Oral Vancomycin Dosages: Your GoodRx Guide

Vancomycin (Vancoin, Firvanq) is a prescription antibiotic that can treat certain infections in your gut when taken orally. It’s FDA approved to treat Clostridioides difficile (C. diff)-associated diarrhea and Staphylococcus enterocolitis.

In most cases, you’ll take oral vancomycin for 7 to 10 days. But your treatment might be longer or shorter. This can depend on the severity of your infection and how well the medication is working for you. Below, we cover what you should know about typical oral vancomycin dosages.

Oral vancomycin dosage forms

When taken by mouth, vancomycin is available as a capsule and an oral liquid. Whether you take one or the other can depend on how you tolerate swallowing pills and product availability. Both dosage forms come as brand-name and generic versions.

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Vancomycin capsules (known by the brand name Vancocin) are available in 125 mg and 250 mg doses. Vancomycin oral solution (brand name Firvanq) must be prepared for you by a healthcare professional. It comes as 25 mg/mL and 50 mg/mL concentrations once it has been made for you. Unlike the capsules, the oral solution must be stored in the refrigerator.

For the oral solution, shake it well before each dose. Use an appropriate oral dosage device, such as a medicine cup or an oral syringe. A pharmacist can show you how to measure your dose correctly.

Both vancomycin capsules and oral solution can be taken with or without food. If the medication is upsetting your stomach, try taking your doses with food to help.

What’s the typical oral vancomycin dosage for adults?

The typical oral vancomycin dosage for adults depends on the infection you’re treating. The dose is the same whether you’re taking the capsules or liquid. Be sure to follow your prescriber’s instructions carefully.

Clostridioides difficile

C. diff infection often causes diarrhea that doesn’t get better, stomach pain, and fever. It usually occurs after you’ve taken an antibiotic.

Oral vancomycin is one treatment option for C. diff infection. The typical oral vancomycin dosage for infectious diarrhea from C. diff in adults is 125 mg by mouth 4 times a day for 10 days. In studies, it took about 5 days for diarrhea to improve after starting treatment.

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Staphylococcal enterocolitis

When a bacteria called Staphylococcus aureus grows too much, enterocolitis (gut inflammation) can happen. Although it’s less common than C. diff infections, this infection can also occur after you take an antibiotic. Diarrhea is the most common symptom.

The typical oral vancomycin dosage for staphylococcal enterocolitis in adults is 500 mg to 2 g by mouth per day for 7 to 10 days. Your daily dose is typically split up into three or four smaller doses throughout the day.

What’s the typical oral vancomycin dosage for children?

For children under 18 years old, the oral vancomycin dosage is based on body weight. The maximum total daily dose is 2 g. Similar to adults, the recommended dosage is the same for the capsules and oral solution.

Clostridioides difficile

The typical oral vancomycin dosage to treat infectious diarrhea from C. diff in children is 40 mg per kilogram of body weight, split up into three or four doses throughout the day, for 7 to 10 days. The maximum total daily dosage is 2 g in a 24-hour period.

Staphylococcal enterocolitis

The typical oral vancomycin dosage to treat staphylococcal enterocolitis in children is 40 mg per kilogram of body weight, split into three or four doses throughout the day, for 7 to 10 days. The maximum total daily dosage is 2 g in a 24-hour period.

Are there dosage adjustments for health conditions?

Dosage adjustments for health conditions aren’t typically necessary with oral vancomycin. This is because unlike the intravenous form, the oral version isn’t usually well absorbed into your body. Instead, most of it stays in your gastrointestinal tract and isn’t processed through the liver or kidneys.

But some people, such as those with kidney problems or colon inflammation, may absorb more oral vancomycin than usual. This can result in significant vancomycin levels in the blood. In this case, your prescriber may want to monitor your blood levels to make sure they’re not too high.

Oral vancomycin can also cause kidney problems, usually within a week of finishing treatment. Older adults and people with preexisting kidney problems may be at higher risk. So your prescriber may order lab work to check your kidney health during and after your treatment.

Make sure to get all your blood work done on time. This will ensure vancomycin continues to be safe for you.

What happens if you miss a dose of oral vancomycin?

Forgetting to take vancomycin doses could make your treatment less effective. This is also the case if you don’t finish the full treatment course as prescribed. In both cases, your infection could come back or be harder to treat.

If you miss a dose, take it as soon as you can. But if it’s close to the time you take your next dose, skip your missed dose and continue with your usual schedule. Continue taking vancomycin until you’ve finished your treatment course, even if you’re feeling better.

Never double up on your medication to make up for missed doses. Taking too much oral vancomycin at one time can raise your risk for side effects.

To help you remember to take your dose, consider setting an alarm. Talk to your prescriber if you’re having trouble remembering to take your vancomycin doses each day.

What should you do if you take too much oral vancomycin?

Taking too much oral vancomycin can worsen side effects such as nausea, stomach pain, and swelling in the arms and legs. It can also lead to more serious side effects, such as kidney damage and hearing problems.

If you think you have taken too much oral vancomycin, contact a healthcare professional. You can also call Poison Control at 1-800-222-1222. They can provide guidance on what to do.

How to save on oral vancomycin

Oral vancomycin is available as brand-name medications and lower-cost generics. With free GoodRx discounts, you could save over 60% off the average retail price of generic vancomycin capsules.

At certain pharmacies, the price of generic vancomycin capsules is as low as $46.00 with GoodRx. And the price of the generic solution is as low as $41.79.

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Written by:

Kristianne Hannemann, PharmD

Kristianne Hannemann, PharmD, is a licensed pharmacist in California. She has been a retail pharmacy manager and staff pharmacist for over 7 years and has contributed drug information content to different health companies.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Patricia Weiser, PharmD

Patricia has 16 years of pharmacist experience. She previously held positions as a community pharmacist, pharmacy manager, and hospital pharmacist.

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