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Understanding Orbactiv: Dosing, Side Effects, Costs, and Clinical Benefits

Staphylococcus aureus, an MRSA bacteria

Some gram-positive bacteria have become resistant to currently available antibiotics. If you are fighting against such bacteria, drugs like Orbactiv can be a lifesaver for you. In this article, we will explore everything you need to know about Orbactiv, including its dosing, side effects, cost, and more.

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What Is Orbactiv?

Orbactiv (oritavancin) is an antibiotic drug. The FDA approved this drug on August 6, 2014, for treating acute bacterial skin and skin structure infections (ABSSSI) in adults [1]. This drug is especially useful in treating infections caused by some specific bacteria resistant to conventional antibiotics. 

Doctors can only use Orbactiv to treat infections caused by specific gram-positive microorganisms. Otherwise, this drug can create antibiotic-resistant bacteria. This medication is given via intravenous infusion, which takes about 3 hours. You only have to take a single dose for it to work.

What Is Orbactiv Used To Treat?

Orbactiv (oritavancin) is a branded prescription antibiotic. It treats adults with acute bacterial skin and skin structure infections caused by specific microorganisms. ABSSSI are serious bacterial infections that affect your skin and the tissues under your skin. These infections can be life-threatening. Symptoms of these infections include pain, redness, fever, chills, fatigue, and pus-filled bumps or sores.

Doctors can only use Orbactiv to treat or prevent infections proven or strongly suspected to be caused by certain gram-positive microorganisms. These microorganisms include [2]:

  • Staphylococcus aureus (including methicillin-susceptible and methicillin-resistant isolates)
  • Streptococcus anginosus group (includes S. anginosus, S. intermedius, and S. constellatus)
  • Streptococcus agalactiae
  • Streptococcus pyogenes
  • Enterococcus faecalis (vancomycin-susceptible isolates only)
  • Streptococcus dysgalactiae

Orbactiv carries the possibility of creating drug-resistant microorganisms. So, you should only take this medication to treat or prevent infections caused by the bacteria mentioned above to lower the risk of developing drug-resistant bacteria and maintain the efficacy of Orbactiv and other medicines.

How Does Orbactiv Work?

Orbactiv is a branded antibiotic that contains the active ingredient oritavancin. It kills bacteria in three ways [2]. First, it blocks the bacteria from creating its own protective outer wall. Second, it can prevent the parts of the bacteria’s cell walls from linking together. Third, it damages the bacteria’s outer membrane, causing it to leak. Together, these three actions make it very effective in killing bacteria. 

Side Effects

Woman with headache as a side effect of taking Orbactiv

Orbactiv can cause side effects ranging from mild to severe. You should immediately consult your doctor if you encounter any severe side effects. Let’s talk about some common and severe side effects [3]:

Common Side Effects

Common side effects include:

  • Headache
  • Nausea
  • Vomiting
  • Diarrhea
  • Skin and soft tissue infection

Severe Side Effects

The severe side effects include the following:

Hypersensitivity Reactions: Orbactiv can cause severe allergic reactions, including anaphylaxis, which can be life-threatening. Signs of an allergic reaction include hives, difficulty breathing, and swelling of the face, lips, or tongue. If you are allergic to glycopeptides, you should be careful when using this medication. Immediately stop using this medication if you experience any allergic reaction while taking it.

Clostridioides difficile Associated Disease (CDAD): This is a severe type of diarrhea that can even be fatal. Contact your doctor right away if you encounter diarrhea after taking Orbactiv.

Infusion-Related Reactions: You may experience some side effects during the infusion. Tell your doctor right away if you feel chills, dizziness, light-headedness, chest pain, or back pain. Stopping or slowing the injection can help reduce the symptoms.

Development of Drug-Resistant Bacteria: Orbactiv is only effective in treating infections caused by certain bacteria. So, you should only use it when the presence of certain specific bacteria is proven or highly suspected. Otherwise, it can create drug-resistant bacteria.

Please note that this is not a list of all possible side effects. Consult your doctor if you encounter any other side effects after receiving Orbactiv.

Dosing

This drug can only be used in adult patients. Your doctor will give you Orbactiv via intravenous infusion. It will take about 3 hours for your infusion to complete. The recommended dosage is 1,200 mg as a single-dose intravenous infusion [2]. But remember that your doctor may modify your dose based on your situation. So, always follow your doctor’s recommendation.

