Vancomycin oral solution (FIRVANQ)

Clinically important systemic absorption can occur with oral FIRVANQ, especially with intestinal inflammation; impaired renal clearance can allow accumulation. The source identifies selected circumstances in which serum concentrations may be useful, including renal impairment, colitis and concurrent aminoglycosides. Nephrotoxicity has occurred during or after therapy, with increased concern in older patients. Follow renal function where clinically appropriate. This is a monitoring caution, not a fixed renal dose-reduction table, and an IV vancomycin renal regimen must not be applied to oral treatment.

Systemic absorption can occur with oral treatment, particularly with inflamed intestinal mucosa and renal insufficiency; serum concentration monitoring may be appropriate in selected patients. Nephrotoxicity has occurred during or after oral therapy. In patients older than 65 years, monitor renal function during and after treatment, including those with initially normal renal function. A routine no-adjustment schedule does not remove these monitoring considerations.

Initial non-fulminant CDI: 125 mg orally four times daily; fulminant CDI: 500 mg orally four times daily. UCSF states no renal adjustment and no hemodialysis adjustment; its fulminant guidance notes consideration of rectal instillation. This selected dosing table is not the complete CDI regimen, recurrence plan or monitoring policy. Oral therapy is not sufficiently absorbed to treat systemic infections.