Learn which medications interact with Vancomycin, including Aminoglycosides, Piperacillin-Tazobactam, and NSAIDs. Know what to tell your doctor before starting.
Vancomycin is a powerful glycopeptide antibiotic used to treat serious infections like MRSA and Clostridioides difficile (C. diff). While it is effective and often life-saving, Vancomycin can interact with other medications in ways that increase the risk of side effects — particularly kidney damage and hearing problems.
This guide explains how Vancomycin drug interactions work, which medications to watch out for, and what to tell your doctor before starting treatment.
Most Vancomycin drug interactions fall into two categories:
These interactions are more likely with IV Vancomycin than oral Vancomycin. Because oral Vancomycin is poorly absorbed into the bloodstream (less than 10%), systemic drug interactions are much less common with the oral form. However, you should still tell your doctor about all medications you take regardless of which form of Vancomycin you receive.
These combinations carry the highest risk and require careful monitoring or avoidance:
This is one of the most well-known Vancomycin interactions. Aminoglycosides are antibiotics that are also toxic to the kidneys and ears. When used together with Vancomycin, the risk of both nephrotoxicity and ototoxicity increases substantially. If both drugs are needed, your doctor will monitor kidney function and drug levels very closely.
Studies have shown that combining Vancomycin with Piperacillin-Tazobactam significantly increases the risk of acute kidney injury (AKI) compared to Vancomycin alone or Vancomycin combined with other beta-lactam antibiotics. Many hospitals have updated their protocols to use alternative combinations when possible.
Amphotericin B is an antifungal medication that is notoriously hard on the kidneys. Combining it with Vancomycin further increases nephrotoxicity risk. If both are needed (for example, in a critically ill patient with both bacterial and fungal infections), kidney function will be monitored frequently.
Cisplatin is a chemotherapy drug that can cause both kidney damage and hearing loss. Using it with Vancomycin increases the risk of both. Oncology and infectious disease teams will coordinate closely if this combination is required.
These are last-resort antibiotics for drug-resistant gram-negative infections. They are highly nephrotoxic on their own, and combining them with Vancomycin increases the risk further.
Loop diuretics can increase the risk of ototoxicity (hearing damage) when used with Vancomycin. If you take Furosemide regularly, your doctor should be aware before starting Vancomycin.
These combinations require monitoring but may still be used together:
While Vancomycin has fewer interactions with supplements and over-the-counter products compared to some other drugs, keep these in mind:
Vancomycin has no significant food interactions. Oral Vancomycin can be taken with or without food. There are no foods you need to avoid during treatment.
However, it is important to stay well-hydrated during Vancomycin treatment, especially with the IV form. Adequate hydration helps protect your kidneys. Ask your doctor how much fluid you should be drinking daily.
Before beginning Vancomycin treatment, make sure your doctor knows:
Your doctor will use this information to decide on the right dose, choose appropriate monitoring, and avoid dangerous combinations.
Vancomycin is generally safe when used with proper monitoring, but its interactions with kidney-toxic and ear-toxic drugs are important to know. The biggest risks come from combining IV Vancomycin with Aminoglycosides, Piperacillin-Tazobactam, and Amphotericin B.
Always give your doctor a complete list of your medications before starting Vancomycin. For more about how Vancomycin works and its side effects, see our guides on how Vancomycin works and Vancomycin side effects. If you need help finding Vancomycin at a pharmacy, Medfinder can help.
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