Oritavancin
Pronunciation: Pronunciation not provided in research notes.
- Generic name
- oritavancin
- Brand names
- ORBACTIV
- Drug class
- Lipoglycopeptide antibiotic
- Form
- Lyophilized powder for reconstitution; single-dose vials
- Route
- Intravenous infusion
- Legal status
- Prescription-only medicine
Availability and supply rules vary by country
Trade names by country: United States
Australia: · Full directory
What oritavancin is and how it works
Oritavancin is an intravenous lipoglycopeptide antibiotic indicated for the treatment of adult patients with acute bacterial skin and skin structure infections (ABSSSI) caused by susceptible Gram-positive microorganisms, including MRSA. (1)
It is administered as a single 1,200 mg IV infusion over 3 hours by a healthcare professional in a clinical setting; it is not a take-home medicine. Only adults 18 years and older with ABSSSI due to susceptible organisms are eligible; pediatric safety and effectiveness have not been established.
Mechanism of action: how oritavancin works
Oritavancin is a lipoglycopeptide antibacterial agent active against Gram-positive bacteria. (1)
What oritavancin is used for
Acute bacterial skin and skin structure infections (ABSSSI)
For adult patients with ABSSSI caused by susceptible isolates of Gram-positive microorganisms, including Staphylococcus aureus (methicillin-susceptible and methicillin-resistant isolates), Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus dysgalactiae, Streptococcus anginosus group, and Enterococcus faecalis (vancomycin-susceptible isolates only). (1)
Before taking oritavancin
Do not take / not appropriate for
- Tell every clinician involved in your care that you received ORBACTIV. Intravenous unfractionated heparin is contraindicated for 120 hours (5 days) after ORBACTIV administration because it artificially prolongs aPTT; clinicians must account for this when making anticoagulation decisions. (all patients) (1)
- If you have a known hypersensitivity to oritavancin products, tell the prescribing clinician before treatment; they must assess this contraindication. (all patients) (1)
Tell your clinician about
- If you are taking warfarin (because of bleeding risk)
- If you have had a previous hypersensitivity reaction to any medication
- If you have a history of osteomyelitis or bone infection
- If you have diarrhea during or after treatment
- If you are pregnant, planning pregnancy, or breastfeeding
- If you have severe renal or hepatic impairment (not studied)
How to take oritavancin
- Oritavancin is administered as a single 1,200 mg intravenous infusion over 3 hours by a healthcare professional in a clinical setting. The dose is prepared from three 400 mg vials reconstituted and diluted in 5% dextrose injection.
- You will be monitored during and after the infusion for infusion-related reactions and hypersensitivity.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1)
Missed dose
Oritavancin is administered as a single intravenous dose by a healthcare professional; there is no patient-directed missed-dose scenario.
Overdose
No specific overdose-management protocol or antidote was identified in the sources reviewed for this page; management would be expected to be supportive. If a medication error or overdose is a concern, this should be directed to a clinician or emergency service according to the clinical situation. (1)
Side effects
The most common adverse reactions (≥3%) include headache, nausea, vomiting, limb and subcutaneous abscesses, and diarrhea. Serious reactions such as hypersensitivity and infusion-related reactions can occur.
Headache
What to notice: Pain or discomfort in the head or neck region.
What to do: Inform the healthcare team; they can provide supportive treatment if needed. (1)
Nausea and vomiting
What to notice: Feeling sick to the stomach or vomiting.
What to do: Tell the healthcare professional monitoring you. (1)
Diarrhea
What to notice: Loose or watery stools, possibly with abdominal cramps.
What to do: Notify the healthcare provider, especially if diarrhea persists or is severe. (1)
Limb and subcutaneous abscesses
What to notice: Pain, swelling, redness, or pus (specific location not established in the sources reviewed for this page).
What to do: Alert the healthcare professional immediately if you notice such symptoms. (1)
Serious warnings
Hypersensitivity reactions including anaphylaxis — emergency
Action: Seek emergency medical attention immediately; call emergency services or alert healthcare staff right away. (1)
Infusion-related reactions — warning
Action: Alert healthcare staff if you feel unwell during or after the infusion; they will assess and manage as needed. (1)
Clostridioides difficile-associated diarrhea — warning
Symptoms: Diarrhea occurring during or after treatment.
Action: Inform your healthcare provider promptly for evaluation and management. (1)
Osteomyelitis — warning
Action: Report new or worsening bone symptoms to your clinician for further assessment. (1)
Warfarin interaction (increased bleeding risk) — warning
Symptoms: Signs of bleeding (specific examples not established in the sources reviewed for this page).
