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The following information outlines essential safety warnings regarding the use of vancomycin injection. It is crucial to review these details carefully and discuss any concerns with your healthcare provider.

• Kidney Problems: While rare, vancomycin injection can lead to significant and potentially life-threatening kidney issues. This risk is elevated for individuals aged 65 and older, those on higher doses, or with a history of kidney problems. Your healthcare provider will conduct blood tests before and during treatment to monitor kidney function. If signs of kidney issues arise, such as fatigue or swelling in the hands and feet, contact your provider immediately. Factors increasing the risk include dehydration, prolonged use, and concurrent use of other kidney-affecting medications.

• Hearing Issues: Vancomycin injection may cause temporary or permanent hearing problems, especially at higher doses or when combined with other medications that affect hearing. Your provider might recommend hearing tests before and during treatment. If you experience hearing loss, ringing in the ears, or dizziness, inform your provider promptly as you may need to discontinue the medication. Older adults are at a higher risk.

• Severe Skin Reactions: There is a possibility of severe skin reactions such as rashes, DRESS, or Stevens-Johnson syndrome. Immediate medical attention is required if you develop symptoms like a rash, blisters, peeling skin, mouth sores, or a high fever.

• Infusion-related Reactions: Administering vancomycin injection too quickly can cause an infusion reaction known as "red man syndrome," characterized by itchy skin and redness in the face and neck. Severe symptoms may include wheezing, difficulty breathing, and chest pain. To prevent this, the injection will be given slowly, and you will be monitored for allergic reactions. Notify your medical team if you experience any symptoms, as they may need to adjust the infusion rate or explore alternative treatments.

• Low White Blood Cell Count: Vancomycin injection can cause a temporary decrease in white blood cells, increasing infection risk. Monitoring of white blood cell count is advised for extended treatments.

• Severe Diarrhea: Antibiotic use, including vancomycin injection, can increase the risk of Clostridioides difficile infection, leading to severe diarrhea for up to two months post-treatment. Your provider will prescribe the minimal effective dose for the shortest duration necessary. Report symptoms such as severe diarrhea, bloody stools, fever, abdominal pain, or nausea to your provider immediately.

Contraindications: Do not use vancomycin injection if you have a known allergy to vancomycin or polysorbate 80. Consult your healthcare provider if this applies to you.

Common side effects:

• Nausea
• Stomach upset
• Pain at the injection site
• Redness at the injection site

Less common but important to monitor:

• Fever
• Chills
• Dizziness

Serious side effects:

• Sudden kidney injury
• Hearing problems
• Severe skin reactions
• Severe diarrhea
• Severe allergic reactions

When taking vancomycin, it's important to be aware of potential interactions with other medications that can increase the risk of side effects. Here are some key interactions to consider:

Kidney Toxicity (Nephrotoxicity): Vancomycin can affect kidney function. Using it alongside other medications that also impact the kidneys can heighten this risk. Such medications include:

• Aminoglycosides: These antibiotics, like gentamicin and Tobramycin, can increase the likelihood of kidney damage when used with vancomycin. If both are necessary, close monitoring of kidney function is essential.

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Common pain relievers such as Ibuprofen and Naproxen may reduce kidney function. Taking them with vancomycin can further elevate the risk of kidney issues.

Hearing Damage (Ototoxicity): Vancomycin has the potential to harm hearing. Combining it with other drugs that can also affect hearing increases this risk. These drugs include:

• Aminoglycosides: In addition to kidney concerns, these antibiotics can also impact hearing. Using them with vancomycin requires careful monitoring for any signs of hearing loss.

• Loop Diuretics: Medications like Furosemide, used to treat fluid retention, can affect hearing. When taken with vancomycin, the risk of hearing damage may rise.

Other Notable Interactions:

• Anesthetic Agents: Some anesthetics can cause reactions like flushing and low blood pressure when administered with vancomycin. To minimize these effects, vancomycin should be infused slowly, ideally over 60 minutes, before anesthesia is given.

• Neuromuscular Blocking Agents: Vancomycin may enhance the effects of these drugs, potentially leading to prolonged muscle relaxation. This is particularly relevant during surgeries requiring muscle relaxation.

• Bile Acid Sequestrants: Medications such as Cholestyramine, used to lower cholesterol, can bind to vancomycin in the gut, reducing its effectiveness. To avoid this, it's recommended to take vancomycin at least three to four hours before or after these medications.

Always inform your healthcare provider about all medications you're taking, including over-the-counter drugs and supplements, to ensure safe and effective use of vancomycin.