Stavance Caution For Usage

Compatibility with other Drugs and Intravenous Fluids: The following diluents are physically and chemically compatible (with 4g/L Vancomycin Hydrochloride): 5% Dextrose Injection; 5% Dextrose Injection and 0.9% Sodium Chloride Injection; Lactated Ringer's Injection, 5% Dextrose, Lactated Ringer's Injection; Normosol-M and 5% Dextrose; 0.9% Sodium Chloride Injection, ISOLYTE E.
Good professional practice suggests that compounded admixtures should be administered as soon after preparation as is feasible.
Vancomycin solution has a low pH and may cause physical instability of other compounds.
Mixtures of solutions of vancomycin and beta-lactam antibiotics have been shown to be physically incompatible. The likelihood of precipitation increases with higher concentrations of vancomycin. It is recommended to adequately flush the intravenous lines between the administrations of these antibiotics. It is also recommended to dilute solutions of vancomycin to mg/mL or less.
Although intravitreal injection is not an approved route of administration for vancomycin, precipitation has been reported after intravitreal injection of vancomycin and ceftazidime for endophthalmitis using different syringes and needles. The precipitates dissolved gradually, with complete clearing of the vitreous cavity over two months and with improvement of visual acuity.
Preparation and Stability: At the time of use, reconstitute the vials of Vancomycin Hydrochloride for Injection, USP with Sterile Water for Injection to a concentration of 50 mg of vancomycin/mL (see following table for volume of diluent). (See Table 4.)

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After reconstitution, the vials may be stored in a refrigerator for 96 hours without significant loss of potency.
Reconstituted solutions of vancomycin (500 mg/10 mL) must be further diluted with at least 100 mL of a suitable infusion solution. For doses of 1gram (20mL), at least 200 mL of solution must be used. The desired dose, diluted in this manner, should be administered by intermittent IV infusion over a period of at least 60 minutes.
Parenteral drug products should be visually inspected for particulate matter and discoloration prior to administration, whenever solution and container permit.