Action: Inform your healthcare provider immediately; they may need to adjust warfarin therapy and monitor closely. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Intravenous unfractionated heparin | Contraindicated for 5 days after oritavancin due to artificially prolonged aPTT, which may affect monitoring. | Tell any clinician involved in your care that you received ORBACTIV, so they can factor in the 120-hour intravenous unfractionated heparin contraindication when making anticoagulation decisions. (1) |
| Warfarin | Concomitant use may increase bleeding risk; monitor for bleeding. | Inform your prescriber; they may monitor more closely or adjust warfarin. (1) |
| Coagulation laboratory tests (aPTT, PT, INR) | Oritavancin artificially prolongs aPTT for up to 120 hours, and PT/INR for up to 12 hours, potentially leading to misinterpretation. | Tell your clinicians and the laboratory that you received ORBACTIV, so they can account for this interference; the choice of monitoring method or anticoagulant is a clinician decision. (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Children (under 18 years)
Safety and effectiveness have not been established in patients under 18 years of age. (1)
Older adults (geriatric)
Insufficient data to determine if elderly respond differently; no dose adjustment based on age alone. (1)
Pregnancy
No adequate human data on use in pregnancy; animal studies at doses equivalent to about 25% of the clinical dose showed no evidence of fetal harm. Discuss the potential benefits and risks with a healthcare provider. (1)
Breastfeeding
Animal data show presence in milk; balance benefits and risks with a healthcare provider. (1)
Renal impairment
No dose adjustment for mild to moderate renal impairment; severe renal impairment has not been studied. (1)
Hepatic impairment
No dose adjustment for mild to moderate impairment; severe hepatic insufficiency not studied. (1)
Monitoring
Before starting
- Check for contraindications: known hypersensitivity to oritavancin, and any planned or recent intravenous unfractionated heparin use.
- Ask about current warfarin use.
During treatment
- Observe for infusion-related reactions during the 3-hour infusion.
- Monitor for signs of hypersensitivity (e.g., anaphylaxis) and treat promptly.
- Monitor for development of diarrhea (C. difficile) during or after treatment.
- Intravenous unfractionated heparin is contraindicated for 120 hours after ORBACTIV; interpret coagulation tests carefully, noting a Factor Xa (chromogenic) assay or an alternative anticoagulant may be considered by the clinician if aPTT monitoring is needed in that window.
- Monitor for signs of osteomyelitis.
- If on warfarin, monitor for bleeding.
Storage
Storage and handling information was not reviewed in this research pass. Refer to the current local product label.
Study the drug class: Glycopeptides
Professional information
Clinician-facing context only. Use the current local prescribing information for detailed dosing, preparation, and monitoring.
United States
Indication: ABSSSI
Dose summary: A single 1,200 mg dose administered by intravenous infusion over 3 hours, prepared from three 400 mg vials (Orbactiv).
Renal context: No dosage adjustment needed for mild to moderate renal impairment; severe renal impairment not studied. Use clinical judgment. (1)
Hepatic guidance
No dose adjustment for mild to moderate hepatic impairment; severe insufficiency not studied.
Overdose note
No specific overdose management protocol was identified; treat with supportive care. In case of medication error, monitor for adverse effects and consult a specialist. (1)
Frequently asked questions
Can oritavancin be used in children?
No, safety and effectiveness have not been established in patients under 18 years of age. (1)
Do I need more than one dose?
The ORBACTIV label describes a single 1,200 mg intravenous dose for ABSSSI. If you have questions about your infection or whether further treatment is needed, ask your prescriber or treating clinician. (1)
What should I avoid after receiving oritavancin?
Intravenous unfractionated heparin is contraindicated for 120 hours (5 days) after ORBACTIV. Inform any healthcare professionals involved in your care, anticoagulation, or coagulation testing that you received ORBACTIV, and tell them if you take warfarin, so they can factor this into their decisions. Coagulation tests may be temporarily unreliable during this window. (1)
What if I have diarrhea after treatment?
Diarrhea could be a sign of C. difficile infection; contact your healthcare provider promptly. (1)
What is the mechanism of action of oritavancin?
Oritavancin is a lipoglycopeptide antibacterial agent active against Gram-positive bacteria. (1)
What is the generic name of Oritavancin?
The generic name is oritavancin. It is sold under brand names including ORBACTIV. (1)
What class of drug is oritavancin?
Oritavancin is classed as: Lipoglycopeptide antibiotic. (1)
References
- ORBACTIV (oritavancin) for injection, for intravenous use — prescribing informationU.S. Food and Drug Administration (DailyMed) · United States · accessed 2026-08-05 · source 1
- KIMYRSA (ORITAVANCIN DIPHOSPHATE) INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION [MELINTA THERAPEUTICS, LLC] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 2
- Oritavancin Injection — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 3
- Kimyrsa — FDA approval record (Drugs@FDA NDA214155)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 4
- oritavancin — RxNorm normalized drug concept (RXCUI 1547611)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 5
Brand names by country
Single-ingredient oritavancin names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Kimyrsa1200 mg/40mL · melinta therapeutics, llc
- Orbactiv400 mg · melinta therapeutics, llc