Name | Vancomycin hydrochloride |
Synonyms | Vancor VANCOR VANCOCIN LYPHOCIN Vancomycin HCl UNII-71WO621TJD VANCOCIN HYDROCHLORIDE vancocinehydrochloride Vancocin hydrochloride Vancocine hydrochloride Vancomycin hydrochloride Vancomycin monohydrochloride VANCOMYCIN, HYDROCHLORIDE, STREPTOMYCES ORIENTALIS Vancomycin Hydrochloride (4 vials, each vial contains 99,300 mcg of vancomycin activity) Vancomycin Hydrochloride (4 vials, each vial contains 100,500 mcg of vancomycin activity) (1S,2R,18R,19R,22S,25R,28R,40S)-48-{[(2S,3R,4S,5S,6R)-3-{[(2S,4S,5S,6S)-4-amino-5-hydroxy-4,6-dimethyltetrahydro-2H-pyran-2-yl]oxy}-4,5-dihydroxy-6-(hydroxymethyl)tetrahydro-2H-pyran-2-yl]oxy}-22-(2-amino-2-oxoethyl)-5,15-dichloro-2,18,32,35,37-pentahydroxy-19-{[(2R)-4-methyl-2-(methylamino)pentanoyl]amino}-20,23,26,42,44-pentaoxo-7,13-dioxa-21,24,27,41,43-pentaazaoctacyclo[26.14.2.2~3,6~.2~14,17~.1~8,12~.1~29,33~.0~10,25~.0~34,39~]pentaconta-3,5,8(48),9,11,14,16,29(45),30,32,34,36,38,46,49-pentadecaene-40-carboxylic acid (non-preferred name) |
CAS | 1404-93-9 |
EINECS | 604-193-8 |
InChI | InChI=1/C66H75Cl2N9O24.ClH/c1-23(2)12-34(71-5)58(88)76-49-51(83)26-7-10-38(32(67)14-26)97-40-16-28-17-41(55(40)101-65-56(54(86)53(85)42(22-78)99-65)100-44-21-66(4,70)57(87)24(3)96-44)98-39-11-8-27(15-33(39)68)52(84)50-63(93)75-48(64(94)95)31-18-29(79)19-37(81)45(31)30-13-25(6-9-36(30)80)46(60(90)77-50)74-61(91)47(28)73-59(89)35(20-43(69)82)72-62(49)92;/h6-11,13-19,23-24,34-35,42,44,46-54,56-57,65,71,78-81,83-87H,12,20-22,70H2,1-5H3,(H2,69,82)(H,72,92)(H,73,89)(H,74,91)(H,75,93)(H,76,88)(H,77,90)(H,94,95);1H/t24-,34+,35-,42+,44-,46+,47+,48-,49+,50-,51+,52+,53+,54-,56+,57+,65-,66-;/m0./s1 |
Molecular Formula | C66H76Cl3N9O24 |
Molar Mass | 1485.71 |
Melting Point | >190°C (dec.) |
Specific Rotation(α) | [α]D20 -30~-40゜ (c=1, H2O) |
Flash Point | 87℃ |
Water Solubility | Soluble in water. Slightly soluble in methanol, ethanol and dimethylsulfoxide. |
Solubility | Soluble in water. |
Appearance | white to brown powder |
Color | colorless to faint yellow or tan |
Merck | 13,9995 |
BRN | 3704657 |
PH | pH (50g/l, 25℃) : 2.5~4.5 |
Storage Condition | 2-8°C |
Stability | Hygroscopic |
Sensitive | Hygroscopic |
MDL | MFCD03613611 |
Use | Narrow antibacterial spectrum, mainly effective against gram-positive bacteria |
Hazard Symbols | Xi - Irritant |
Risk Codes | R43 - May cause sensitization by skin contact R42 - May cause sensitization by inhalation |
Safety Description | S36/37 - Wear suitable protective clothing and gloves. S24/25 - Avoid contact with skin and eyes. S22 - Do not breathe dust. S36 - Wear suitable protective clothing. |
WGK Germany | 2 |
RTECS | YW4380000 |
FLUKA BRAND F CODES | 8-10-21 |
HS Code | 29419090 |
Toxicity | LD50 in mice (mg/kg): 489 i.v.; 1734 i.p.; 5000 s.c.; 5000 orally (Anderson) |
Reference Show more | 1. Wang Min. Analysis of the guiding significance of vancomycin blood concentration monitoring for clinical medication [J]. Clinical medical research and practice 2020 v.5(16):114-116. 2. Wu Qin, Xu Ziyang, Liu Liping, et al. Role of intestinal flora in stress-induced hypertension in rats [J]. Biotechnology Bulletin, 2020, v.36;No.331(02):88-95. 3. Zhe Hao, Xiaodong Lin, Jinjie Li, Yanliang Yin, Xia Gao, Shuo Wang, Yaqing Liu, Multifunctional nanoplatform for dual-mode sensitive detection of pathogenic bacteria and the real-time bacteria inactivation, Biosensors and Bioelectronics, Volume 173, 2021, 4. Wan, Mimi, et al. "in situ growth of mesoporous silica with drugs on titanium surface and its biomedical applications." ACS applied materials & interfaces 9.22 (2017): 18609-18618.https://doi.org/10.1021/acsami.7b05163 5. Yao, Ye, et al. "Berberine alleviates type 2 diabetic symptoms by altering gut microbiota and reducing aromatic amino acids." Biomedicine & Pharmacotherapy 131 (2020): 110669.https://doi.org/10.1016/j.biopha. 2020.110669 6. Rong, Qian, et al. "In vitro and in vivo bactericidal activity of Tinospora sagittata (Oliv.) Gagnep. var. craveniana (SY Hu) Lo and its main effective component, palmatine, against porcine Helicobacter pylori." BMC complementary and alternative medicine 1 7. [IF=5.458] Tong Li-Tao et al."Pea Protein Reduce Serum Cholesterol Levels in Hypercholesterolemia Hamsters by Modulating Compositions Of Gut Microbiota And Metabolites."iScience. 2021 Mar 12 8. [IF=6.475] Chunjun Li et al."Colon and gut microbiota greatly affect the absorption and utilization of astaxanthin derived from Haematococcus pluvialis."FOOD RESEARCH INTERNATIONAL. 2022 Jun;156:111324 |
