Celovan Special Precautions

To reduce development of drug-resistant bacteria, the drug should be used only for the treatment or prevention of infections proven or strongly suspected to be caused by susceptible bacteria.
Prolonged use of Vancomycin may result in the overgrowth of non-susceptible organisms. Careful observation of the patient is essential. If superinfection occurs during therapy, appropriate measures should be taken. In rare instances, there have been reports of pseudomembranous colitis due to C. difficile developing in patients who received IV Vancomycin.
In order to minimize the risk of nephrotoxicity when treating patients with underlying renal dysfunction or patients receiving concomitant therapy with an aminoglycoside, serial monitoring of renal function should be performed and particular care should be taken in following appropriate dosing schedules. Serial tests of auditory function may be helpful to minimize the risk of cytotoxicity.
Reversible neutropenia has been reported in patients receiving Vancomycin. Patients who will undergo prolonged therapy with Vancomycin or those who are receiving concomitant drugs which may cause neutropenia should have periodic monitoring of the leukocyte count.
Thrombophlebitis may occur, the frequency and severity of which can be minimized by administering the drug slowly as a dilute solution (2.5 to 5 g/L) and by rotating the sites of infusion. There have been reports that the frequency of infusion-related adverse reactions (including hypotension flushing, erythema, urticaria and pruritus) increases with the concomitant administration of anesthetic agents. These reactions may be minimized by the administration of Vancomycin as a 60 minute infusion prior to the anesthetic induction.
The safety and efficacy of Vancomycin administration by the intraperitoneal and intrathecal (intralumbar or intraventricular) routes have not been assessed.