.