The titer per 1 mg, calculated as anhydrous, shall not be less than 10.5 million units of natamycin.
take this product, add water to make a solution containing about 50mg per lml, according to the law (General 0631),pH value should be 2.5~4.5.
take 5 parts of this product and add water respectively to make about 0.lg solution, the solution should be clear; If it is cloudy, it should not be more concentrated than the 1# turbidity standard solution (General 0902 first method); If it is colored, no deeper color shall be compared with the yellow or yellow-orange Standard Colorimetric solution No. 6 (General rule 0901, Method 1).
take an appropriate amount of this product, add water to dissolve and quantitatively dilute to make about 0.lg of the solution, according to UV-visible spectrophotometry (General rule 0401), measured at a wavelength of 450nm, absorbance should not exceed 0.10.
According to the method under vancomycin B, according to Formula 2, the single impurity should not exceed 4.0%, and the total amount of impurities should not exceed 7.0%.
take about 0.2g of this product, precision weigh it, place it in the top empty bottle, add 5ml of water to dissolve it, seal it, and use it as a test solution. Precision weigh an appropriate amount of anhydrous ethanol, A solution containing about 0.2mg per 1 ml was prepared by quantitative dilution with water, and 5ml was accurately weighed, placed in a headspace bottle, and sealed as a reference solution. According to the determination method of residual solvent (General rule 0861 first method), the capillary column with polyethylene glycol (PE020M)(or similar polarity) as stationary liquid is used as the column, and the column temperature is 50°C; the inlet temperature was 150°C; The detector temperature was 250°C; The headspace bottle equilibrium temperature was 80°C and the equilibrium time was 30 minutes. Measure the sample solution and the reference solution respectively by Headspace injection, record the chromatogram, and calculate the peak area according to the external standard method. The residual amount of ethanol should meet the requirements.
take this product, according to the determination of moisture (General 0832 first method 1), the water content shall not exceed 5.0%.
take l.Og of this product and check it according to law (General rule 0841). The residue left shall not exceed 0.5%.
The residue left under the ignition residue item shall not contain more than 30 parts per million of heavy metal when examined by law (General rule 0821, Law II).
take this product, check according to law (General rule 1143), the amount of endotoxin per 1 mg of vancomycin should be less than 0.25EU. (For injection)
take the appropriate amount of this product, precision weighing, dissolving and quantitatively diluting with sterile water to make a solution containing about 10 million of the unit of the unit of the drug per 1 ml, determined according to microbiological assay for antibiotics (General rule 1201 first method).
peptide antibiotics.
sealed and stored at 2-8°C.
This product is a sterile freeze-dried product made of vancomycin hydrochloride and suitable excipients. The titer per lmg calculated as anhydrous substance shall not be less than 10 million units. Based on the average loading, the vancomycin content shall be between 90.0% and 115.0% of the labeled amount.
