text: Pharmacology Teicoplanin exhibits a very long biological half-life of about 45-70h (sufficient plasma levels can thus be sustained with once-daily administration). Elimination is almost exclusively renal. It is mostly excreted unchanged.
  Adverse effects
  Adverse effects of teicoplanin are usually limited to local effects or hypersensitivity reactions. While there is potenial for nephrotoxicity and ototoxicity, incidence of such organ toxicity is rare if recommended serum concentrations are successfully maintained.
  Considerations
  Reduced renal function slows teicoplanin clearance, consequently increasing its elimination half-life. Elimination half-life is longer in the elderly due to the reduced renal function in this population.
  Chemistry
  Teicoplanin (TARGOCID, marketed by Sanofi Aventis Ltd) is actually a mixture of several compounds, five major (named teicoplanin A2-1 through A2-5) and four minor (named teicoplanin RS-1 through RS-4).
  All teicoplanins share a same glycopeptide core, termed teicoplanin A3-1 — a fused ring structure to which two carbohydrates (mannose and N-acetylglucosamine) are attached. The major and minor components also contain a third carbohydrate moiety — β-D-glucosamine — and differ only by the length and conformation of a side-chain attached to it. Teicoplanin A2-4 and RS-3 have chiral side chains while all other side chains are achiral. Teicoplanin A3 lacks both the side chains as well as the β-D-glucosamine moiety.
  The structures of the teicoplanin core and the side-chains that characterize the five major as well as four minor teicoplanin compounds are shown below.