Vancomycin IV
Renal

Renal

Not On Dialysis (CrCl)

Refer to Vancomycin Nomogram

Hemodialysis

  • Loading dose: 25 mg/kg IV once
  • Maintenance dose:
    • <70 kg: 500 mg IV qHD
    • ≥70 kg: 750 mg IV qHD

Draw Level pre-second maintenance dose

Target Level- Pre-HD level: 10-20 mg/L

Continuous Ambulatory Peritoneal Dialysis (CAPD)

Intravenous (IV)
  • Loading dose: 20 mg/kg IV once
  • Maintenance dose: 20 mg/kg IV q4-7 days (monitor trough levels)
Intraperitoneal
  • Loading dose: 30 mg/kg IP once
  • Maintenance dose: 30 mg/kg IP q5-7 days

Draw levels 3-4 days after first dose

Target trough level: 10-20 mg/L