Medications

Vancomycin

Vancomycin

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Comprehensive medication guide to {drug} including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.

Estimated Insurance Pricing
$10–$50 copay for oral forms; IV Vancomycin is typically covered under medical benefit when administered in hospitals or infusion centers.
Estimated Cash Pricing
$39–$120 for generic oral capsules (125 mg, 40 count) with discount coupons from GoodRx or SingleCare; brand Firvanq oral solution runs $122–$593.
Medfinder Findability Score
40
/100
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Post Author

Peter Daggett

Last Updated

February 15, 2026

Vancomycin 2026 Availability, Prices, and Tips to Find

What Is Vancomycin?

Vancomycin is a glycopeptide antibiotic used to treat serious bacterial infections caused by gram-positive organisms, particularly methicillin-resistant Staphylococcus aureus (MRSA). It is considered a last-line antibiotic for many life-threatening infections.

The oral form is primarily used to treat Clostridioides difficile (C. diff) infections, staphylococcal enterocolitis, and pseudomembranous colitis. The IV form is used for systemic infections including endocarditis, septicemia, bone infections, skin and soft tissue infections, and lower respiratory tract infections caused by susceptible organisms.

Vancomycin is available as the brand names Vancocin (capsules) and Firvanq (oral solution), as well as multiple generic formulations from manufacturers like Pfizer/Hospira, Fresenius Kabi, Hikma, Xellia, and Baxter.

How Does Vancomycin Work?

Vancomycin works by inhibiting bacterial cell wall synthesis. It binds to the D-alanyl-D-alanine terminus of peptidoglycan precursors in the bacterial cell wall, which prevents the polymerization and cross-linking steps needed to build a strong cell wall. Without a functional cell wall, the bacteria become structurally weak and ultimately die.

This mechanism makes Vancomycin effective only against gram-positive bacteria. Importantly, oral Vancomycin is poorly absorbed (less than 10% bioavailability), which is why the oral form works locally in the gut for C. diff infections but cannot treat systemic infections. The IV form must be used for bloodstream, bone, heart valve, and other systemic infections.

What Doses Are Available for Vancomycin?

  • Oral Capsules: 125 mg, 250 mg
  • Oral Solution (Firvanq): 25 mg/mL, 50 mg/mL
  • IV Powder for Injection: 500 mg, 1 g, 1.25 g, 1.5 g, 5 g, 10 g vials
  • Premixed IV Solution: 5 mg/mL, 10 mg/mL

How Hard Is It to Find Vancomycin in Stock?

Vancomycin currently has a findability score of 40 out of 100, meaning it can be difficult to locate — especially the IV (injection) form. The FDA and ASHP have listed Vancomycin injection as being in active shortage since 2023, with supply constraints continuing into 2025–2026 across multiple manufacturers including Fresenius Kabi, Pfizer/Hospira, and Hikma.

Oral Vancomycin capsules and Firvanq oral solution are generally easier to find, though some pharmacies may experience intermittent stock issues. If you're struggling to find Vancomycin in stock, Medfinder can help you locate a pharmacy near you that has it available.

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Who Can Prescribe Vancomycin?

Vancomycin is most commonly prescribed by:

  • Infectious Disease Specialists — for complex MRSA and resistant bacterial infections
  • Hospitalists / Internal Medicine — for inpatient management of serious infections
  • Emergency Medicine Physicians — for acute, life-threatening infections
  • Gastroenterologists — for C. difficile treatment (oral form)
  • Surgeons — for surgical prophylaxis and post-operative infections
  • Critical Care / Pulmonologists — for ICU patients with severe infections
  • Orthopedic Surgeons — for prosthetic joint infections
  • Nephrologists — managing infections in dialysis patients

Vancomycin is not typically prescribed via telehealth, as IV administration requires in-person clinical settings, and oral Vancomycin for C. diff usually requires confirmed lab diagnosis.

Is Vancomycin a Controlled Substance?

No, Vancomycin is not a controlled substance and has no DEA schedule. It is a prescription antibiotic that requires a valid prescription from a licensed healthcare provider but does not carry the additional restrictions associated with controlled substances.

Common Side Effects of Vancomycin

  • Nausea and vomiting
  • Abdominal pain
  • Diarrhea
  • Headache
  • Back pain
  • Red Man Syndrome — flushing and rash on the upper body, typically caused by rapid IV infusion (managed by slowing the infusion rate)
  • Phlebitis (irritation at the IV site)
  • Fever

Serious side effects that require immediate medical attention include:

  • Nephrotoxicity (kidney damage) — especially with concurrent nephrotoxic drugs
  • Ototoxicity (hearing loss or tinnitus)
  • Severe allergic reactions including anaphylaxis
  • Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis
  • Thrombocytopenia or neutropenia

Alternative Medications to Vancomycin

If Vancomycin is unavailable or not appropriate, your doctor may consider these alternatives:

  • Linezolid (Zyvox) — An oxazolidinone antibiotic effective against MRSA, available in both oral and IV forms. Often used when Vancomycin cannot be tolerated or for MRSA pneumonia.
  • Daptomycin (Cubicin) — A cyclic lipopeptide antibiotic for complicated skin infections and MRSA bacteremia. IV only and cannot be used for pneumonia.
  • Fidaxomicin (Dificid) — A macrocyclic antibiotic specifically for C. difficile infections. Preferred over oral Vancomycin for recurrent C. diff due to lower recurrence rates.
  • Telavancin (Vibativ) — A lipoglycopeptide antibiotic related to Vancomycin, used for complicated skin infections and hospital-acquired MRSA pneumonia. IV only.

Drug Interactions with Vancomycin

Vancomycin has several important drug interactions, particularly with other medications that affect the kidneys or hearing:

  • Aminoglycosides (Gentamicin, Tobramycin) — Significantly increased risk of nephrotoxicity and ototoxicity
  • Piperacillin-Tazobactam (Zosyn) — Increased risk of acute kidney injury when combined with Vancomycin
  • Amphotericin B — Additive nephrotoxicity
  • Cisplatin — Increased nephrotoxicity and ototoxicity
  • Colistin / Polymyxin B — Additive nephrotoxicity
  • Loop Diuretics (Furosemide) — Increased ototoxicity risk
  • NSAIDs — May increase nephrotoxicity risk
  • Cyclosporine, Tacrolimus, Voclosporin — Increased nephrotoxicity
  • Warfarin — Potential for increased anticoagulant effect; monitor INR closely

No significant food interactions. Oral Vancomycin can be taken with or without food.

Final Thoughts on Vancomycin

Vancomycin remains one of the most critical antibiotics in modern medicine, especially for treating MRSA and C. difficile infections. However, the ongoing shortage of the IV formulation — persisting since 2023 — has made it challenging for hospitals and patients to secure consistent supply.

If you or a loved one needs Vancomycin and your pharmacy is out of stock, Medfinder can help you search for nearby pharmacies that currently have it available. For the oral form, generic capsules with discount coupons can bring costs down to as low as $39 for a full course. Always work with your prescribing physician to explore alternatives if Vancomycin is temporarily unavailable.

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