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Oritavancin parenteral

Updated 2 Feb 2023 | Glycopeptide antibiotics


Infusions of oritavancin.

Drugs List

  • oritavancin 400mg powder for solution for infusion vial
  • TENKASI 400mg powder for concentrate for soln for infusion vial
  • Therapeutic Indications


    Treatment of skin and skin structure infections



    1200mg administered as a single dose by intravenous infusion over 3 hours.


    For intravenous infusion only.


    Children under 18 years
    Concomitant medication consider washout period, see prescribing information

    Precautions and Warnings

    Severe hepatic impairment
    Severe renal impairment

    Advise ability to drive/operate machinery may be affected by side effects
    Consult national/regional policy on the use of anti-infectives
    Previous/Concurrent medicine consider washout period: See prescribing info
    Suspend treatment or reduce rate until infusion reactions resolve
    Monitor for signs and symptoms of osteomyelitis
    Consider pseudomembranous colitis if patient presents with diarrhoea
    Prolonged use may result in superinfection with non-susceptible organisms
    May affect results of some laboratory tests
    Consider alternative antibacterial therapy if osteomyelitis is suspected
    Discontinue if hypersensitivity reactions occur

    Infusion-associated reactions characterised by chest pain, chest discomfort, chills, tremor, back pain, neck pain, dyspnoea, hypoxia, abdominal pain and fever have been observed with the use of oritavancin including after the administration of more than one dose of oritavancin (1200mg) during a single course of therapy.

    Oritavancin is active against Gram positive bacteria only. In mixed infections where Gram negative and/or certain types of anaerobic bacteria are suspected, oritavancin should be co-administered with appropriate antibacterial agent(s).

    Pregnancy and Lactation


    Use oritavancin with caution during pregnancy.

    The manufacturer advises, as a precautionary measure, that it is preferable to avoid the use of oritavancin during pregnancy unless the potential benefit justifies the potential risk to the fetus.

    At the time of writing there are no or limited amount of data from the use of oritavancin in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity.


    Oritavancin is contraindicated during breastfeeding.

    The manufacturer advises that the patient either discontinues oritavancin or discontinues breastfeeding taking into account the benefit of breastfeeding for the child and the benefit of therapy for the women.

    Available pharmacodynamic/toxicological data in animals have shown excretion of oritavancin in milk. It is unknown whether oritavancin/metabolites are excreted in human milk. A risk to newborns/infants cannot be excluded.

    Side Effects

    "Red man" syndrome (flushing of upper body)
    Abdominal pain
    Abnormal liver function tests
    Alanine aminotransferase increased
    Anaphylactic reaction
    Anaphylactic shock
    Antibiotic-associated colitis
    Aspartate aminotransferase increased
    Back pain
    Chest discomfort
    Chest pain
    Erythema at injection site
    Erythema multiforme
    Hypersensitivity reactions
    Increased susceptibility to infection
    Infusion related reaction
    Infusion site induration
    Infusion site reaction
    Leukocytoclastic vasculitis
    Neck pain
    Peripheral oedema
    Phlebitis (injection site)
    Pseudomembranous colitis
    Respiratory disorders
    Serum bilirubin increased
    Skin reactions

    Effects on Laboratory Tests

    Use of intravenous unfractionated heparin sodium is contraindicated for 120 hours (5 days) after oritavancin administration because the activated partial thromboplastin time (aPTT) test results may remain falsely elevated for up to 120 hours after oritavancin administration. For patients that require aPTT monitoring within 120 hours of oritavancin dosing, a non-phospholipid dependent coagulation test such as a Factor Xa (chromogenic) assay or an alternative anticoagulant not requiring aPTT monitoring may be considered.

    Oritavancin has been shown to artificially prolong prothrombin time (PT) and international normalised ratio (INR) for up to 12 hours. Therefore the monitoring of the anticoagulation effect of warfarin is unreliable up to 12 hours after an oritavancin dose.

    Oritavancin concentrations that are found in the blood of patients following administration of a single dose have shown to artificially prolong; Activated Clotting Time (ACT) for up to 24 hours, Silica Clot Time (SCT) for up to 18 hours, and Dilute Russell's Viper Venom Test (DRVVT) for up to 72 hours.


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: July 2022

    Reference Sources

    Summary of Product Characteristics: Tenkasi 400mg powder for concentrate for solution for infusion. A. Menarini Farmaceutica Internazionale SRL. Revised July 2021.

    NICE Evidence Services Available at: Last accessed: 20 July 2022

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