Telavancin

Products

Telavancin is commercially available as a powder for the preparation of a concentrate for infusion solution (Vibativ). It was approved in the EU in 2011.

Structure and properties

Telavancin (C80H106Cl2N11O27P, Mr = 1755.6 g/mol) is a complex molecule and a semisynthetic derivative of vancomycin. It was supplemented with, among other things, a lipophilic decylaminoethyl side chain on the vancosamine sugar, which enhances anchoring in the membrane and thereby binding to the target. Telavancin is lipophilic and exists as a white to lightly colored amorphous powder that is sparingly soluble in water.

Effects

Telavancin (ATC J01XA03) is bactericidal to Gram-positive bacteria including . Effects are based on inhibition of bacterial cell wall synthesis by binding to peptidoglycan precursors. In contrast to vancomycin, it additionally interferes with bacterial membrane function.

Indications

For the treatment of adults with nosocomial pneumonia including ventilator-associated pneumonia known or suspected to be caused by methicillin-resistant (MRSA). In the United States, telavancin is approved for the treatment of complicated skin infections caused by Gram-positive bacteria.

Dosage

According to the drug label. The drug is administered as an intravenous infusion once daily for 1-3 weeks.

Contraindications

Telavancin is contraindicated in hypersensitivity, severe renal insufficiency, acute renal failure, and during pregnancy. For complete precautions, see the drug label.

Interactions

No clinically relevant drug-drug interactions have been reported. Telavancin may interfere with laboratory tests used to monitor blood clotting and for protein determinations.

Adverse Effects

Telavancin is arrhythmogenic, nephrotoxic, probably teratogenic, and ototoxic. The most common possible adverse effects include fungal infections, insomnia, taste disturbances, headache, dizziness, nausea, constipation, diarrhea, vomiting, increases in alanine aminotransferase and aspartate aminotransferase, pruritus, skin rash, acute renal failure, increased blood creatinine levels, frothy urine, fatigue, and chills.