Possibility of accumulation in severe renal dysfunction.
Oral/rectal therapy: serum sample monitoring not typically required. Some systemic absorption of enteral vancomycin may occur in patients with renal failure who have mucosal disruption from colitis. Monitoring serum vancomycin levels may be considered for these patients with renal failure who have severe colitis and require a prolonged course of enteral vancomycin.
Bile acid sequestrants may diminish the therapeutic effects of vancomycin. Avoid concurrent administration when possible. If use of both agents is necessary, separate doses by at least 2 hours to minimize significant interaction.