Q: Can you provide a liquid formulation for vancomycin HCl?
A: Vancomycin HCl, a glycopeptide antibiotic, is used to treat gram-positive bacterial infections, most notably pseudomembranous colitis caused by the anaerobic bacillus Clostridium difficile. This form of colitis is often seen as an iatrogenic infection following large-dose antibiotic therapy that kills much of normal gut flora, and can in extreme cases lead to toxic megacolon and death.
Vancomycin HCl is administered as a parenteral solution or oral capsule (125 and 250 mg/capsule). Therapeutic compliance can be enhanced by administration of oral liquid preparations in selected cases.
Oral liquid preparations of vancomycin HCl for oral solution formerly were available as 500 mg/6 mL and 250 mg/5 mL (Vancoled, Lederle; Vancocin HCl, Viropharma), but currently are listed in the FDA Orange Book as “discontinued.”
Several formulations for extemporaneous preparation of vancomycin HCl oral solution have been published. One recent example uses a unique vehicle to compound vancomycin 50 mg/mL (Whaley PA, Voudrie MA II. Stability of vancomycin in SyrSpend SF. Int J Pharm Compounding. 2012;16(2):167-169).