Oritavancin
General Information
Lipoglycopeptide
Restricted formulary antimicrobial: For details see OUH netFormulary
AWaRe antibiotic classification: 'Reserve'. All indications to be discussed with Micro/ID.
- Use with caution in patients with a history of glycopeptide sensitivity (e.g.vancomycin) due to the possibility of cross-reactivity. Monitor patients with a history of glycopeptide sensitivity before and after the infusion.
- Use of intravenous unfractionated heparin sodium is contraindicated for 120 hours (5 days) after oritavancin administration because activated partial thromboplastin time (aPTT) test results may remain falsely elevated for up to 120 hours after oritavancin administration.
Standard dose
1200mg STAT iv, administered over 3 hours
Obesity
No dose adjustment required.
Renal and hepatic impairment
Renal impairment
No dose adjustment required in renal impairment. Use in severe renal impairment or renal replacement therapy is unlicensed. A one-off unlicensed use form should be completed.
Hepatic impairment
No dose adjustment required.
Effect on assays for coagulation tests
Oritavancin may interfere with the following coagulation tests:
- aPTT for up to 120 hours
- Prothrombin time (PT) and INR for up to 12 hours
- Activated Clotting Time (ACT) for up to 24 hours
- Silica Clotting Time (SCT) for up to 18 hours
- Dilute Russell's Viper Venom Test (DRVVT) for up to 72 hours
Notable interactions
- Warfarin
- Unfractionated heparin.
- Use of intravenous unfactionated heparin sodium is contraindicated for 120 hours (5 days) after oritavancin administration because activated partial thromboplastin time (aPTT) test results may remain falsely elevated for up to 120 hours after oritavancin administration.
This is not a complete list. Please see the BNF, Summary of Product Characteristics, or speak to a pharmacist.
Pregnancy and breastfeeding
Pregnancy
Avoid unless potential benefit outweighs risk. No human data available. Animal studies do not indicate harm.
Breastfeeding
Avoid breastfeeding. No human data available. Oritavancin and its metabolites are excreted in animal breastmilk. Risk to infant cannot be excluded. Discuss with pharmacy.
References
1. British National Formulary, Oritavancin. Available at: bnf.nice.org.uk/drugs/oritavancin/ Accessed on: 15th May 2023.
2. Gilbert, D. Oritavancin, Sanford Web Edition, Available at: webedition.sanfordguide.com/en/drug-information/antibacterial-agents/glyco-lipoglyco-peptides/oritavancin Last updated: 19th April 2023. Accessed on: 15th May 2023.
3. A. Menarini SRL, Summary of Product Characteristics: Tenkasi 400mg powder for concentrate for solution for infusion. Available at: medicines.org.uk/emc/product/13554. Last updated: 7th April 2022. Accessed on 15th May 2023
4. Renal Drug Database, Oritavancin. Available at: renaldrugdatabase.com/monographs/oritavancin. Last updated: 21st November 2017. Accessed on: 15th May 2023.