Pregnancy Category: C
ClassificationTherapeutic: anti infectives
Treatment of complicated skin/skin structure infections caused by susceptible bacteria.Hospital-acquired and ventilator-associated bacterial pneumonia caused by Staphylococcus aureus
Inhibits bacterial cell wall synthesis by interfering with the polymerization and cross-linking of peptidoglycan.
Bactericidal action against susceptible organisms.Active against Staphylococcus aureus (including methicillin-susceptible and -resistant strains), Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus anginosus (including S. anginosus, S. intermedius, and S. constellatus), and Enterococcus faecalis (vancomycin-susceptible strains only).
Absorption: IV administration results in complete bioavailability.
Distribution: Penetrates blister fluid.
Metabolism and Excretion: Metabolism is not known; 76% excreted unchanged in urine <1% in feces.
Half-life: 8 hr.
|IV||unknown||end of infusion||24 hr|
Contraindicated in: HypersensitivityCongenital long QT syndrome, known prolongation of the QT interval, uncompensated HF, or severe left ventricular hypertrophy (risk of fatal arrhythmias); Obstetric: Do not use unless potential maternal benefit outweighs potential risk to fetus.
Use Cautiously in: Renal impairment (efficacy may be ↓; dose ↓ recommended for CCr ≤50 mL/min) (↑ risk of mortality in patients with CCr ≤50 mL/min; use only if benefit outweighs risk) (↑ risk of renal impairment);Diabetes, HF, hypertension (↑ risk of renal impairment) Geriatric: Consider age-related ↓ in renal function, adjust dose accordingly (↑ risk of adverse renal reactions); Lactation: Use cautiously; Pediatric: Safety and effectiveness not established.
Adverse Reactions/Side Effects
Central nervous system
- QT interval prolongation
- pseudomembranous colitis (life-threatening)
- taste disturbance (most frequent)
- nausea (most frequent)
- vomiting (most frequent)
- abdominal pain
- foamy urine (most frequent)
- anaphylaxis (life-threatening)
- infusion reactions
Drug-Drug interactionConcurrent use of other medications known to prolong QT interval may ↑ risk of arrhythmias.Concurrent use of NSAIDs, ACE inhibitors, and loop diuretics may ↑ risk of adverse renal effects.
Complicated Skin/Skin Structure Infections
Intravenous (Adults) 10 mg/kg ever 24 hr for 7–14 days.
Hospital-Acquired/Ventilator-Associated Bacterial Pneumonia
Intravenous (Adults) 10 mg/kg ever 24 hr for 7–21 days.
Renal ImpairmentIntravenous (Adults) CCr 30–50 mL/min—7.5 mg/kg every 24 hr; CCr 10–≤30 mL/min—10 mg/kg every 48 hr.
Sterile lyophilized powder for IV use (requires reconstitution): 250 mg/vial, 750 mg/vial
- Assess for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC) at beginning of and throughout therapy.
- Obtain specimens for culture and sensitivity prior to therapy. First dose may be given before receiving results.
- Assess women of child bearing age for pregnancy. Women should have a negative serum pregnancy test before starting telavancin.
- Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of pseudomembranous colitis. May begin up to several weeks following cessation of therapy.
- Monitor for infusion reactions (Red-man syndrome—flushing of upper body, urticaria, pruritus, rash). May resolve with stopping or slowing infusion.
- Observe patient for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Discontinue drug and notify health care professional immediately if symptoms occur. Keep epinephrine, an antihistamine, and resuscitation equipment close by in case of anaphylactic reaction.
- Lab Test Considerations: Monitor renal function (serum creatinine. creatinine clearance) prior to, every 48–72 hrs during, and at the end of therapy. May cause nephrotoxicity. If renal function decreases, reassess need for telavancin.
- May interfere with prothrombin time, INR, aPTT, activated clotting time, and coagulation based factor Xa tests. Collect blood samples for theses tests as close to next dose of telavancin as possible.
- Interferes with urine qualitative dipstick protein assays and quantitative dye methods; may use microalbumin assays.
Potential Nursing DiagnosesRisk for infection (Indications)
Diarrhea (Adverse Reactions)
- Intermittent Infusion: Reconstitute the 250 mg vial with 15 mL and the 750 mg vial with 45 mL of D5W, sterile water for injection, or 0.9% NaCl for concentrations of 15 mg/mL. Reconstitution time is usually under 2 min but may require up to 20 min. Mix thoroughly with contents dissolved completely. Do not administer solution that is discolored or contains particulate matter. Discard vial if vacuum did not pull diluent into vial. Time in vial plus time in bag should not exceed 4 hr at room temperature or 72 hr if refrigerated. Diluent: For doses of 150–800 mg dilute further with 100–250 mL of D5W, 0.9% NaCl, or LR.Concentration: For doses <150 mg or >800 mg dilute for a final concentration of 0.6–8 mg/mL.
- Rate: Administer over at least 60 min to minimize infusion reactions.
- Y-Site Incompatibility: Do not mix or administer with other medications. Flush line with D5W, 0.9% NaCl, or LR before and after administration.
- Y-Site Compatibility: amphotericin B lipid complex, ampicillin/sulbactam, azithromycin, calcium gluconate, caspofungin, cefepime, ceftazidime, ceftriaxone, ciprofloxacin, dexamethasone, diltiazem, dobutamine, dopamine, doripenem, doxycycline, ertapenem, famotidine, fluconazole, gentamicin, hydrocortisone, labetalol, magnesium sulfate, mannitol, meropenem, metoclopramide, milrinone, norepinephrine, ondansetron, pantoprazole, phenylephrine, piperacillin/tazobactam, potassium chloride, potassium phosphates, ranitidine, sodium bicarbonate, sodium phosphates, tigecycline, tobramycin, vasopressin
- Y-Site Incompatibility: amphotericin B colloidal, amphotericin B liposome, digoxin, esomeprazole, furosemide, levofloxacin, micafungin
- Instruct patient to notify health care professional immediately if diarrhea, abdominal cramping, fever, or bloody stools occur and not to treat with antidiarrheals without consulting health care professionals.
- Inform patient that common side effects include taste disturbance, nausea, vomiting, headache and foamy urine. Notify health care professional if signs of infusion reaction occur.
- Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.
- Advise female patients to use effective contraception during therapy and to notify health care professional if pregnancy is suspected. Encourage pregnant patients to enroll in the VIBATIV pregnancy registry by calling 1-888-658-4228.
- Instruct the patient to notify health care professional if symptoms do not improve.
- Resolution of the signs and symptoms of infection. Length of time for complete resolution depends on the organism and site of infection.