Reconstitution of 750mg Vancomycin
For a 750mg dose of vancomycin, you need to first reconstitute a 1-gram vial with 20 mL of sterile water for injection, then withdraw 15 mL of the resulting solution (which contains 750mg).
Step-by-Step Reconstitution Process
According to FDA labeling, vancomycin vials should be reconstituted to achieve a concentration of 50 mg/mL 1:
Initial Reconstitution
- 1-gram vial: Add 20 mL of Sterile Water for Injection
- This creates a 50 mg/mL concentration (1000mg ÷ 20mL = 50mg/mL)
Obtaining 750mg Dose
- Withdraw 15 mL from the reconstituted 1-gram vial
- Calculation: 750mg ÷ 50mg/mL = 15 mL
Critical Next Step - Further Dilution Required
The reconstituted solution MUST be further diluted before administration 1:
- Add the 15 mL of reconstituted vancomycin to at least 150 mL of compatible IV solution (0.9% sodium chloride or 5% dextrose)
- For doses between 500mg-1000mg, use 100-200 mL of diluent
- Infuse over at least 60 minutes to prevent red man syndrome
Alternative Using 500mg Vial
If using 500mg vials instead:
- Reconstitute one 500mg vial with 10 mL sterile water (creates 50mg/mL)
- Reconstitute a second 500mg vial with 10 mL sterile water
- Withdraw 10 mL from first vial (500mg) + 5 mL from second vial (250mg) = 750mg total
Storage After Reconstitution
- Reconstituted vials: 14 days refrigerated 1
- Further diluted solutions in 0.9% saline or D5W: 14 days refrigerated 1
- Other compatible solutions: 96 hours refrigerated 1
Common Pitfall to Avoid
Never administer the reconstituted vancomycin directly without further dilution. The 50mg/mL concentration is too concentrated for direct IV administration and significantly increases the risk of infusion-related reactions, including red man syndrome and phlebitis. The vancomycin solution has a low pH (2.5-4.5) that requires dilution for safe administration 1.