November 30, 2015
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Dalvance Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

Dalvance (dalbavancin) for injection is a lipoglycopeptide used to treat adult patients with acute bacterial skin and skin structure infections (ABSSSI) caused by susceptible isolates of the following Gram-positive microorganisms: Staphylococcus aureus (including methicillin susceptible and methicillin-resistant strains), Streptococcus pyogenes, Streptococcus agalactiae and Streptococcus anginosus group (including S. anginosus, S. intermedius, S. constellatus). Common side effects include nausea, headache, and diarrhea.

For treatment of adults with ABSSSI, the recommended two-dose regimen of Dalvance is 1000 mg followed one week later by 500 mg. Each dose should be administered over 30 minutes by intravenous infusion. Dalvance may interact with cytochrome P450 (CYP450) substrates, inhibitors, or inducers. Tell your doctor all medications and supplements you use. During pregnancy, Dalvance should be used only if prescribed. It is unknown if this drug passes into breast milk. Consult your doctor before breastfeeding.

Our Dalvance (dalbavancin) for injection Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is Prescribing information?

The FDA package insert formatted in easy-to-find categories for health professionals and clinicians.

Dalvance FDA Prescribing Information: Side Effects
(Adverse Reactions)


Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in clinical trials of DALVANCE cannot be directly compared to rates in the clinical trials of another drug and may not reflect rates observed in practice.

Adverse Reactions In Clinical Trials

Adverse reactions were evaluated for 1778 patients treated with DALVANCE and 1224 patients treated with comparator antibacterial drugs in seven Phase 2 and Phase 3 clinical trials. A causal relationship between study drug and adverse reactions was not always established. The median age of patients treated with DALVANCE was 47 years, ranging between 16 and 93 years old. Patients treated with DALVANCE were predominantly male (60%) and Caucasian (78%).

Serious Adverse Reactions and Adverse Reactions Leading to Discontinuation

Serious adverse reactions occurred in 109/1778 (6.1%) of patients treated with DALVANCE and in 80/1224 (6.5%) of patients treated with comparator. DALVANCE was discontinued due to an adverse reaction in 53/1778 (3%) patients and the comparator was discontinued due to an adverse reaction in 35/1224 (2.8%) patients.

Most Common Adverse Reactions

The most common adverse reactions in patients treated with DALVANCE were nausea (5.5%), headache (4.7%), and diarrhea (4.4%). The median duration of adverse reactions was 4.0 days in both treatment groups.

Table 1 lists selected adverse reactions occurring in more than 2% of patients treated with DALVANCE in clinical trials.

Table 1: Selected Adverse Reactions in Phase 2/3 Trials (Number (%) of Patients)

(N = 1778)
(N = 1224)
Nausea 98 (5.5) 78 (6.4)
Vomiting 50 (2.8) 37 (3)
Diarrhea 79 (4.4) 72 (5.9)
Headache 83 (4.7) 59 (4.8)
Rash 48 (2.7) 30 (2.4)
Pruritus 38 (2.1) 41 (3.3)
* Comparators included linezolid, cefazolin, cephalexin, and vancomycin.

The following selected adverse reactions were reported in DALVANCE treated patients at a rate of less than 2% in these clinical trials:

Blood and lymphatic system disorders: anemia, hemorrhagic anemia, leucopenia, neutropenia, thrombocytopenia, petechiae, eosinophilia, thrombocytosis

Gastrointestinal Disorders: gastrointestinal hemorrhage, melena, hematochezia, abdominal pain General Disorders and administration site conditions: infusion-related reactions

Hepatobiliary disorders: hepatotoxicity

Immune system disorders: anaphylactoid reaction

Infections and infestations: Clostridium difficile colitis, oral candidiasis, vulvovaginal mycotic infection

Investigations: hepatic transaminases increased, blood alkaline phosphatase increased, international normalized ratio increased.

Metabolism and nutrition disorders: hypoglycemia

Nervous System disorders: dizziness

Respiratory, thoracic and mediastinal disorders: bronchospasm

Skin and Subcutaneous Tissue Disorders: urticaria

Vascular disorders: flushing, phlebitis, wound hemorrhage, spontaneous hematoma

Alanine Aminotransferase (ALT) Elevations

Among patients with normal baseline ALT levels, more DALVANCE than comparator treated patients had post-baseline ALT elevations greater than 3 times the upper limit of normal (ULN), 12 (0.8%) vs. 2 (0.2%), respectively including three subjects with post-baseline ALT values greater than 10 times ULN. Eight of 12 patients treated with DALVANCE and one comparator patient had underlying conditions which could affect liver enzymes, including chronic viral hepatitis and a history of alcohol abuse. In addition, one DALVANCE-treated subject in a Phase 1 trial had post-baseline ALT elevations greater than 20 times ULN. ALT elevations were reversible in all subjects. No comparator-treated subject with normal baseline transaminases had post-baseline ALT elevation greater than 10 times ULN.

Read the entire FDA prescribing information for Dalvance (Dalbavancin for Injection)

Report Problems to the Food and Drug Administration


You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

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