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Orbactiv

oritavancin

Used for Skin Infection

Orbactiv (oritavancin) is a newer antibiotic that treats skin infections caused by certain bacteria. It's commonly used for people who have, or might have, an infection from resistant bacteria. It's given as an injection through the veins for one dose and is available as a brand-name medication only, which can be expensive.

Reviewed by:

Robert Chad Hakim, PharmD, BCCCP

Kristianne Hannemann, PharmD

Last reviewed on June 2, 2022

Basics Side effects Pros & cons Pharmacist tips FAQs Warnings Dosage Contraindications Alternatives Images Prices Medicare

What is Orbactiv (oritavancin)?

What is Orbactiv (oritavancin) used for?

Skin and skin structure infections caused by certain bacteria in adults

How Orbactiv (oritavancin) works

Orbactiv (oritavancin) is an antibiotic. It fights against certain bacteria called Gram-positive bacteria. The medication works by preventing the bacteria from making their protective covering properly. It's also able to break through this covering, which causes the bacteria to die.

Are you looking for information on Dalvance (dalbavancin) or vancomycin (Vancocin) instead?

Drug Facts

Common BrandsOrbactiv, Kimyrsa

Drug ClassAntibiotic

Controlled Substance ClassificationNot a controlled medication

Generic StatusNo lower-cost generic available

AvailabilityPrescription only

What are the side effects of Orbactiv (oritavancin)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Nausea (10%)
Headache (7%)
Vomiting (5%)
Infection in limb or under the skin (4%)
Diarrhea (4%)

Other Side Effects

Dizziness
Inflammation in vein at injection site
Fast heart rate

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.

Serious allergic reaction: hives, rash, blisters, skin reddening, swelling of the lips or tongue, difficulty breathing
C. difficile-related diarrhea: foul-smelling diarrhea, frequent bowel movements (up to 15 times per day), fever, stomach pain or cramps

Source: DailyMed

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
Bone pain
Infusion reactions—chest pain, shortness of breath or trouble breathing, feeling faint or lightheaded
Severe diarrhea, fever
Unusual vaginal discharge, itching, or odor

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

Diarrhea
Dizziness
Headache
Nausea
Vomiting

Pros and cons of Orbactiv (oritavancin)

Pros

Has been shown to avoid unnecessary hospital admissions

Works well to treat skin and skin structure infections caused by resistant bacteria

Only need to get one dose, because it lasts for about 2 weeks

Can be used in certain people with kidney or liver problems

Cons

Needs to be injected by a healthcare provider

Infusion takes 1 to 3 hours, depending on which brand you get

Brand name only, which can be expensive

The Infectious Diseases Society of America (IDSA) hasn't made a recommendation for how to use Orbactiv (oritavancin) in their current clinical practice guidelines for skin and soft tissue infections.

Pharmacist tips for Orbactiv (oritavancin)

Make sure to mark on your calendar when you're supposed to see your provider and receive your dose of Orbactiv (oritavancin) so your infection can be treated. It's important to get your dose of Orbactiv (oritavancin) even if your skin infection looks better, because it might get worse or become harder to treat.

Contact your provider if you develop other symptoms of an illness or if your symptoms become worse. Orbactiv (oritavancin) can only treat infections caused by bacteria, and won't help if you have an infection caused by a virus or fungus.

Orbactiv (oritavancin) can interact with a lot of commonly used medications. Make sure to tell your provider about all the medications you take before receiving Orbactiv (oritavancin).

If you're taking a blood thinner called warfarin (Coumadin), tell your provider who manages your blood thinner medication that you received Orbactiv (oritavancin). Orbactiv (oritavancin) can falsely raise your INR or international normalized ratio (a blood test result that your provider uses to check how well your blood is clotting).

If you get admitted into the hospital within 5 days of receiving Orbactiv (oritavancin), tell your providers caring for you in the hospital that you've received this medication. Orbactiv (oritavancin) affects which medications your provider will give you to help prevent blood clots while you're hospitalized.

Frequently asked questions about Orbactiv (oritavancin)

What's the difference between Orbactiv and Kimyrsa?

