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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Dalbavancin Hydrochloride
Generic Name
Dalbavancin Hydrochloride
Active Ingredient
DalbavancinCategory
Other
Salt Form
Hydrochloride
Variants
1
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 500 mg/25mL | INJECTION, POWDER, FOR SOLUTION | INTRAVENOUS | 65219-120 |
Detailed information about Dalbavancin Hydrochloride
References used for this content
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Dalbavancin Hydrochloride, you must consult a qualified healthcare professional.
Dalbavancin is a long-acting lipoglycopeptide antibiotic used to treat acute bacterial skin and skin structure infections (ABSSSI) caused by specific Gram-positive bacteria, including MRSA.
For the treatment of Acute Bacterial Skin and Skin Structure Infections (ABSSSI) in adults, the standard recommended dosage of Dalbavancin can be administered in one of two ways, as determined by the prescribing physician:
Clinical trials, such as the DISCOVER trials published in the New England Journal of Medicine (2014), demonstrated that the single-dose regimen is non-inferior to the two-dose regimen, offering greater convenience for many patients.
Dalbavancin is approved for use in pediatric patients from birth to less than 18 years of age. The dosage is based on the child's age and weight:
Healthcare providers must calculate these doses precisely based on the child's actual body weight at the time of treatment.
In patients with chronic renal impairment whose creatinine clearance (CrCl) is less than 30 mL/min and who are not receiving regularly scheduled hemodialysis, the dose must be reduced.
No dosage adjustment is required for patients receiving regularly scheduled hemodialysis.
No dosage adjustment is recommended for patients with mild hepatic impairment (Child-Pugh Class A). Caution should be exercised in patients with moderate to severe hepatic impairment (Child-Pugh Class B or C), as there is limited data available, and the drug's clearance may be altered.
Clinical studies have shown that the pharmacokinetics of Dalbavancin are not significantly altered by age alone. Therefore, no dosage adjustment is required for geriatric patients unless they have significant renal impairment (CrCl < 30 mL/min).
Dalbavancin is not a medication you take at home by yourself. It is administered by a healthcare professional in a hospital, clinic, or infusion center.
Because Dalbavancin is often given as a single dose or just two doses a week apart, missing a dose is uncommon but serious. If you miss your second dose in the two-dose regimen, contact your healthcare provider immediately to reschedule. The effectiveness of the treatment depends on maintaining therapeutic levels in your tissues.
There is no specific antidote for Dalbavancin overdose. Because the drug is not significantly removed by hemodialysis, treatment of an overdose would involve supportive care and monitoring by medical professionals. Symptoms of overdose are likely to be an exaggeration of the drug's side effects, such as severe nausea or skin rashes.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose or skip appointments without medical guidance.
In clinical trials, Dalbavancin was generally well-tolerated. The most frequently reported side effects, occurring in more than 10% of some study populations (though often less in others), include:
These side effects may occur in 1% to 10% of patients:
> Warning: Stop taking Dalbavancin and call your doctor immediately if you experience any of the following:
Because Dalbavancin is typically administered as a short-course (1-2 doses), long-term side effects are rare. However, the drug stays in the system for several weeks.
No FDA black box warnings currently exist for Dalbavancin. However, the FDA does mandate warnings regarding hypersensitivity and the risk of C. difficile infection, which are standard for high-potency antibiotics.
Report any unusual symptoms to your healthcare provider, even if they occur weeks after your infusion, due to the long-lasting nature of this medication.
Dalbavancin is a potent antibiotic that should only be used to treat infections proven or strongly suspected to be caused by susceptible bacteria. Using it for viral infections (like the common cold) will not work and increases the risk of antibiotic resistance. Patients must disclose their full medical history, especially any history of kidney disease, liver disease, or previous allergic reactions to glycopeptide antibiotics like vancomycin (Vancocin), oritavancin (Orbactiv), or telavancin (Vibativ).
There are no FDA black box warnings for Dalbavancin as of 2026. This indicates that the drug does not carry the highest level of safety warning typically reserved for medications with a high risk of permanent disability or death when used as directed.
If you are receiving Dalbavancin, your healthcare provider may order the following tests:
Dalbavancin may cause dizziness in some patients. You should wait to see how the medication affects you before driving a car or operating heavy machinery. If you feel lightheaded or dizzy after your infusion, avoid these activities and consult your doctor.
There is no direct chemical interaction between Dalbavancin and alcohol. However, alcohol can dehydrate the body and strain the liver, which may complicate the recovery from a serious skin infection. It is generally advised to avoid alcohol while your body is fighting a systemic infection.
Because Dalbavancin is long-acting, it cannot be "stopped" once it has been injected; the drug will remain in your tissues for several weeks. There is no withdrawal syndrome associated with Dalbavancin. However, failing to receive the second dose (in a two-dose regimen) can lead to the infection returning or the bacteria becoming resistant to the drug.
