HealthDirect Pharmacy Services Product Focus
Indication and Description
Firvanq® is a glycopeptide antibacterial oral solution indicated in adults and pediatric patients less than 18 years of age for the treatment of C. Difficile associated diarrhea and Enterocolitis caused by Staphylococcus aureus (MSSA, MRSA). It is not indicated to treat other types of infections.1
Dosage and Administration
- Adults with C. Diff– recommended dose is 125mg PO QID for 10 days.
- Adults with Staphylococcal enterocolitis- recommended dose is 500mg-2g in 3-4 divided doses for 7-10 days.
Contraindications
Hypersensitivity to Vancomycin.
Adverse Reactions
Nausea, abdominal pain, vomiting, diarrhea, flatulence, pyrexia, peripheral edema, fatigue, urinary tract infection, hypokalemia, back pain, headache.
Serious Side Effects
Nephrotoxicity with increased risk in geriatric populations, ototoxicity, toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome (SJS), drug reaction with eosinophilia and systemic symptoms (DRESS), acute generalized exanthematous pustulosis (AGEP), and linear lgA bullous dermatosis (LABD), and superinfections.
Drug/Drug interactions2
No drug interactions have been conducted with Firvanq®. General interactions with Vancomycin include: BCG, cholera vaccine, bile acid sequestrants, colistimethate, sodium picosulfate, typhoid vaccine.
Dosage Form/Storage
- Prior to administration, Firvanq® must be reconstituted by a healthcare provider to produce the solution.
- Each kit contains: 1 bottle vancomycin powder, 1 pre-measured grape flavored diluent to be added to the vancomycin bottle.
- Shake the reconstituted solution of Firvanq® well before each use
- Use an oral dosing device that measures the appropriate volume of the oral solution in milliliters
- Store reconstituted solution in refrigerator, (36–46 F).
- Discard after 14 days from reconstitution, or if it appears hazy or contains particulates.
Monitoring Parameters
- Renal function during and following treatment
- Monitoring serum vancomycin levels may be considered for patients with renal failure who have severe colitis.
Table 1: Vancomycin Concentration and Volume after Reconstitution.
| Vancomycin Concentration after Reconstitution | Final Volume of Firvanq after Reconstitution | Vancomycin Strength per Bottle | Diluent for Firvanq |
|---|---|---|---|
| 25 mg/mL | 150 mL | 3.75 g | 147 mL |
| 25 mg/mL | 300 mL | 7.5 g | 295 mL |
| 50 mg/mL | 150 mL | 7.5 g | 145 mL |
| 50 mg/mL | 300 mL | 15.0 g | 289 mL |
References
- “Firvanq” Azurity Pharmaceuticals, Inc.
- “Vancomycin” Lexicomp-Drugs Online, Hudson: Lexicomp, Inc.
