Pregnancy: Category C. Adverse events have not been observed in animal reproduction studies. Vancomycin crosses the placenta and can be detected in fetal serum amniotic fluid, and cord blood.
Adverse fetal effects, including sensorineural hearing loss or nephrotoxicity, have not been reported following maternal use during the second or third trimesters of pregnancy. The pharmacokinetics of vancomycin may be altered during pregnancy and pregnant patients may be need a higher dose of vancomycin. Maternal half-life is unchanged, but the volume of distribution and the total plasma clearance may be increased.
Lactation: Vancomycin is excreted in human milk following IV administration. Vancomycin is recommended for the treatment of mild, moderate, or severe Clostridium difficile infections in breast-feeding women. Due to the potential for serious adverse reactions in the breast-feeding infant, the manufacturer recommends a decision be made whether to discontinue breast-feeding or to discontinue the drug, taking into account the importance of treatment to the mother.