> Important: Discuss all your medical conditions with your healthcare provider before starting Dalbavancin.
There are currently no drugs that are strictly contraindicated (never to be used) with Dalbavancin based on direct chemical interactions. However, Dalbavancin should not be mixed in the same IV line with other medications. It is specifically incompatible with saline-based solutions. If the same IV line is used for sequential infusion of different drugs, the line must be flushed with 5% Dextrose Injection (D5W) before and after Dalbavancin administration.
Since Dalbavancin is administered intravenously, its absorption is not affected by food. There are no known interactions with grapefruit juice, dairy, or high-fat meals. However, staying well-hydrated with water is recommended to help the kidneys process the medication.
There is limited data on the interaction between Dalbavancin and herbal supplements. However, supplements that can affect liver function (such as Kava or high doses of Green Tea Extract) or kidney function should be discussed with a doctor. St. John's Wort is not expected to interact because Dalbavancin does not use the CYP3A4 pathway.
Dalbavancin can interfere with certain laboratory tests:
For each major interaction, the mechanism usually involves shared pathways of elimination (kidneys) or physical incompatibility in the IV fluid. The clinical consequence is usually an increased risk of side effects rather than a loss of drug efficacy.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking.
Dalbavancin must NEVER be used in the following circumstances:
Conditions requiring a careful risk-benefit analysis by a physician include:
Cross-sensitivity refers to the risk that if you are allergic to one drug, you will be allergic to another in the same family. Patients allergic to other glycopeptides, such as:
...should inform their doctor, as they may experience a similar reaction to Dalbavancin. The chemical structure of these drugs involves a large cyclic peptide, which the immune system may recognize across different specific medications.
> Important: Your healthcare provider will evaluate your complete medical history before prescribing Dalbavancin.
Dalbavancin is classified by the FDA as a drug that should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. There are no adequate and well-controlled studies in pregnant women. Animal reproduction studies in rats and rabbits did not show evidence of teratogenicity (birth defects) at doses up to 1.2 to 3 times the human dose. However, delayed fetal maturation was observed in rats.
It is not known whether Dalbavancin is excreted in human milk. However, the drug is present in the milk of lactating rats. Because many drugs are excreted in human milk and because of the potential for adverse effects on the nursing infant (such as alterations in gut flora or allergic sensitization), a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Dalbavancin is approved for pediatric patients from birth to 18 years old for the treatment of ABSSSI. Clinical trials have shown that the safety and effectiveness in children are similar to those in adults.
In clinical trials, approximately 15% of patients were 65 years of age or older. No overall differences in safety or effectiveness were observed between these patients and younger patients. However, because elderly patients are more likely to have decreased renal function, and Dalbavancin is partially cleared by the kidneys, dose adjustments based on creatinine clearance are more common in this population. There is no increased fall risk specifically associated with Dalbavancin, though dizziness is a possible side effect.
Renal impairment significantly affects how Dalbavancin is cleared from the body.
> Important: Special populations require individualized medical assessment.
Dalbavancin is a bactericidal lipoglycopeptide. Its molecular mechanism involves the inhibition of cell wall biosynthesis. It binds with high affinity to the D-alanyl-D-alanine terminus of the peptidoglycan precursors in the bacterial cell wall. This binding prevents the cross-linking (transpeptidation) and elongation (transglycosylation) of the peptidoglycan layer. Without a functional cell wall, the bacterial cell cannot withstand osmotic pressure and undergoes lysis. The addition of a lipophilic side chain (a decylaminoethyl group) allows the molecule to anchor into the bacterial cytoplasmic membrane, which significantly increases its potency against Gram-positive organisms compared to vancomycin.
The antibacterial activity of Dalbavancin is concentration-dependent. The primary predictor of its efficacy is the ratio of the area under the curve (AUC) to the minimum inhibitory concentration (MIC) of the pathogen (AUC/MIC). It exhibits a prolonged post-antibiotic effect (PAE), meaning it continues to suppress bacterial growth even after the concentration drops below the MIC.
| Parameter | Value |
|---|---|
| Bioavailability | 100% (Intravenous) |
| Protein Binding | 93% (Primarily to Albumin) |
| Half-life | ~14.7 days (346 hours) |
| Tmax | End of 30-minute infusion |
| Metabolism | Not mediated by CYP450 |
| Excretion | Renal 42%, Fecal 20% |
Dalbavancin is classified as a Lipoglycopeptide Antibiotic. It is closely related to other glycopeptides like Vancomycin and Teicoplanin, and other lipoglycopeptides like Oritavancin and Telavancin. Within the therapeutic area of anti-infectives, it is considered a "narrow-spectrum" antibiotic because it is only active against Gram-positive bacteria.
