Vancomycin interactions

Vancomycin (Vancocin, Firvanq), an antibiotic has 21 documented interactions across the FDA labels and fact sheets we index: 4 major, 15 moderate, 2 minor, and 0 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

Interactions from the label

Major interactions (4)

  • CidofovirantiviralMajor

    Nephrotoxic agents Concomitant administration of cidofovir injection and agents with nephrotoxic potential [e.g., intravenous aminoglycosides (e.g., tobramycin, gentamicin, and amikacin), amphotericin B, foscarnet, intravenous pentamidine, vancomycin, and nonsteroidal anti-inflammatory agents] is contraindicated. (Cidofovir label, Drug interactions)

  • GentamicinaminoglycosideMajor

    Concurrent and/or sequential systemic or topical use of other potentially neurotoxic and/or nephrotoxic drugs, such as cisplatin, cephaloridine, kanamycin, amikacin, neomycin, polymyxin B, colistin, paromomycin, streptomycin, tobramycin, vancomycin, and viomycin, should be avoided (see PRECAUTIONS, Drug Interactions section). (Gentamicin label, Boxed warning)

  • NeomycinaminoglycosideMajor

    Concurrent and/or sequential systemic, oral or topical use of other aminoglycosides, including paromomycin and other potentially nephrotoxic and/or neurotoxic drugs such as bacitracin, cisplatin, vancomycin, amphotericin B, polymyxin B, colistin and viomycin, should be avoided because the toxicity may be additive. (Neomycin label, Boxed warning)

  • PentamidineQT-prolonging drugMajor

    Because the nephrotoxic effects may be additive, the concomitant or sequential use of Pentamidine Isethionate and other nephrotoxic drugs such as aminoglycosides, amphotericin B, cisplatin, foscarnet, or vancomycin should be closely monitored and avoided, if possible. (Pentamidine label, Drug interactions)

Moderate interactions (15)

  • AdefovirantiviralModerate

    However, this is of special importance in patients at risk of or having underlying renal dysfunction and patients taking concomitant nephrotoxic agents such as cyclosporine, tacrolimus, aminoglycosides, vancomycin and non-steroidal anti-inflammatory drugs [See Adverse Reactions (6.2) and Clinical Pharmacology (12.3) ]. (Adefovir label, Warnings and precautions)

  • AmikacinaminoglycosideModerate

    The risk is higher in older patients, patients who are receiving higher doses, who have an underlying hearing loss, who are receiving concomitant therapy with another ototoxic agent, such as an aminoglycoside or who have underlying renal impairment. (Vancomycin label, Warnings and precautions)

  • CeftriaxonecephalosporinModerate

    Vancomycin, Amsacrine, Aminoglycosides, and Fluconazole Vancomycin, amsacrine, aminoglycosides, and fluconazole are physically incompatible with ceftriaxone in admixtures [see Dosage and Administration (2.3) ]. (Ceftriaxone label, Drug interactions)

  • CyclosporineimmunosuppressantModerate

    …fibric acid derivatives (e.g., bezafibrate, fenofibrate) gentamicin ketoconazole colchicine ranitidine methotrexate tobramycin diclofenac trimethoprim with sulfamethoxazole naproxen vancomycin sulindac During the concomitant use of a drug that may exhibit additive or synergistic renal impairment with cyclosporine, close monitoring of renal function (in particular… (Cyclosporine label, Drug interactions)

  • Desfluranegeneral anestheticModerate

    To reduce the risk of infusion reactions, administer Vancomycin Injection over a period of 60 minutes or greater and also prior to intravenous anesthetic agents. (Vancomycin label, Warnings and precautions)

  • Etomidategeneral anestheticModerate

    To reduce the risk of infusion reactions, administer Vancomycin Injection over a period of 60 minutes or greater and also prior to intravenous anesthetic agents. (Vancomycin label, Warnings and precautions)

  • Isofluranegeneral anestheticModerate

    To reduce the risk of infusion reactions, administer Vancomycin Injection over a period of 60 minutes or greater and also prior to intravenous anesthetic agents. (Vancomycin label, Warnings and precautions)

  • KetamineCNS depressantModerate

    To reduce the risk of infusion reactions, administer Vancomycin Injection over a period of 60 minutes or greater and also prior to intravenous anesthetic agents. (Vancomycin label, Warnings and precautions)

  • MethohexitalbarbiturateModerate

    To reduce the risk of infusion reactions, administer Vancomycin Injection over a period of 60 minutes or greater and also prior to intravenous anesthetic agents. (Vancomycin label, Warnings and precautions)

  • Piperacillin and tazobactampenicillin antibioticModerate

    The risk of AKI increases with higher vancomycin serum levels, prolonged exposure, concomitant administration of other nephrotoxic drugs, concomitant administration of piperacillin-tazobactam [see Drug Interactions (7.2) ] , volume depletion, pre-existing renal impairment and in critically ill patients and patients with co-morbid conditions that predispose to… (Vancomycin label, Warnings and precautions)

  • PlazomicinaminoglycosideModerate

    The risk is higher in older patients, patients who are receiving higher doses, who have an underlying hearing loss, who are receiving concomitant therapy with another ototoxic agent, such as an aminoglycoside or who have underlying renal impairment. (Vancomycin label, Warnings and precautions)

  • PropofolCNS depressantModerate

    To reduce the risk of infusion reactions, administer Vancomycin Injection over a period of 60 minutes or greater and also prior to intravenous anesthetic agents. (Vancomycin label, Warnings and precautions)

  • Rocuroniumneuromuscular blockerModerate

    Antibiotics Drugs which may enhance the neuromuscular blocking action of nondepolarizing agents such as Rocuronium Bromide Injection include certain antibiotics (e.g., aminoglycosides; vancomycin; tetracyclines; bacitracin; polymyxins; colistin; and sodium colistimethate). (Rocuronium label, Drug interactions)

  • Sevofluranegeneral anestheticModerate

    To reduce the risk of infusion reactions, administer Vancomycin Injection over a period of 60 minutes or greater and also prior to intravenous anesthetic agents. (Vancomycin label, Warnings and precautions)

  • TobramycinaminoglycosideModerate

    The risk is higher in older patients, patients who are receiving higher doses, who have an underlying hearing loss, who are receiving concomitant therapy with another ototoxic agent, such as an aminoglycoside or who have underlying renal impairment. (Vancomycin label, Warnings and precautions)

Minor mentions (2)

  • Closely evaluate the renal function of patients Examples: Aminoglycosides, amphotericin B, systemic bacitracin, cisplatin, cyclosporine, foscarnet, or parenteral vancomycin Angiotensin Converting Enzyme (ACE) Inhibitors Clinical Impact: The hyponatremic and hypotensive effects of ACE inhibitors may be diminished by the concomitant administration of aspirin due… (Butalbital, aspirin, caffeine, and codeine label, Drug interactions)

  • LinezolidantibioticMinor

    …Patients With Catheter-Related Bloodstream Infections, Including Those With Catheter-Site Infections An imbalance in mortality was seen in patients treated with linezolid relative to vancomycin/dicloxacillin/oxacillin in an open-label study in seriously ill patients with intravascular catheter-related infections [78/363 (21.5%) vs. 58/363 (16.0%); odds ratio 1.426,… (Linezolid label, Warnings and precautions)

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.