Drug reference

Teicoplanin

Glycopeptide · Antibiotic

GlycopeptideAntibioticATC null

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

1 major

SEVERE in our sources

PREGNANCY

FDA category + note

Top interactionssee all 9 →

Aminoglycosides (e.g., Amikacin, Gentamicin)SevereDatabase

Mechanism

Teicoplanin is a glycopeptide antibiotic that, like vancomycin, binds with high affinity to the D-Ala-D-Ala terminus of peptidoglycan precursor units, blocking both transglycosylation and transpeptidation steps of cell wall synthesis. However, teicoplanin has an exceptionally long half-life (45-70 hours) due to high protein binding (90-95%) and tissue distribution, permitting once-daily or even thrice-weekly dosing after loading — a major practical advantage over vancomycin which requires twice-daily infusions.

Indications

Antibacterial prophylaxis for operations on stomach or oesophagus in patients at high risk of meticillin-resistant Staphylococcus aureusAntibacterial prophylaxis for open biliary surgery in patients at high risk of meticillin-resistant Staphylococcus aureusAntibacterial prophylaxis for resections of colon and rectum for carcinoma, resections in inflammatory bowel disease, and appendicectomy in patients at high risk of meticillin-resistant Staphylococcus aureusBiliary complications following liver transplantationenterococcal endocarditis (along with gentamicin)MRSA infectionspenicillin resistant streptococcal infectionsosteomyelitissurgical prophylaxis (as alternative to vancomycin)

Dosing

Adult: Serious infections: 6 mg/kg IV every 12h for 3 doses, then 6 mg/kg OD. Endocarditis/bone: 12 mg/kg every 12h for 3-5 doses, then 12 mg/kg OD. Surgical prophylaxis: 400 mg single dose.
Renal adjustment: dose needs to be reduced in renal insufficiency

Pharmacokinetics

Half-life

3–4 days

Excretion

largely excreted unchanged by kidney

Side effects

Common

rashesfevergranulocytopeniahearing loss (occasionally)

Pregnancy & lactation

Pregnancy

Drug interactions

Aminoglycosides (e.g., Amikacin, Gentamicin)

Severe

Database

Increased risk of acute kidney injury and hearing loss/vestibular dysfunction.

Avoid concomitant use if possible. If co-administration is necessary, monitor renal function (serum creatinine, urine output) and drug levels (teicoplanin trough, aminoglycoside peak/trough) closely. Consider audiometry and vestibular function tests, especially in high-risk patients or with prolonged therapy. Adjust doses as needed.

Amphotericin B

Moderate

Database

Increased risk of acute kidney injury.

Monitor renal function closely. Ensure adequate hydration. Consider lipid formulations of amphotericin B if available and appropriate to reduce nephrotoxicity.

Ciclosporin

Moderate

Database

Increased risk of acute kidney injury.

Monitor renal function (serum creatinine, BUN) closely. Adjust doses of teicoplanin or ciclosporin as needed. Consider therapeutic drug monitoring for both drugs.

Cisplatin

Moderate

Database

Increased risk of acute kidney injury and hearing loss.

Monitor renal function and hearing closely. Avoid concomitant use if possible, especially in patients with pre-existing renal impairment. Ensure adequate hydration.

Loop Diuretics (e.g., Furosemide)

Moderate

Database

Increased risk of hearing loss and, less commonly, renal dysfunction, especially in patients with pre-existing renal impairment or high doses of either drug.

Monitor renal function and hearing, especially in patients with pre-existing renal impairment or when high doses are used. Maintain adequate hydration. Consider alternative diuretics if ototoxicity is a concern.

Non Steroidal Anti Inflammatory Drugs (nsaids)

Moderate

Database

Increased risk of acute kidney injury.

Monitor renal function, especially in elderly patients, those with pre-existing renal impairment, or during prolonged concomitant use. Ensure adequate hydration. Consider alternative analgesics if possible.

Radiocontrast Agents

Moderate

Database

Increased risk of contrast-induced nephropathy.

Ensure adequate hydration before and after contrast administration. Monitor renal function closely. Consider delaying teicoplanin administration if possible, or using lower doses of contrast agent.

Tacrolimus

Moderate

Database

Increased risk of acute kidney injury.

Monitor renal function (serum creatinine, BUN) closely. Adjust doses of teicoplanin or tacrolimus as needed. Consider therapeutic drug monitoring for both drugs.

Vancomycin

Moderate

Database

Increased risk of acute kidney injury and hearing loss, particularly with high doses or prolonged therapy.

Generally, these drugs are not used concomitantly due to similar spectrum of activity. If co-administration is unavoidable (e.g., for specific resistant infections), monitor renal function and hearing closely. Adjust doses based on therapeutic drug monitoring.