This product is white or off-white powder or loose lumps.
take this product, according to the item of vancomycin hydrochloride under the identification of (1), (3) test, showed the same results.
The content under the item of loading amount difference was obtained by measuring according to the method under the item of vancomycin hydrochloride.
Same as vancomycin hydrochloride.
0.5g (500,000 units) (as per C66H75C12N9024).
sealed and stored at 30°C or less.
glycopeptide antibiotics | vancomycin hydrochloride is a glycopeptide antibiotic, which is the hydrochloride salt of vancomycin and is white or white-like crystalline powder at room temperature. Its mechanism of action is alanyl alanine that binds to the terminal of the precursor peptide of the cell wall of sensitive bacteria with high affinity, blocking the synthesis of the polymer peptidoglycan that constitutes the bacterial cell wall, resulting in cell wall defects and killing bacteria. In addition, it may also alter bacterial cell membrane permeability and selectively inhibit RNA synthesis. Vancomycin hydrochloride is characterized by a strong bactericidal effect on gram-positive bacteria, and a strong antibacterial activity against Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes, Streptococcus pneumoniae, etc.; Anaerobic Streptococcus, Clostridium difficile, Bacillus anthracis, Actinomycetes, Diphtheria, Neisseria, Streptococcus viridans, Streptococcus bovis, Streptococcus faecalis, etc. also have certain antibacterial effects. It is ineffective for most gram-negative bacteria, Mycobacterium, Rickettsia, Chlamydia or fungi. Clinically suitable for the treatment of infections caused by methicillin-resistant Staphylococcus aureus and other bacteria: sepsis, infective endocarditis, osteomyelitis, arthritis, burns, surgical trauma and other superficial secondary infections, Pneumonia, lung abscess, empyema, peritonitis, meningitis, pseudomembranous enteritis, skin and soft tissue infections, etc. The first choice for the treatment of enterococcal endocarditis and corynebacterium (diphtheria-like bacilli) endocarditis in penicillin-allergic patients. Andy edited and sorted out the above information. |
vancomycin | vancomycin is a polypeptide antibiotic. Glycopeptide antibiotics from Streptomyces orientalis (Orientalis of Streptomyces) or Agromycetes (Orientalis of Amycolatopsis). In the late 1950s, the drug came out with its good effect on penicillin-resistant Staphylococcus, and became a powerful "trump card" antibiotic against G bacteria, such as Staphylococcus aureus, Streptococcus pyogenes, and Streptococcus pneumoniae. Later, due to the discovery of its greater toxicity, coupled with the less toxic anti-staphylococcal semi-synthetic penicillin and cephalosporins successively on the market in the 1960s, and the drug resistance problem at that time was not very acute, which restricted its application. In recent years, due to methicillin-resistant Staphylococcus aureus (MRSA), methicillin-resistant Staphylococcus epidermidis (MRSE) infections have increased, and it has been found that Clostridium difficile (CD) is the main cause of antibiotic-related pseudomembranous enteritis. The application of vancomycin has been increasing day by day, and the special status of vancomycin has been re-established in clinical practice. Since the 1990s, it has been praised by international antibiotic experts as "the last line of defense for humans to deal with refractory drug-resistant strains". according to the results of some literatures and the distribution of clinical drug-resistant strains at present, vancomycin is the first choice for diseases caused by MRSA and MRSE infection. vancomycin treatment for related diarrhea or pseudomembranous enteritis caused by CD is also quite certain, especially for critically ill patients. In addition, vancomycin is also the top grade for rare penicillin-G-resistant pneumococcal infection and severe infection caused by penicillin-resistant corynebacterium JK strain. because vancomycin has good curative effect on diseases caused by multiple drug-resistant bacteria, its market sales have increased year by year in the past 10 years. In the past few years, the annual growth rate of vancomycin in the international market has been maintained at 3-4%, and has risen to 5-6% in the past two years. According to antibiotic experts, the global total output of vancomycin in the mid-1990s averaged 20-25 tons per year, and in 1999 it has risen to 30 tons. |
