From the Guidelines
Vancomycin is contraindicated in patients with known hypersensitivity to the drug, as it can cause severe allergic reactions, including anaphylaxis. The use of vancomycin should be approached with caution in certain patient populations, including those with renal impairment, as it can exacerbate kidney damage and increase the risk of nephrotoxicity 1.
- Renal impairment: Vancomycin doses should be adjusted based on the patient's estimated creatinine clearance, and renal function should be closely monitored 1.
- Hypersensitivity reactions: Patients with a history of hypersensitivity to vancomycin should avoid its use due to the risk of severe allergic reactions, including anaphylaxis.
- Pregnancy and lactation: While vancomycin may be used in pregnant women when the benefits outweigh the risks, its use should be approached with caution, especially during the first trimester 1.
- Ototoxicity: Vancomycin can cause ototoxicity, and its use should be avoided in patients with certain types of hearing loss 1. It is essential to weigh the potential benefits and risks of vancomycin use in each patient, considering factors such as the severity of the infection, the presence of contraindications, and the availability of alternative treatments 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Contraindications for Vancomycin
The following are contraindications for vancomycin:
- Hypersensitivity to vancomycin 2, 3, 4
- Nephrotoxicity: vancomycin can cause kidney damage, especially with high doses or prolonged use 2, 3, 5, 6
- Ototoxicity: vancomycin can cause hearing loss, especially with high doses or prolonged use 2, 3, 6, 4
- Phlebitis: vancomycin can cause inflammation of the veins, especially with prolonged use 2, 3, 4
- Red man syndrome: a rare but potentially life-threatening allergic reaction to vancomycin 2, 3
- Neutropenia: vancomycin can cause a decrease in white blood cell count, especially with high doses or prolonged use 2
- Interstitial nephritis: vancomycin can cause inflammation of the kidneys, especially with high doses or prolonged use 2
Special Considerations
- Vancomycin should be used with caution in patients with renal impairment, as it can exacerbate kidney damage 5, 6
- Vancomycin should be used with caution in patients with hearing impairment, as it can exacerbate hearing loss 6
- Vancomycin should be used with caution in neonates, as the evidence on its toxicity in this population is limited 6
- Vancomycin should be used with caution in patients receiving concomitant nephrotoxic drugs, as it can increase the risk of kidney damage 6