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Important Note

The following information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. Consult your healthcare professional before using this drug.





This medication is a combination antibiotic used to treat serious bacterial infections that have not responded to treatment with other antibiotics.

How To Use

Give this medication by vein (IV) over 1 hour in a dextrose solution (5% Dextrose in Water). Usually, this drug is used for at least 7 days; or use as directed by your doctor. Because this product does not contain preservatives, it must be prepared in a laminar air flow hood as close as possible to each dose. Do not prepare this drug and save for later use. Follow all instructions for proper mixing and dilution with the correct IV fluids. Ask your pharmacist if you have questions regarding the use of this medication. Before using, check this product visually for particles or discoloration. If any of these are present, do not use the drug. If more that one drug is to be given through the same IV line, the IV line should be flushed before and after use with a dextrose solution (5% Dextrose in Water). Do not give other IV drugs together with this medication without flushing the IV line. Antibiotics work best when the amount of the medicine in your body is kept at a constant level. Therefore, use this drug at the same time each day. Continue to use this drug until all has been used even if symptoms disappear after a few days. Stopping the medication too early may allow bacteria to continue to grow, which may result in a relapse of the infection. Inform your doctor if your condition does not improve in 7 to 10 days. Learn how to store and discard needles and medical supplies safely. Consult your pharmacist.

Side Effects

Nausea, vomiting, diarrhea, rash, swelling and pain at the injection site, itching, and headache may occur. If any of these effects persist or worsen, notify your doctor. Tell your doctor immediately if any of these serious side effects occur: joint pain, muscle pain, stomach pain, chest pain, change in heart rhythm, severe diarrhea (pseudomembranous colitis), blood in the urine. If you notice other effects not listed above, contact your doctor or pharmacist.


Tell your doctor your medical history, including: allergies (especially to other streptogramin antibiotics such as pristinamycin, virginiamycin), kidney disease, liver problems (e.g., hyperbilirubinemia), blood clots, diabetes. Tell your doctor if you have had diarrhea and stomach pain while taking other antibiotics. This may be a symptom of a different infection (pseudomembranous colitis) that requires another medication. Tell your doctor if you are pregnant before using this product. It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

Drug Interactions

Tell your doctor of all prescription and nonprescription medication you may use, especially of: cyclosporine, tacrolimus, anti-HIV medications (e.g., delavirdine, indinavir, nevirapine, ritonavir), certain anti-cancer drugs (e.g., docetaxel, paclitaxel, vinca alkaloids), calcium channel blockers (e.g., diltiazem, nifedipine, verapamil), certain cholesterol-lowering drugs (e.g., lovastatin, simvastatin), astemizole, terfenadine, midazolam, diazepam, cisapride, carbamazepine, quinidine, lidocaine, disopyramide, digoxin, corticosteroids (e.g., methylprednisolone). Do not mix this product or flush the IV line with saline (e.g., salt solutions) or heparin products. Check with your pharmacist about the mixing of this product with other medications. Do not start or stop any medicine without doctor or pharmacist approval.


If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include trouble breathing, vomiting, tremors, and loss of coordination.


Do not share this medication with others. This medication has been prescribed for your current condition only. Do not use it later for another infection unless told to do so by your doctor. A different medication may be necessary in those cases. Laboratory and/or medical tests will be performed to monitor your progress.

Missed Dose

If you miss a dose, contact your doctor or pharmacist to establish a new dosing schedule.


Before mixing, store the drug in the refrigerator at 36 to 46 degrees F (2 to 8 degrees C). The mixed solution should not be frozen. After mixing the medication in the correct IV solution (dextrose 5% in water), the product is stable at room temperature (below 86 degrees F or 30 degrees C) for 5 hours or stored in the refrigerator (36 to 46 degrees F or 2 to 8 degrees C) for 2 days.