pharmacokinetics | oral malabsorption, intravenous administration can be widely distributed in most tissues and body fluids throughout the body. The peak blood concentrations of 500mg and 1g were 10-30mg/L and 25-50mg/L, respectively. the distribution volume of this drug is 0.43-1.25L/kg. Its effective antibacterial concentration can be reached in serum, pericardium, pleura, peritoneum, ascites and synovial fluid, but not in bile. Vancomycin hydrochloride can penetrate the placenta, but cannot quickly penetrate the normal blood-cerebrospinal fluid barrier. When the meninges are inflamed, it can penetrate into the cerebrospinal fluid and reach an effective antibacterial concentration. The protein binding rate of this drug is about 55%. The elimination half-life is 6 hours (4-11 hours) in adults, and can be extended to 7.5 days in patients with severe renal insufficiency; about 2-3 hours in children. The drug is metabolized by the liver, and about 80%-90% is excreted through the kidney in its original form within 24 hours, and a small amount is excreted with bile and milk. Hemodialysis or peritoneal dialysis cannot effectively remove this drug; however, there are reports that blood perfusion or blood filtration can improve clearance. |
instructions for administration | (1). this drug is strongly irritating to tissues and should not be injected intramuscularly or intravenously. Leakage of liquid medicine should be avoided as far as possible during intravenous drip. (2), in order to reduce the incidence of adverse reactions (such as "red neck syndrome", thrombophlebitis), the speed of intravenous drip should not be too fast, and the time of each drip should be at least 1 hour. (3), when treating staphylococcal endocarditis, the course of treatment should be not less than 28 days. (4), vancomycin hydrochloride is incompatibility with chloramphenicol, heparin, aminophylline, sodium bicarbonate, steroid hormone, methicillin, heavy metal drugs, alkaline solution, etc. (5), treatment of overdose: excessive use of vancomycin hydrochloride can cause oliguria and renal failure. Treatment includes:(1) symptomatic and supportive treatment. (2) Conventional hemodialysis and peritoneal dialysis are not effective for drug removal; however, hemoperfusion or hemofiltration can improve drug clearance. (6) preparation of solution:(1) preparation of oral liquid: vancomycin containing 500mg per bottle is diluted with distilled water to prepare a solution of 500mg/6ml for oral administration. the oral liquid can be stored for 14 days in a refrigerator at 4 ℃. (2) Preparation of intravenous drip solution: ① During intermittent infusion, the solution is prepared with 500mg of medicine and 10ml of water, then added to 5% glucose injection or 0.9% sodium chloride injection, diluted to less than 5 mg/ml, and then injected. 500mg dose infusion time at least 60 minutes or 1000mg infusion time at least 100 minutes. For patients who need to limit the amount of fluid, the maximum concentration can reach 10mg/ml. ② For continuous intravenous drip, 1~2g dose should be added to 5% glucose injection or 0.9% sodium chloride injection. (7), the maintenance amount of patients with renal dysfunction is calculated by the following formula: maintenance dose (md/d)= 150 +(15 × creatinine clearance rate ml/min). (8), blood drug concentration must be monitored during treatment, peak concentration should not exceed 25~40 μg/ml, valley concentration should not exceed 5~10 μg/ml. Above 60 μg/ml is the poisoning range. If the blood concentration cannot be monitored, adjust the dose according to the creatinine clearance rate. |
adverse reactions | the main adverse reactions of vancomycin hydrochloride clinically are as follows: ototoxicity: tinnitus or ear fullness, hearing loss or even loss, auditory nerve damage, etc. It is especially easy to occur when applied in large doses, for a long time, in the elderly or in people with renal insufficiency. Nephrotoxicity: Mainly damages renal tubules. Early may have proteinuria, tubular urine, followed by hematuria, oliguria, etc.; severe cases can cause renal failure. It is especially easy to occur in large doses (blood concentration exceeds 60~100mg/L), long-term, elderly or renal insufficiency. Allergy: "Red neck syndrome" may occur in a small number of patients with rapid and high-dose intravenous administration ". Manifested as chills or fever, syncope, itching, nausea, vomiting, tachycardia, rash or facial flushing; redness or tingling of the neck root, upper body, back, arms, etc. (caused by histamine release), occasionally hypotension and shock-like symptoms. Its incidence was higher than that of norvancomycin and teicoplanin. Local reaction: severe pain at the injection site may occur during intramuscular injection or intravenous administration, and thrombophlebitis may occur in severe cases. Gastrointestinal tract: oral administration may have nausea, vomiting, oral odor and other symptoms. |
use | narrow antibacterial spectrum, mainly effective against gram-positive bacteria narrow antibacterial spectrum, mainly effective against gram-positive bacteria. it is a narrow-spectrum antibiotic, which is only effective for gram-positive bacteria, such as hemolytic streptococcus, pneumococcus, gonococcus and enterococcus, which are sensitive to drug-resistant Staphylococcus aureus. Its mechanism of action is to inhibit the synthesis of the bacterial cell wall. It mainly binds to the bacterial cell wall, and some amino acids cannot enter the glycopeptides in the cell wall. |