Dalvance Injection: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Dalvance Injection (dalbavancin) is a glycopeptide antibiotic given by IV infusion to treat serious skin infections caused by susceptible Gram-positive bacteria, including MRSA. It works by interfering with bacterial cell wall formation, which stops the bacteria from surviving and multiplying. A notable feature of Dalvance is that it can often be given as just one or two IV doses rather than requiring daily infusions over several weeks.

What is Dalvance Injection

Dalvance is an antibiotic given by IV infusion that fights certain bacteria. It is used for serious skin infections caused by susceptible Gram-positive bacteria.

Dalvance Injection uses

• Treatment of adult and pediatric patients with acute bacterial skin and skin structure infections (ABSSSI) caused by susceptible Gram-positive bacteria such as Staphylococcus aureus (including MRSA), Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus dysgalactiae, Streptococcus anginosus group, and Enterococcus faecalis (vancomycin-susceptible)

Benefits of Dalvance Injection

• Can treat serious skin infections with as little as one or two IV doses, instead of daily dosing for weeks
• Effective against methicillin-resistant Staphylococcus aureus (MRSA) and other resistant Gram-positive bacteria
• Treats susceptible Gram-positive bacterial infections
• Active against certain MRSA infections
• Provides a long duration of antibacterial activity
• May be given as a single IV dose
• Avoids the need for frequent daily antibiotic infusions in suitable patients

How Dalvance Injection works

Dalvance works by interfering with the bacteria's ability to build their cell walls, which stops the bacteria from surviving and multiplying.

Dalvance Injection dosage

Dalvance is given as an IV infusion into a vein by a healthcare provider; each infusion takes at least 30 minutes. It is usually given as either one single dose, or as two doses with the second dose given one week after the first.

The medicine must not be shaken after mixing, to avoid foaming. The mixed medicine should look clear or slightly yellow; do not use it if it has changed color or has particles in it. It should not be infused together with other medications or electrolytes in the same line without flushing the line first.

Tell your caregivers right away if you feel itching, tingling, back pain, rash, or sudden warmth/redness in your upper body during the infusion, since infusing too quickly can cause these reactions.

Use for the full length of time prescribed, even if you start feeling better quickly, since stopping early can allow the infection to come back or become resistant to treatment. Dosing for children is based on their age and body weight.

Available forms and strengths

• Powder for injection/infusion (lyophilized powder in a single-dose vial, 500 mg per vial, to be mixed into a solution for IV infusion)

Side effects of Dalvance Injection

Common

• Nausea
• Headache
• Diarrhea
• Vomiting
• Rash
• Itching (pruritus)

Serious

• Serious allergic (anaphylactic) reactions and serious skin reactions
• Infusion-related reactions (flushing of the upper body, hives, itching, rash, back pain) from infusing too quickly
• Liver enzyme (ALT) elevations/liver problems
• Clostridioides difficile-associated diarrhea (severe watery or bloody diarrhea, which can signal a serious intestinal infection)
• Low blood counts (anemia, low white blood cells, low platelets)
• Gastrointestinal bleeding
• Bronchospasm

Warnings and precautions

• Dalvance can cause serious allergic reactions, including anaphylaxis, and serious skin reactions. If you have a history of allergy to other glycopeptide antibiotics (like vancomycin), tell your doctor, since there may be a higher chance of a similar reaction with Dalvance.
• Infusing Dalvance too quickly can cause flushing of the upper body, hives, itching, rash, and/or back pain. Slowing or stopping the infusion usually stops these reactions.
• Diarrhea caused by C. difficile bacteria has happened with almost all antibiotics, including Dalvance, and can range from mild to life-threatening. This can even occur more than two months after you finish treatment.
• Using Dalvance when there is no proven or strongly suspected bacterial infection is unlikely to help you and can increase the risk that bacteria become resistant to antibiotics.
• Dalvance should not be mixed with saline solutions, which can cause the drug to form particles, and should not be infused at the same time as other medicines or electrolytes through the same line.
• It isn't known whether Dalvance can harm an unborn baby, since there are no well-controlled studies in pregnant women. Tell your doctor if you are pregnant; this medicine should be used in pregnancy only if the benefit outweighs the possible risk.
• It isn't known whether Dalvance passes into human breast milk. Your doctor will weigh the benefits of breastfeeding against your need for this medicine and any possible risks to the baby.
• People with reduced kidney function need a lower dose of Dalvance, since the drug is mainly removed from the body by the kidneys.
• No dose change is needed for mild liver problems, but doctors should be cautious prescribing Dalvance to people with moderate or severe liver impairment, since there isn't enough data to know the right dose for them.
• No major direct interaction with alcohol is established, but alcohol is best avoided if illness or treatment causes nausea or dizziness.
• Dalvance usually does not directly impair driving, but avoid driving if dizziness or other adverse effects occur.

Storage

• Store unmixed powder at room temperature away from moisture and heat
• After mixing (reconstitution), store refrigerated or at controlled room temperature; do not freeze
• Use the mixed and diluted medicine within 48 hours of mixing
• Each single-use vial is for one use only; throw away any unused medicine after the dose is given, even if some remains in the vial

When to see a doctor

• Get emergency medical help right away if you have signs of a serious allergic reaction, such as hives, difficulty breathing, or swelling of your face, lips, tongue, or throat.
• Call your doctor right away if you have severe stomach pain or diarrhea that is watery or bloody, as this could be a sign of a serious intestinal infection.
• Tell your caregivers immediately if you feel itching, tingling, back pain, or sudden warmth in your upper body during the infusion.

Alternatives

• Vancomycin
• Daptomycin
• Linezolid