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telavancin (Rx)Brand and Other Names:Vibativ

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injection

  • 250mg/vial
  • 750mg/vial
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Skin & Skin Structure Infections

Indicated for skin and skin structure infections caused by Gram-positive bacteria including Staphylococcus aureus (including methicillin-resistant and methicillin-susceptible strains), Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus anginosus group (includes S anginosus, S intermedius, and S constellatus), and Enterococcus faecalis (vancomycin-susceptible isolates only)

10 mg/kg IV q24hr for 7-14 days; infuse over 1 hr 

Pneumonia

Indicated for hospital-acquired, including ventilator-associated bacterial pneumonia caused by susceptible isolates of Staphylococcus aureus (including methacillin-relesistant and vancomycin-intermediate strains) when alternative treatments are not suitable

10 mg/kg IV q24hr for 7-21 days; infuse over 1 hr 

Dosing Considerations

Pneumonia: Approved only to treat Staphylococcus aureus, not other pneumonia-causing bacteria

Renal Impairment

CrCl 30-50 mL/minute: 7.5 mg/kg IV q24hr

CrCl 10-29 mL/minute: 10 mg/kg IV q48hr

Safety and efficacy not established

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Interactions

Interaction Checker

telavancin and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Taste disturbance

            Nausea

            Vomiting

            Foamy urine

            1-10%

            Diarrhea

            Dizziness

            Rigors

            Pruritus

            Rash

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            Warnings

            Black Box Warnings

            Renal impairment

            • Increased mortality compared with vancomycin in patients with pre-existing moderate/severe renal impairment (CrCl 50 mL/min or less) who were treated for hospital-acquired bacterial pneumonia/ventilator-associated bacterial pneumonia
            • Use with pre-existing moderate/severe renal impairment should be considered only when the anticipated benefit to the patient outweighs the potential risk
            • Nephrotoxicity: New onset or worsening renal impairment has occurred; monitor renal function in all patients

            Pregnancy

            • Women of childbearing potential should have a serum pregnancy test prior to administration
            • Avoid during pregnancy unless potential benefit to the patient outweighs potential risk to the fetus
            • Adverse developmental outcomes observed in 3 animal species at clinically relevant doses raise concerns about potential adverse developmental outcomes in humans

            Contraindications

            Hypersensitivity

            Use of intravenous unfractionated heparin sodium

            Cautions

            New onset or worsening renal impairment has been reported (monitor renal function)

            Efficacy decreased with moderate-to-severe baseline renal impairment (ie, CrCl <50 mL/min) for skin and skin structure infections

            Administer over at least 1 hr to minimize infusion-related adverse reactions

            Clostridium difficile-associated diarrhea may occur

            May prolong QTc interval; coadministration with other drugs that prolong QTc interval (eg, phenothiazine, TCAs, macrolide antibiotics, class I and III antiarrhythmic agents) increased risk for life-threatening arrhythmias

            Interferes with coagulation tests including PT, INR, and APT, but does not interfere with coagulation

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            Pregnancy & Lactation

            Pregnancy category: C

            Women of childbearing potential should have serum pregnancy test before administration

            Adverse developmental outcomes observed in 3 animal species at clinically relevant doses raise concerns about potential for human fetal harm

            Lactation: Unknown if excreted in breast milk

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Lipoglycopeptide antibiotic that is a synthetic derivative of vancomycin

            Inhibits bacterial cell wall synthesis by interfering with polymerization and cross-linking of peptidoglycan

            Unlike vancomycin, telavancin also depolarizes the bacterial cell membrane and disrupts its functional integrity

            Absorption

            Poor oral absorption

            Distribution

            Protein Bound: 90%

            Vd: 133-145 mL/kg

            Metabolism

            Metabolic pathway not yet identified; not metabolized by CYP450 isoenzymes

            Elimination

            Half-life: 8 hr

            Clearance: 13.1-13.9 mL/hr/kg

            Excretion: 75% urine; <1% feces

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            Administration

            IV Compatibility

            Data limited

            Do not add other drugs or infuse simultaneously through same IV line

            Flush IV line before and after infusion for sequential infusion of additional medications

            IV Preparation

            250 mg vial reconstitution

            • Add 15 mL of D5W, SWI, or NS
            • Resultant solution concentration 15 mg/mL (total volume approximately 17 mL)

            750 mg vial reconstitution

            • Add 45 mL of D5W, SWI, or NS
            • Resultant solution concentration 15 mg/mL (total volume approximately 50 mL)

            Further dilution

            • Solutions for further dilution before infusion include: D5W, NS, lactated Ringer's injection
            • Doses of 150-800 mg: dilute further in 100-250 mL of IV solution
            • Doses <150 mg or >800 mg: dilute further to final concentration of 0.6-8 mg/mL

            IV Administration

            Intermittent infusion over 60 min

            Stability

            No preservative or bacteriostatic agent in product

            Reconstituted solution or further diluted

            • Stored at room temp: Use within 4 hr
            • Stored refrigerated: Use within 72 hr
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            Formulary

            FormularyPatient Discounts

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            • View the formulary and any restrictions for each plan.
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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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