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Dalvance
dalbavancin
Adult Dosing .
Dosage forms: INJ
skin/skin structure infections, acute bacterial
- [1500 mg IV x1]
- Alt: 1000 mg IV x1, then 1wk later, 500 mg IV x1
renal dosing
- [one-dose regimen]
- CrCl <30: 1125 mg x1
- HD: no adjustment; no supplement; PD: not defined
- [two-dose regimen]
- CrCl <30: 750 mg x1, then 1wk later, 375 mg x1
- HD: no adjustment; no supplement; PD: not defined
hepatic dosing
- [see below]
- Child-Pugh Class A: no adjustment; Child-Pugh Class B or C: not defined, caution advised
Peds Dosing .
- Dosage forms: INJ
skin/skin structure infections, acute bacterial
- [<6 yo]
- Dose: 22.5 mg/kg/dose IV x1; Max: 1500 mg/dose
- [6 yo and older]
- Dose: 18 mg/kg/dose IV x1; Max: 1500 mg/dose
renal dosing
- [see below]
- CrCl >30: no adjustment; CrCl <30: not defined, consider adult renal dosing for guidance
- HD: not defined, consider adult renal dosing for guidance; PD: not defined
hepatic dosing
- [see below]
- Child-Pugh Class A: no adjustment; Child-Pugh Class B or C: not defined, caution advised
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- caution: CrCl <30
- caution: hepatic impairment
- caution: abx-associated colitis hx, recent
Drug Interactions .
Overview
dalbavancin
lipoglycopeptide antibiotic
- alters GI flora
Avoid/Use Alternative
- fecal microbiota, live
- methotrexate
Caution Advised
- lactulose
- sodium picosulfate
Adverse Reactions .
Serious Reactions
- hypersensitivity rxn
- anaphylactoid rxn
- anaphylaxis
- infusion rxn, severe
- C. difficile-assoc. diarrhea
- superinfection
Common Reactions
- nausea
- headache
- diarrhea
- vomiting
- rash
- pruritus
- ALT elevated
- vancomycin flushing syndrome (rapid IV use)
Safety/Monitoring .
Monitoring Parameters
Cr at baseline
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; no human data available; dose-dependent risk of delayed fetal maturation and death based on animal data at 3.5x recommended human dose
Lactation
Clinical Summary
may use while breastfeeding; no human data available, though risk of infant harm not expected based on drug properties; no human data available to assess effects on milk production
Pharmacology .
Metabolism: unknown; CYP450: none
Excretion: urine (33% unchanged), feces 20%; Half-life: 346h
Subclass: Glycopeptides/Lipopeptides
Mechanism of Action
binds to peptidoglycan and cell membrane, inhibiting cell wall synthesis
Formulary .
No Formulary Selected
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