What is Vancomycin (Oral Route): Uses, Dosage, Side Effects and More

Vancomycin taken by mouth is a powerful antibiotic that fights serious bacterial infections in your intestines. Unlike the intravenous form that treats infections throughout your body, oral vancomycin works locally in your digestive system where it's needed most.

This medication belongs to a class called glycopeptide antibiotics, and it's particularly effective against certain stubborn bacteria that don't respond to other treatments. Your doctor might prescribe it when you have specific intestinal infections that require this targeted approach.

What is Vancomycin?

Vancomycin is a strong antibiotic that was first discovered in soil samples back in the 1950s. When taken orally, it stays mainly in your intestines rather than spreading throughout your body like other antibiotics do.

This unique characteristic makes oral vancomycin especially useful for treating infections that happen right in your digestive tract. Think of it as a targeted medicine that goes directly to where the problem bacteria are living and multiplying.

The oral form comes as capsules or a liquid that you can mix with water or juice. Your pharmacist will help you understand exactly how to prepare and take your specific formulation.

What is Vancomycin Used For?

Oral vancomycin treats two main types of serious intestinal infections. The most common reason doctors prescribe it is for Clostridioides difficile infection, often called C. diff, which causes severe diarrhea and colon inflammation.

Your doctor might also recommend oral vancomycin for enterocolitis caused by Staphylococcus aureus bacteria. This condition creates inflammation in your small intestine and colon, leading to uncomfortable symptoms like cramping and diarrhea.

These infections often develop after you've taken other antibiotics that disrupted the normal, healthy bacteria in your intestines. When the good bacteria are reduced, harmful bacteria can take over and cause these serious infections.

It's worth noting that oral vancomycin won't help with infections in other parts of your body, like pneumonia or skin infections. For those conditions, your doctor would need to prescribe the intravenous form or a different antibiotic altogether.

How Does Vancomycin Work?

Vancomycin is considered a strong antibiotic that works by disrupting how bacteria build their cell walls. Without proper cell walls, the harmful bacteria can't survive and multiply in your intestines.

When you take oral vancomycin, it passes through your stomach and reaches your intestines where it stays concentrated. This local action means it can fight the infection right where it's happening without significantly affecting the rest of your body.

The medication specifically targets the bacteria causing your infection while having less impact on the beneficial bacteria in other parts of your digestive system. This targeted approach helps reduce some of the side effects you might experience with other antibiotics.

Most people start feeling better within a few days of starting treatment, though you'll need to complete the full course to ensure all the harmful bacteria are eliminated.

How Should I Take Vancomycin?

Take oral vancomycin exactly as your doctor prescribes, typically three to four times daily. You can take it with or without food, but taking it with a small amount of food might help reduce stomach upset.

If you're taking capsules, swallow them whole with a full glass of water. Don't crush, chew, or open the capsules unless your doctor specifically tells you to do so.

For the liquid form, your pharmacist will provide specific mixing instructions. Usually, you'll mix the powder with water or juice right before taking each dose. The mixture might taste bitter, so having a favorite drink nearby can help.

Try to space your doses evenly throughout the day. Setting phone reminders can help you remember to take your medicine at the right times, which is important for keeping steady levels in your system.

If you're also taking other medications, check with your pharmacist about timing. Some medicines work better when taken at different times from vancomycin.

How Long Should I Take Vancomycin For?

Most people take oral vancomycin for 7 to 10 days, though your specific treatment length depends on your infection type and how you respond to the medication. Your doctor will determine the right duration based on your individual situation.

For C. diff infections, treatment typically lasts 10 days for a first episode. If you've had this infection before, your doctor might prescribe a longer course or a different dosing schedule to prevent it from coming back.

It's crucial to complete the entire course even if you start feeling better after a few days. Stopping early can allow remaining bacteria to multiply again, potentially leading to a more serious infection that's harder to treat.

Some people need extended treatment courses, especially if they have recurring infections. Your doctor will monitor your progress and adjust the treatment plan as needed.

What Are the Side Effects of Vancomycin?

Most people tolerate oral vancomycin well since it stays mainly in the intestines. However, you might experience some digestive side effects as your body adjusts to the medication.

