Vancomycin Hydrochloride for Injection

Vancomycin

• Brand(s): Vancocin and other generics (Note that only specific DINs are reimbursed by the EAP)
• Dosage Form/Strength: 125 mg capsules, 250 mg capsules (on case-by-case basis only)

Effective September 30, 2019, Vancomycin oral tablets for the treatment of Uncomplicated Clostridium difficile infection may be accessed upon meeting Limited Use Criteria on the Ontario Drug Benefit Formulary.

Vancomycin Injection to be used as an oral solution for Clostridium difficile Infection may be accessed through the Telephone Request Service.

Case-by-case consideration for requests not meeting the Limited Use criteria (e.g., higher doses, longer durations, tapering regimens exceeding the dosing limits under LU, complicated C. difficile Infections) may be considered through external review. Please submit requests to EAP providing adequate and relevant clinical details to support the request.

EAP Drug Request Form:

Standard Form for EAP Drug Requests