Both Orbactiv and Kimyrsa are made from the same manufacturer (Melinta Therapeutics) and are very similar to each other. They both contain the antibiotic called oritavancin. The major difference is that Kimyrsa is infused over 1 hour, whereas Orbactiv is infused over 3 hours.

When would my provider consider to use Orbactiv (oritavancin) for treatment?

Orbactiv (oritavancin) is used to treat infections caused by certain bacteria called Gram-positive bacteria. But, it's commonly used for people who are confirmed to have a severe skin infection from resistant bacteria that are known to respond to Orbactiv (oritavancin). It's more convenient than other antibiotics, because it only needs to be given once.

Do I have to be in the hospital to get Orbactiv (oritavancin)?

No, you don't have to be admitted into the hospital. But, depending on the hospital, some places may choose to admit you. Since you only need one dose of Orbactiv (oritavancin) to complete therapy, it can also be given to you at an outpatient clinic or infusion center after you leave the hospital. This helps avoid problems and high costs related to the need for hospital admission to receive IV antibiotics.

Can Orbactiv (oritavancin) be used in children?

Orbactiv (oritavancin) is only approved for use in adults 18 years and older. However, there are current and ongoing studies that have shown Orbactiv (oritavancin) can be safe and works well for children. Ask your child's provider about antibiotics that are right for your child.

Can I receive Orbactiv (oritavancin) if I'm pregnant?

Orbactiv (oritavancin) hasn't been studied in pregnant females, so it's not exactly known how safe it is for you and your baby. In studies looking at how Orbactiv (oritavancin) affects pregnant animals, the medication didn't harm the unborn babies. Orbactiv (oritavancin) should be used in pregnant females only if it's clearly needed. If you're pregnant, talk with your provider to see if Orbactiv (oritavancin) is right for you.

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What are the risks and warnings for Orbactiv (oritavancin)?

Orbactiv (oritavancin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Severe allergic reactions

Risk factors: Allergy to other related antibiotics

Severe allergic reactions to Orbactiv (oritavancin) are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis (closing of the throat). Tell your provider if you're allergic to other related antibiotics (e.g., vancomycin (Vancocin)) before receiving Orbactiv (oritavancin). If you notice dizziness, a choking sensation, difficulty breathing, or swelling around your eyes, lips, or tongue after receiving Orbactiv (oritavancin), get medical attention right away.

Infusion reactions

Infusion-related reactions are possible during your Orbactiv (oritavancin) infusion. These reactions can include flushing of the upper body, hives, itching, or rash. Others might include chest or back pain, chills, and shaking. If any of these reactions happen, tell your provider right away so they can slow or stop the infusion.

Diarrhea from

Nearly all antibiotics, including Orbactiv (oritavancin), can cause an infection with a bacteria called Clostridioides difficile (C. diff). This infection causes diarrhea. Antibiotics change the amount of normal bacteria in your stomach and intestines, which can lead to an overgrowth of C. diff. It's important to recognize the difference between diarrhea as a side effect of Orbactiv (oritavancin) and C. diff-related diarrhea. C. diff-related diarrhea can cause foul-smelling diarrhea, frequent bowel movements (even up to 15 times per day), fever, and nausea, and is a medical emergency. If you have any of these symptoms, get medical attention right away so you can be tested for C. diff and receive treatment.

Orbactiv (oritavancin) dosage forms

Typical dosing for Orbactiv (oritavancin)

Orbactiv: The typical dose is 1.2 grams injected into the vein (intravenously, IV) over 3 hours for one dose.
Kimyrsa: The typical dose is 1.2 grams given IV over 1 hour for one dose.

Orbactiv (oritavancin) contraindications

Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Orbactiv (oritavancin) will not be safe for you to take.

Use of IV heparin for 5 days after receiving Orbactiv (oritavancin)

What are alternatives to Orbactiv (oritavancin)?

There are a number of medications that your doctor can prescribe in place of Orbactiv (oritavancin). Compare a few possible alternatives below.

Orbactiv (oritavancin)

Used for:

Skin and skin structure infections caused by certain bacteria in adults

View Prices

Dalvance (dalbavancin)