Cost

Orbactiv is available as a powder for injection, with a strength of 400 mg per vial. Each vial costs around $1,225 [4]. For a single dose, you need 3 vials. So, the total cost of treatment is around $3,675. However, the actual cost depends on your insurance coverage, location, treatment plan, and the pharmacy you visit. Be sure to contact us if you are interested in receiving financial assistance.

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FAQs

Here are some frequently asked questions about Orbactiv:

1. Does Orbactiv cause hair loss?

No. It does not cause hair loss. In clinical trials, patients didn’t mention hair loss (alopecia) as a side effect [2]. However, if you experience any hair loss after taking Orbactiv, consult your doctor.

2. Can I use this medication if I have liver or kidney problems?

You can safely use Orbactiv if you have mild to moderate liver or kidney problems. There is no need to adjust your dosage in these cases. However, there is no clinical safety data on severe liver or kidney disease patients [2]. So, you should consult your doctor for more information.

3. Is It safe during pregnancy or breastfeeding?

There is still no data on the safety of Orbactiv usage during pregnancy or breastfeeding [2]. You should only use it during pregnancy or breastfeeding if your doctor thinks that the benefits outweigh the potential risks. 

4. Is Orbactiv effective against all types of bacteria?

No. It is only effective against some specific gram-positive bacteria, including resistant strains like MRSA. So, be sure to only use it according to your doctor’s recommendation. 

5. Does Orbactiv interact with other medications?

Yes. Orbactiv can interact with some medicines, including blood thinner drugs like heparin or warfarin. If you are already taking heparin or warfarin, then Orbactiv may increase your risk of bleeding. So, you should inform your doctor about all the medicines you take, including over-the-counter drugs, before getting this treatment.

6. What are the clinical benefits?

According to the clinical trial data, the majority of patients treated with Orbactiv were able to stop the spread of their skin infection and recover from their fever in two to three days [2]. In another study, researchers found that Orbactiv cured 68 patients out of 75 who suffered from gram-positive infections [5].

REFERENCES:

  1. Drug Approval package: Brand Name (Generic Name) NDA #. (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/nda/2014/206334Orig1s000TOC.cfm
  2. HIGHLIGHTS OF PRESCRIBING INFORMATION. (2022). https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/206334s007lbl.pdf
  3. Melinta Therapeutics, Inc. (n.d.). Orbactiv® (oritavancin) for injection | Melinta Therapeutics, Inc. https://www.orbactiv.com/
  4. Orbactiv Prices, Coupons, Copay Cards & Patient Assistance. (n.d.). Drugs.com. https://www.drugs.com/price-guide/orbactiv
  5. Brownell, L. E., Adamsick, M. L., McCreary, E. K., Vanderloo, J. P., Ernst, E. J., Jackson, E. R., & Schulz, L. T. (2020). Clinical Outcomes and Economic Impact of Oritavancin for Gram-Positive Infections: A Single academic Medical Center health System experience. Drugs – Real World Outcomes, 7(S1), 13–19. https://doi.org/10.1007/s40801-020-00192-w
This information is not a substitute for medical advice or treatment. Talk to your doctor or healthcare provider about your medical condition prior to starting any new treatment. AmeriPharma® Specialty Care assumes no liability whatsoever for the information provided or for any diagnosis or treatment made as a result, nor is it responsible for the reliability of the content. AmeriPharma® Specialty Care does not operate all the websites/organizations listed here, nor is it responsible for the availability or reliability of their content. These listings do not imply or constitute an endorsement, sponsorship, or recommendation by AmeriPharma® Specialty Care. This webpage may contain references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with AmeriPharma® Specialty Care.
Dr. Mark Alfonso
MEDICALLY REVIEWED BY Dr. Mark Alfonso, PharmD, BCMTMS

Dr. Mark Alfonso, PharmD was born and raised in Pueblo, CO. He received his pharmacy degree from the University of Colorado School of Pharmacy at the Anschutz Medical Campus in 2010. He was board certified in medication therapy management in 2022. The most rewarding part of his job is helping to answer patient questions and concerns. His areas of expertise are community pharmacy and medication therapy management. In his free time, he enjoys reading and running.

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