Common questions about Dalbavancin Hydrochloride
Dalbavancin is a powerful intravenous antibiotic used to treat serious skin and skin structure infections caused by Gram-positive bacteria. It is specifically approved for conditions like cellulitis, major abscesses, and infected wounds, including those caused by MRSA (Methicillin-resistant Staphylococcus aureus). Unlike many other antibiotics that require daily doses for weeks, Dalbavancin is unique because it stays in the body for a long time. This allows a full course of treatment to be completed in just one or two doses. It is typically administered in a hospital or clinic setting by a healthcare professional.
The most common side effects reported by patients receiving Dalbavancin include nausea, headache, and diarrhea. Some patients may also experience vomiting, rash, or itching at the site of the intravenous infusion. These symptoms are generally mild and tend to go away on their own as the body processes the medication. However, because the drug remains in your system for several weeks, side effects can theoretically persist or appear later. If you experience severe symptoms like persistent watery diarrhea or a high fever, you should contact your doctor immediately.
There is no known direct chemical interaction between Dalbavancin and alcohol that would cause a dangerous reaction. However, doctors generally recommend avoiding alcohol while you are being treated for a serious bacterial infection. Alcohol can weaken the immune system, cause dehydration, and place extra stress on the liver, all of which can slow down your recovery process. Since Dalbavancin is processed partly by the liver, it is best to let your body focus on healing. Always check with your healthcare provider for specific advice regarding your lifestyle during treatment.
The safety of Dalbavancin during pregnancy has not been fully established in human studies. Animal studies have shown that high doses might cause some delays in fetal development, but it did not cause major birth defects. Because of the lack of human data, Dalbavancin is only used during pregnancy if the potential benefit to the mother clearly outweighs the potential risk to the unborn baby. If you are pregnant or planning to become pregnant, you must discuss the risks and benefits with your doctor. They may consider alternative antibiotics with more established safety profiles in pregnancy.
Dalbavancin begins working almost immediately after the intravenous infusion starts, as the drug enters the bloodstream and travels to the site of the skin infection. In clinical trials, many patients showed signs of improvement, such as a reduction in the size of the skin lesion and a decrease in fever, within 48 to 72 hours. Because of its very long half-life, the drug continues to kill bacteria for up to two weeks after a single dose. Even if you feel better quickly, the medication will continue working in the background to ensure the infection is fully eradicated. You should follow up with your doctor as scheduled to monitor your progress.
Since Dalbavancin is administered as a single or two-dose intravenous infusion by a healthcare professional, you cannot 'stop' taking it in the traditional sense once it has been injected. The medication is designed to remain in your body's tissues for several weeks to provide a continuous cure. If you are on the two-dose regimen, it is critical that you do not skip the second dose, even if your skin infection looks better. Skipping the second dose could allow the infection to return or lead to the development of antibiotic-resistant bacteria. Always complete the treatment plan as prescribed by your medical team.
If you are receiving the two-dose regimen of Dalbavancin and you miss your appointment for the second dose (usually given 8 days after the first), you must call your healthcare provider immediately. The effectiveness of the treatment depends on having the correct amount of medicine in your system over a two-week period. Your doctor will need to reschedule the infusion as soon as possible to prevent the bacteria from growing back. Since this drug is not self-administered, your clinic will help you manage your schedule. Missing the first dose simply means your treatment has not yet begun.
There is no clinical evidence to suggest that Dalbavancin causes weight gain. In the clinical trials used for its FDA approval, weight changes were not reported as a common or significant side effect. Because Dalbavancin is typically given as a one-time or two-time dose, it does not have the long-term metabolic effects associated with some other classes of medications. If you notice sudden weight gain or swelling (edema) while being treated for an infection, you should report this to your doctor. Such symptoms could be related to your body's response to the infection or other underlying health conditions rather than the antibiotic itself.
Dalbavancin does not interact with the cytochrome P450 enzyme system, which is the pathway many other drugs use, so it has fewer drug-drug interactions than many other antibiotics. However, it should be used cautiously with other medications that can affect the kidneys, such as certain pain relievers (NSAIDs) or other IV antibiotics. It is also important to note that Dalbavancin cannot be mixed in the same IV bag or line with other medications, especially those containing saline. Always provide your doctor with a complete list of all prescriptions, over-the-counter drugs, and supplements you are taking to ensure safety.
As of 2026, Dalbavancin is primarily available as the brand-name drug Dalvance. While the initial patents for new drugs eventually expire, allowing for generic versions to be produced, you should check with your pharmacist for the most current availability of a generic equivalent. Generic drugs must meet the same strict FDA standards for safety and effectiveness as the brand-name version. Because Dalbavancin is a complex biological-style molecule, the production of generics (or biosimilars) can be more difficult than for simple tablets. Your insurance provider can also tell you which version of the medication is covered under your plan.
Other drugs with the same active ingredient (Dalbavancin)