Firvanq Vancomycin HCI Oral Solution

Aug 2, 2021 | Clinical Insight

HealthDirect Pharmacy Services Product Focus

Indication and Description

Firvanq® is a glycopeptide antibacterial oral solution indicated in adults and pediatric patients less than 18 years of age for the treatment of C. Difficile associated diarrhea and Enterocolitis caused by Staphylococcus aureus (MSSA, MRSA). It is not indicated to treat other types of infections.1

Dosage and Administration

  • Adults with C. Diff– recommended dose is 125mg PO QID for 10 days.
  • Adults with Staphylococcal enterocolitis- recommended dose is 500mg-2g in 3-4 divided doses for 7-10 days.


Hypersensitivity to Vancomycin.

Adverse Reactions

Nausea, abdominal pain, vomiting, diarrhea, flatulence, pyrexia, peripheral edema, fatigue, urinary tract infection, hypokalemia, back pain, headache.

Serious Side Effects

Nephrotoxicity with increased risk in geriatric populations, ototoxicity, toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome (SJS), drug reaction with eosinophilia and systemic symptoms (DRESS), acute generalized exanthematous pustulosis (AGEP), and linear lgA bullous dermatosis (LABD), and superinfections.

Drug/Drug interactions2

No drug interactions have been conducted with Firvanq®. General interactions with Vancomycin include: BCG, cholera vaccine, bile acid sequestrants, colistimethate, sodium picosulfate, typhoid vaccine.

Dosage Form/Storage

  • Prior to administration, Firvanq® must be reconstituted by a healthcare provider to produce the solution.
  • Each kit contains: 1 bottle vancomycin powder, 1 pre-measured grape flavored diluent to be added to the vancomycin bottle.
  • Shake the reconstituted solution of Firvanq® well before each use
  • Use an oral dosing device that measures the appropriate volume of the oral solution in milliliters
  • Store reconstituted solution in refrigerator, (36–46 F).
  • Discard after 14 days from reconstitution, or if it appears hazy or contains particulates.

Monitoring Parameters

  • Renal function during and following treatment
  • Monitoring serum vancomycin levels may be considered for patients with renal failure who have severe colitis.
Table 1: Vancomycin Concentration and Volume after Reconstitution.
Vancomycin Concentration after ReconstitutionFinal Volume of Firvanq after ReconstitutionVancomycin Strength per BottleDiluent for Firvanq
25 mg/mL150 mL3.75 g147 mL
25 mg/mL300 mL7.5 g295 mL
50 mg/mL150 mL7.5 g145 mL
50 mg/mL300 mL15.0 g289 mL


  1. “Firvanq” Azurity Pharmaceuticals, Inc.
  2. “Vancomycin” Lexicomp-Drugs Online, Hudson: Lexicomp, Inc.
For complete prescribing information: visit this website or call (800)-461-7449

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John Wind, RPH

As HealthDirect’s Consultant Pharmacist Manager, John provides leadership and guidance to the Consultant Pharmacist team.  John has been provided LTC communities with personalized clinical consulting for more than 20 years.

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