Common side effects that many people experience include nausea, stomach pain, and changes in bowel movements. These symptoms are usually mild and often improve as your body gets used to the medicine.

Here are the most frequently reported side effects:

• Nausea or upset stomach
• Abdominal pain or cramping
• Vomiting
• Diarrhea (different from infection-related diarrhea)
• Bitter or metallic taste in your mouth
• Loss of appetite

These common effects usually fade within a few days as your body adjusts to the treatment.

Less common but more serious side effects can occur in some people. While these are rare, it's important to recognize them and contact your doctor if they develop.

Watch for these concerning symptoms:

• Severe stomach pain that doesn't improve
• Blood in your stool
• Fever or chills
• Persistent vomiting that prevents you from keeping the medicine down
• Signs of dehydration like dizziness or decreased urination
• Unusual fatigue or weakness

If you experience any of these serious side effects, reach out to your healthcare provider right away for guidance.

Very rarely, some people might develop an allergic reaction to vancomycin. Signs include rash, itching, swelling of your face or throat, or difficulty breathing. If you notice any of these symptoms, seek emergency medical attention immediately.

Who Should Not Take Vancomycin?

Most people can safely take oral vancomycin, but certain individuals need special consideration or might not be good candidates for this medication. Your doctor will review your medical history to make sure it's safe for you.

People with known allergies to vancomycin or similar antibiotics should avoid this medication. If you've had reactions to other antibiotics in the past, make sure to tell your doctor about these experiences.

If you have kidney problems, your doctor will need to monitor you more closely. While oral vancomycin doesn't typically affect kidney function like the IV form can, people with severe kidney disease might need dose adjustments.

Those with hearing problems should also discuss this with their doctor. Although rare with the oral form, vancomycin can sometimes affect hearing, especially in people who already have hearing issues.

Pregnant and breastfeeding women can usually take oral vancomycin when necessary, but your doctor will carefully weigh the benefits and risks. The medication doesn't typically cause problems for developing babies, but it's always best to discuss your specific situation.

People taking certain other medications might need dose adjustments or additional monitoring. Always provide your doctor with a complete list of all medicines, supplements, and over-the-counter products you're using.

Vancomycin Brand Names

Oral vancomycin is available under several brand names, with Vancocin being the most commonly recognized one. You might also encounter Firvanq, which is an oral solution formulation that's easier to measure and take.

Generic versions of oral vancomycin are also available and work just as effectively as the brand-name options. Your insurance might prefer the generic version, which can help reduce your out-of-pocket costs.

The different brand names and formulations all contain the same active ingredient, so they're equally effective for treating your infection. Your pharmacist can help you understand which version you're receiving and how to take it properly.

Vancomycin Alternatives

Several other antibiotics can treat the same intestinal infections as oral vancomycin. Fidaxomicin (Dificid) is another option for C. diff infections and might have fewer side effects for some people.

Metronidazole (Flagyl) used to be a first-line treatment for C. diff infections, though it's now typically reserved for less severe cases or when other options aren't suitable. Your doctor might consider this if you've had problems with vancomycin before.

For certain situations, your doctor might recommend a combination approach or newer treatments like fecal microbiota transplantation, especially for recurring infections that don't respond well to standard antibiotics.

The choice of antibiotic depends on several factors including the specific bacteria causing your infection, your medical history, and how severe your symptoms are. Your doctor will select the most appropriate treatment for your particular situation.

Is Vancomycin Better Than Metronidazole?

For most C. diff infections, oral vancomycin is now considered more effective than metronidazole. Recent studies show that people taking vancomycin tend to have better cure rates and fewer recurrences.

Vancomycin works more specifically against the bacteria causing your infection and stays concentrated in your intestines where it's needed. Metronidazole, while still useful in some cases, doesn't target the infection as precisely.

However, metronidazole might still be appropriate for certain situations, such as mild infections or when cost is a significant concern. Your doctor will consider your specific circumstances when choosing between these options.

Both medications are effective antibiotics, but current medical guidelines favor vancomycin for most intestinal infections because of its superior outcomes and more targeted action.