Mersa IV 500/Mersa IV 1000 Dosage/Direction for Use

Infusion-related events are related to both the concentration and the rate of administration of Vancomycin (Mersa IV 500 & 1000).
Concentrations of no more than 5 mg/mL and rates of no more than 10 mg/min are recommended in adults. In selected patients in need of fluid restriction, a concentration up to 10 mg/mL may be used. Use of such higher concentrations may increase the risk of infusion-related events. Infusion-related events may occur, however, at any rate or concentration.
Adults: The usual dosage for intravenous infusion is 500 mg as Vancomycin (Mersa IV 500 & 1000) every 6 hours or 1 g as vancomycin (potency) every 12 hours or as prescribed by the physician. Other patient factors, such as age or obesity, may call for modification of the usual daily dose. The total duration of therapy is determined by the type and severity of the infection and the clinical response of the patient. In staphylococcal endocarditis, treatment for three weeks or longer is recommended.
Children: The usual intravenous dosage of Vancomycin (Mersa IV 500 & 1000) is 10 mg/kg per dose given every six hours. Each dose should be administered over a period of at least 60 minutes.
Infants: In both neonates and infants, an initial dose of 15 mg/kg is suggested, followed by 10 mg/kg every 12 hours for neonates in the first week of life and thereafter every eight hours up to the age of one month. Each dose should be administered over 60 minutes. Close monitoring of serum concentrations of Vancomycin (Mersa IV 500 & 1000) may be warranted in these patients (see Table 1).

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Patients with renal impairment and the elderly: In patients with impaired renal function, dosage reduction may be required. In premature infants and the elderly, greater dosage reductions than expected may be necessary because of decrease renal function. See Table 2.

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Table 2 is not valid for functionally anephric patients. For such patients, an initial dose of 15 mg/kg of body weight should be given to achieve prompt therapeutic serum concentrations. The dose required to maintain stable concentrations is 1.9 mg/kg/24 hr. In patients with marked renal impairment, it may be more convenient to give maintenance doses of 250-1000 mg once every several days rather than administering this drug on a daily basis. In anuria, a dose of 1000 mg every 7-10 days has been recommended.
The creatinine clearance is calculated by the following formula: See Equation.
Men: Creatinine clearance = Body weight (kg) x (140-age)/72 x serum creatinine (mg/dL)
Women: 0.85 x men's value
The serum creatinine must represent a steady state of renal function. Such a calculated creatinine clearance is an over estimate of actual clearance in the following cases: Patients with decreased renal function such as shock, severe heart failure or oliguria, patients with abnormal relationship between muscle mass and total body weight such as obesity, liver disease, edema or ascites, patients with debilitation, malnutrition or inactivity.