Does vancomycin come in 250 mg? Clarifying the Dosage for Oral and IV Use

October 12, 2025 •

3 min read

Over 50% of antibiotics worldwide are used in livestock, yet human medical uses remain critically important for fighting severe infections. One such medication is vancomycin, and a common question patients have is, "Does vancomycin come in 250 mg?" The answer is yes, but it is important to understand that this strength is specific to the oral capsule form used to treat certain intestinal infections, and not for widespread systemic infections.

Quick Summary

Oral vancomycin is available in 250 mg capsules for treating intestinal infections like C. difficile. This oral form has poor systemic absorption and is distinct from the intravenous form used for serious systemic infections.

Key Points

Oral Vancomycin Comes in 250 mg: Vancomycin is manufactured as oral capsules in 125 mg and 250 mg strengths, often sold under the brand name Vancocin.
Oral vs. Intravenous Use: Oral vancomycin is exclusively for treating intestinal infections, whereas the intravenous (IV) form is necessary for systemic infections.
Poor Systemic Absorption: The oral formulation is not effective for infections outside the gut because it is poorly absorbed into the bloodstream.
Oral Solution Recall: In March 2024, some lots of vancomycin oral solution (not capsules) were recalled due to potential over-potency.
Always Requires a Prescription: Vancomycin in all its forms and strengths is a powerful antibiotic that requires a doctor's prescription.
Dosage Varies by Infection: The appropriate dose of vancomycin depends on the type, location, and severity of the infection, and is determined by a healthcare provider.

Oral Vancomycin: The 250 mg Capsule

Yes, vancomycin is commercially available as a 250 mg oral capsule. These capsules are specifically formulated for use within the gastrointestinal tract and are not meant for systemic infections. The oral administration of vancomycin is particularly effective for conditions affecting the gut because the drug is poorly absorbed into the bloodstream. This allows it to act locally in the intestines to combat the bacteria causing the infection.

Oral vancomycin is primarily indicated for two specific conditions:

Clostridioides difficile (C. diff)-associated diarrhea: A condition characterized by severe diarrhea and colitis that can occur after prolonged antibiotic use.
Staphylococcal enterocolitis: An inflammation of the small intestine caused by Staphylococcus aureus.

The 250 mg capsule is one of the available oral strengths. A healthcare provider determines the appropriate dosage based on the specific infection and patient's condition.

Oral vs. Intravenous Vancomycin: A Critical Distinction

A crucial aspect of vancomycin pharmacology is the significant difference between its oral and intravenous (IV) forms. While the oral capsule targets infections within the intestines, the IV formulation is necessary for any infection outside the gastrointestinal tract.

Why Oral Is Not Absorbed Systemically

The poor systemic absorption of oral vancomycin is a defining feature of its use. Because the drug's molecules are large and cannot easily pass through the intestinal wall into the bloodstream, they remain concentrated in the gut where they are needed. This is a key reason why oral vancomycin is completely ineffective for treating infections in other areas of the body, such as pneumonia, bloodstream infections, or meningitis.

Vancomycin Formulations and Strengths

Vancomycin comes in a variety of strengths and forms to accommodate different treatment needs. The correct formulation and dosage depend on the infection's location and severity.

Oral Capsules: The primary oral formulation, available in 125 mg and 250 mg strengths under brands like Vancocin.
Oral Solution: Available as a powder for oral solution that is reconstituted by a pharmacist to concentrations such as 25 mg/mL or 50 mg/mL.
Intravenous (IV) Injection: Available in vials as a sterile powder for reconstitution, in strengths like 500 mg, 750 mg, 1 g, and higher.

Important Safety and Recall Information

Patients and healthcare providers should be aware of recent safety information regarding vancomycin formulations. In March 2024, Amneal Pharmaceuticals issued a voluntary nationwide recall of certain lots of their vancomycin hydrochloride for oral solution, 250 mg/5 mL. The recall was prompted by the discovery that some bottles were potentially super-potent, meaning they could contain a higher dose than labeled, which may be harmful to patients. Patients should always check with their pharmacist to ensure they are using a safe and approved product.

Comparison Table: Oral vs. Intravenous Vancomycin


Feature	Oral Vancomycin (e.g., 250 mg capsule)	Intravenous (IV) Vancomycin
Primary Use	Intestinal infections (C. difficile, staphylococcal enterocolitis)	Systemic infections (MRSA, endocarditis, sepsis, etc.)
Systemic Absorption	Poorly absorbed into the bloodstream; acts locally in the gut	Well-absorbed systemically to reach target organs
Available Strengths	125 mg and 250 mg capsules, plus oral solutions	Vials of sterile powder (e.g., 500 mg, 1 g) for reconstitution
Treatment Focus	Eradicating bacteria within the intestines	Treating infections throughout the body
Absorption Monitoring	Not typically required due to minimal systemic absorption	Serum trough monitoring is standard practice
Administration	By mouth	By slow infusion into a vein

Conclusion

In conclusion, the answer to the question "Does vancomycin come in 250 mg?" is a qualified yes. The 250 mg strength is an oral capsule used exclusively for treating specific intestinal infections. This is critically different from the vancomycin formulation used for systemic infections, which must be administered intravenously. Proper understanding of vancomycin's different forms and routes of administration is essential for safe and effective treatment. Patients should always follow their doctor's prescription and consult a healthcare professional for any questions regarding their medication.

For authoritative and up-to-date information on drug labeling, visit the official FDA website.

Frequently Asked Questions

No, oral vancomycin is only effective for treating intestinal infections like C. difficile and staphylococcal enterocolitis. Its poor systemic absorption means it cannot treat infections in other parts of the body.

Vancocin is a common brand name for vancomycin capsules, which are available in both 125 mg and 250 mg strengths.

While oral vancomycin is used for C. difficile, a healthcare provider will determine the correct dose based on the specific case.

Vancomycin for oral use is typically available as capsules, not tablets. A healthcare provider or pharmacist can confirm the specific formulation you have.

In March 2024, Amneal Pharmaceuticals recalled certain lots of vancomycin oral solution (250 mg/5 mL) because some bottles might have been overfilled, leading to a potentially harmful higher dose.

Oral vancomycin is not effective against systemic infections like MRSA. Such infections require the intravenous form of vancomycin, as the oral version is not absorbed into the bloodstream.

Yes, vancomycin is a powerful antibiotic and a prescription-only medication in all its forms and strengths. It cannot be purchased over-the-counter.

Oral vancomycin has a large molecular size that prevents it from passing through the intestinal walls into the bloodstream. This characteristic is precisely what makes it effective for targeting infections within the gut.