Approved Formulary
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Vancomycin Initial Dosing (DASON)
All maintenance doses = 15 mg/kg.
For target trough 15-20, give 20 mg/kg load.
For Goal Trough 10-15:
CrCl ≥ 70: interval = q12h.
CrCl ≥ 35 and < 70: interval = q24h.
CrCl < 35 or Dialysis: Pulse Dosing.
For Goal Trough 15-20:
CrCl ≥ 70: interval = q8h.
CrCl ≥ 50 and < 70: interval = q12h.
CrCl ≥ 35 and < 50: interval = q24h.
CrCl < 35 or Dialysis: Pulse Dosing.
All doses are rounded to nearest 250 mg
and are based on Total Body Weight.
Max. dose = 2 grams.
• Use closest interval that is longer than t1/2. (Interval should NEVER be shorter than t1/2.)
• Order a serum creatinine with each trough level.
• Exercise caution when using q8h dosing. A decision to dose q8h should be reviewed with another pharmacist. Order a daily trough level with any q8h regimens.
• Consider scaling back by one dosing interval in patients with BMI > 30.
• Night shift dosing of initial dose only, with clinical staff to manage the subsequent regimen.
All maintenance doses = 15 mg/kg.
For target trough 15-20, give 20 mg/kg load.
For Goal Trough 10-15:
CrCl ≥ 70: interval = q12h.
CrCl ≥ 35 and < 70: interval = q24h.
CrCl < 35 or Dialysis: Pulse Dosing.
For Goal Trough 15-20:
CrCl ≥ 70: interval = q8h.
CrCl ≥ 50 and < 70: interval = q12h.
CrCl ≥ 35 and < 50: interval = q24h.
CrCl < 35 or Dialysis: Pulse Dosing.
All doses are rounded to nearest 250 mg
and are based on Total Body Weight.
Max. dose = 2 grams.
• Use closest interval that is longer than t1/2. (Interval should NEVER be shorter than t1/2.)
• Order a serum creatinine with each trough level.
• Exercise caution when using q8h dosing. A decision to dose q8h should be reviewed with another pharmacist. Order a daily trough level with any q8h regimens.
• Consider scaling back by one dosing interval in patients with BMI > 30.
• Night shift dosing of initial dose only, with clinical staff to manage the subsequent regimen.