Vancomycin trough
Drug LevelsNormal range
10–20 µg/mL (target depends on indication; AUC dosing where used)
Critical high: > 25 µg/mL (typical flag)
☎ When to call
Trough above target or rising creatinine on vanco — call pharmacy/provider before giving the next dose, not after.
What you do
- Draw the trough within 30 min BEFORE the next dose — a mistimed trough is a wasted stick
- High trough: hold and clarify before infusing; watch creatinine
- Infuse over ≥ 60 min — rapid infusion causes vancomycin flushing reaction
Causes of HIGH vancomycin trough
Causes of LOW vancomycin trough
Source: Pagana, Mosby's Manual of Diagnostic and Laboratory Tests, 7th ed.; ASHP/IDSA vancomycin guidelinesReference only — verify against your facility's policy.
