Teicoplanin

Indications
Parenteral
Severe Gram-positive infections
Adult: Initially, 6 mg/kg on first day, followed by 3 mg/kg/day. Severe infection: 6 mg/kg every 12 hr for the 1st 3 doses followed by 6 mg/kg/day. Doses may be given via IM inj, IV bolus or IV infusion over 30 minutes.
Child: Loading dose: 10 mg/kg every 12 hr for 3 doses followed by 6-10 mg/kg/day depending on severity of the infection. Neonates: Loading dose: 16 mg/kg on the 1st day, followed by maintenance doses of 8 mg/kg/day by IV infusion.
Renal impairment: Usual dose to be given for first 3 days, thereafter adjust dose according to CrCl.
CrCl (ml/min)Dosage Recommendation
40-601/2 initial dose given daily or initial dose every 2 days.
<401/3 initial dose given daily or initial dose every 3 days.

Intravenous
Prophylaxis of Gram-positive infection in high-risk patients undergoing surgery
Adult: 400 mg as single dose at induction of anesth.
Intravenous
Continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis
Adult: If the patient is febrile, an initial loading dose of 400 mg may be given. Teicoplanin is added to the dialysis solution at a concentration of 20 mg/litre; dose is added into each bag of solution in the first wk, followed by alternate bags in the second wk and then in the overnight dwell bag in the third wk.
Renal impairment: Dose adjustment may be required.

Special Populations: Renal insufficiency: Creatinine clearance 40-60 mL/min: Usual doses for 1st 3 days, followed by 1/2 the normal daily dose; <40 mL/min): Usual doses for 1st 3 days, followed by 1/3 of the normal dose. Alternative: Usual daily dose only every 2-3 days.

Incompatibility: Incompatible with aminoglycosides and should not be mixed before injection.
Contraindications
Hypersensitivity.
Warnings / Precautions
Preexisting renal insufficiency, hypersensitivity to vancomycin. Perform periodic haematological studies, renal, LFT. Pregnancy, lactation.
Adverse Reactions
Fever, chills, allergic reactions, GI disturbances, headache, dizziness, "red-man" syndrome, disturbances in liver enzymes, renal impairment, ototoxicity, blood dyscrasias. Pain, erythema, thrombophloebitis, abscess at site of admin.
Potentially Fatal: Stevens-Johnson syndrome, toxic epidermal necrolysis.
Drug Interactions
Other nephrotoxic and/or neurotoxic drugs.
See Below for More teicoplanin Drug Interactions
Mechanism of Actions
Glycopeptide antibiotic with spectrum of activity is similar to vancomycin but teicoplanin may be more active in vitro against enterococci and some anaerobic organisms but some coagulase-negative Staphylococci are less sensitive to teicoplanin than to vancomycin.
Absorption: Poorly absorbed from the GI tract. IM bioavailability: 90%. Peak plasma concentrations: 1 hr (IV); 2-4 hr (IM).
Distribution: Protein binding: 90-95%. Poor penetration into the CSF. It is taken up into white blood cells.
Excretion: Excreted unchanged via urine (97%).
Storage Conditions
Intravenous: Store below 25°C. Reconstituted solutions may be stored for 24 hr at 2-8°C. Parenteral: Store below 25°C. Reconstituted solutions may be stored for 24 hr at 2-8°C.
ATC Classification
J01XA02 - teicoplanin ; Belongs to the class of glycopeptide antibacterials. Used in the systemic treatment of infections.
Storage
Intravenous: Store below 25°C. Reconstituted solutions may be stored for 24 hr at 2-8°C. Parenteral: Store below 25°C. Reconstituted solutions may be stored for 24 hr at 2-8°C.
Available As
  • Teicoplanin 200 mg
  • Teicoplanin 400 mg
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