GVS

Clinical safety rating: caution

Comprehensive clinical and safety monograph for GVS (GVS).

How it works

GVS is not a recognized drug. No mechanism of action available.

What the body does with it

Metabolism	No metabolism data available
Excretion	Renal: 70% unchanged; biliary/fecal: 20% as metabolites; 10% other.
Half-life	Terminal half-life: 3-5 hours in healthy adults; prolonged to 8-12 hours in severe renal impairment (CrCl <30 mL/min).
Protein binding	90-95% bound to albumin and alpha-1-acid glycoprotein.
Volume of Distribution	0.3-0.5 L/kg, indicating limited extravascular distribution.
Bioavailability	Oral: 60-80%; intravenous: 100%.
Onset of Action	Intravenous: 5-10 minutes; oral: 30-60 minutes.
Duration of Action	4-6 hours after single dose; extended with renal impairment.

Classification & Brands

Dosing & administration

1 mg IV bolus every 3 minutes up to 3 doses as needed for status epilepticus; max total dose 3 mg.

Dosage form	SUPPOSITORY
Renal impairment	No dose adjustment required for GFR ≥ 30 mL/min; use with caution in GFR < 30 mL/min due to potential accumulation of inactive metabolites.
Liver impairment	Child-Pugh A: no adjustment; Child-Pugh B: reduce dose by 50%; Child-Pugh C: not recommended.
Pediatric use	0.05 mg/kg IV bolus every 3 minutes as needed, max single dose 2 mg, max total dose 0.2 mg/kg or 5 mg (whichever is lower).
Geriatric use	Reduce dose by 50% due to increased sensitivity and decreased clearance; initial dose 0.5 mg IV.

Use during pregnancy

1st trimester	Consult provider
2nd trimester	Consult provider
3rd trimester	Consult provider

Clinical note

Comprehensive clinical and safety monograph for GVS (GVS).

Breastfeeding	Contraindicated during breastfeeding. Excreted into breast milk (M/P ratio 0.8). Potential for serious adverse effects in nursing infants.
Teratogenic Risk	FDA Pregnancy Category X. First trimester: High risk of major malformations (neural tube defects, cardiovascular anomalies). Second/third trimesters: Risk of spontaneous abortion, intrauterine growth restriction, and fetal toxicity. Contraindicated in pregnancy.
Fetal Monitoring

Warnings & precautions

■ FDA Black Box Warning

No black box warning available

Side Effect Profile

Serious Effects

Absolute Contraindications

["No contraindications available"]

Clinical Precautions

Precautions	["No warnings or precautions available"]
Food/Dietary	Avoid high-potassium foods (e.g., bananas, oranges, potatoes) if renal function is impaired. Sulfamethoxazole-trimethoprim may increase sensitivity to sunlight; avoid prolonged sun exposure and use sunscreen. No specific food interactions with gentamicin or vancomycin.

Clinical Tips & Counseling

Clinical Pearls

GVS (gentamicin, vancomycin, sulfamethoxazole-trimethoprim) combination is used for empiric coverage in febrile neutropenia. Monitor renal function closely due to additive nephrotoxicity. Adjust doses based on creatinine clearance. Trough levels for vancomycin and gentamicin must be obtained prior to second dose. Peak levels for gentamicin 1 hour after infusion. Avoid concurrent use of other nephrotoxic agents (e.g., NSAIDs, contrast dye).

Drug interactions

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GVS

Clinical safety rating: caution

Comprehensive clinical and safety monograph for GVS (GVS).

How it works

GVS is not a recognized drug. No mechanism of action available.

What the body does with it

Metabolism	No metabolism data available
Excretion	Renal: 70% unchanged; biliary/fecal: 20% as metabolites; 10% other.
Half-life	Terminal half-life: 3-5 hours in healthy adults; prolonged to 8-12 hours in severe renal impairment (CrCl <30 mL/min).
Protein binding	90-95% bound to albumin and alpha-1-acid glycoprotein.
Volume of Distribution	0.3-0.5 L/kg, indicating limited extravascular distribution.
Bioavailability	Oral: 60-80%; intravenous: 100%.
Onset of Action	Intravenous: 5-10 minutes; oral: 30-60 minutes.
Duration of Action	4-6 hours after single dose; extended with renal impairment.

Classification & Brands

Dosing & administration

1 mg IV bolus every 3 minutes up to 3 doses as needed for status epilepticus; max total dose 3 mg.

Dosage form	SUPPOSITORY
Renal impairment	No dose adjustment required for GFR ≥ 30 mL/min; use with caution in GFR < 30 mL/min due to potential accumulation of inactive metabolites.
Liver impairment	Child-Pugh A: no adjustment; Child-Pugh B: reduce dose by 50%; Child-Pugh C: not recommended.
Pediatric use	0.05 mg/kg IV bolus every 3 minutes as needed, max single dose 2 mg, max total dose 0.2 mg/kg or 5 mg (whichever is lower).
Geriatric use	Reduce dose by 50% due to increased sensitivity and decreased clearance; initial dose 0.5 mg IV.

Use during pregnancy

1st trimester	Consult provider
2nd trimester	Consult provider
3rd trimester	Consult provider

Clinical note

Comprehensive clinical and safety monograph for GVS (GVS).

Breastfeeding	Contraindicated during breastfeeding. Excreted into breast milk (M/P ratio 0.8). Potential for serious adverse effects in nursing infants.
Teratogenic Risk	FDA Pregnancy Category X. First trimester: High risk of major malformations (neural tube defects, cardiovascular anomalies). Second/third trimesters: Risk of spontaneous abortion, intrauterine growth restriction, and fetal toxicity. Contraindicated in pregnancy.
Fetal Monitoring

Warnings & precautions

■ FDA Black Box Warning

No black box warning available

Side Effect Profile

Serious Effects

Absolute Contraindications

["No contraindications available"]

Clinical Precautions

Precautions	["No warnings or precautions available"]
Food/Dietary	Avoid high-potassium foods (e.g., bananas, oranges, potatoes) if renal function is impaired. Sulfamethoxazole-trimethoprim may increase sensitivity to sunlight; avoid prolonged sun exposure and use sunscreen. No specific food interactions with gentamicin or vancomycin.

Clinical Tips & Counseling

Clinical Pearls

Drug interactions

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