# Vanco: Better take it 4x or 2x a day? **URL:** \ **Category:** Life with Primary Sclerosing Cholangitis\ **Created:** [December 8, 2021, 8:23pm UTC](https://forum.livingwithpsc.org/t/vanco-better-take-it-4x-or-2x-a-day/4840 "2021-12-08T20:23:04Z")\ **Posts on this page:** 8\ **Page:** 1
**Author:** ![31diga05](https://avatars.discourse-cdn.com/v4/letter/3/67e7ee/32.png) [@31diga05](https://forum.livingwithpsc.org/u/31diga05)\ **Post date:** [December 8, 2021, 8:23pm UTC](https://forum.livingwithpsc.org/t/vanco-better-take-it-4x-or-2x-a-day/4840/1 "2021-12-08T20:23:04Z")
Hello, I’m Dieter from Italy. As usually vanco for treatment of PSC is nearly unknown in Italy, I’m very glad that my hepatologist is very committed to the patients and open to new medications. With the advice of another specialist I started with 1000 mg/die for a month, then to be reduced to 500 mg/die. Whereas with the higher dose all LFTs were significantly reduced, the reduction to the half let increase the values again. (By the way: UDCA, bezafibrato, prednisone and prednisolone show no or no clear effect.) Now I continue again with 1000 mg/die and after a month we will see the result. My question is: Can anyone tell me (and explain why) whether it is more effective to take vanco four times a day 250 mg, or is it better only 2 times 500 mg? Thanks for your answers! ---
**Author:** ![Andreas](https://sea1.discourse-cdn.com/flex019/user_avatar/forum.livingwithpsc.org/andreas/32/1538_2.png) [@Andreas](https://forum.livingwithpsc.org/u/Andreas)\ **Post date:** [December 9, 2021, 6:28pm UTC](https://forum.livingwithpsc.org/t/vanco-better-take-it-4x-or-2x-a-day/4840/2 "2021-12-09T18:28:39Z")
Hi Dieter! Glad to hear that vanco helped you! 😃 Honestly, no one really knows the answer to this. Usually, vanco is taken 3-4 times a day when taken orally and 2 times a day when taken through iv. I’ve been taking vanco for 3+ years and I take my vanco 3 times a day, but I’m not super strict on exact timings. ---
**Author:** ![jace0221](https://avatars.discourse-cdn.com/v4/letter/j/c68b51/32.png) [@jace0221](https://forum.livingwithpsc.org/u/jace0221)\ **Post date:** [December 10, 2021, 3:02am UTC](https://forum.livingwithpsc.org/t/vanco-better-take-it-4x-or-2x-a-day/4840/3 "2021-12-10T03:02:29Z")
I think 1000 mg is a little low. My son takes 1500 mg/day (500 mgx3). He’s been taking it since 2017. ---
**Author:** ![rjm](https://sea1.discourse-cdn.com/flex019/user_avatar/forum.livingwithpsc.org/rjm/32/808_2.png) [@rjm](https://forum.livingwithpsc.org/u/rjm)\ **Post date:** [December 11, 2021, 6:24pm UTC](https://forum.livingwithpsc.org/t/vanco-better-take-it-4x-or-2x-a-day/4840/4 "2021-12-11T18:24:37Z")
I believe the theory was - since it is an antibiotic - that you needed to spread out the dosing evenly through the day to maintain a constant level. BUT on carefully listening (and relistening) to this posting by Cactusgirl, [Hypothesis on Vancomycin 'brand' differences for PSC effectiveness - #15 by Cactusgirl](https://forum.livingwithpsc.org/t/hypothesis-on-vancomycin-brand-differences-for-psc-effectiveness/4748/15) , I notice the Doctors there talk about a simpler twice a day dosing of Vancomycin for PSC. I think I’m interpreting it correctly that this is how they are prescribing for some patients. I’ve actually been kind of curious about this myself because switching to 2 times a day (2 \* 250 mg for me) would de-complicate life a bit. And so I’ve been doing so without confirmation on the basis of the Doc’s discussion in that video. Anyone out there, correct me if they think otherwise - maybe Cactusgirl can weigh in on if the 2 times a day vanco dosing is actually in practice. ---
**Author:** ![Cactusgirl](https://sea1.discourse-cdn.com/flex019/user_avatar/forum.livingwithpsc.org/cactusgirl/32/237_2.png) [@Cactusgirl](https://forum.livingwithpsc.org/u/Cactusgirl)\ **Post date:** [December 11, 2021, 8:10pm UTC](https://forum.livingwithpsc.org/t/vanco-better-take-it-4x-or-2x-a-day/4840/5 "2021-12-11T20:10:44Z")
My daughter has been dosing her OV twice a day for 6 years. You should try the less frequent dosing and check your liver chemistries monthly for 2 months. If no changes then you should be good to go. ---
**Author:** ![Cactusgirl](https://sea1.discourse-cdn.com/flex019/user_avatar/forum.livingwithpsc.org/cactusgirl/32/237_2.png) [@Cactusgirl](https://forum.livingwithpsc.org/u/Cactusgirl)\ **Post date:** [December 11, 2021, 8:12pm UTC](https://forum.livingwithpsc.org/t/vanco-better-take-it-4x-or-2x-a-day/4840/6 "2021-12-11T20:12:10Z")
We are optimistic that there will be clinical trial for OV in Italy soon!! ---
**Author:** ![SusanG](https://sea1.discourse-cdn.com/flex019/user_avatar/forum.livingwithpsc.org/susang/32/1407_2.png) [@SusanG](https://forum.livingwithpsc.org/u/SusanG)\ **Post date:** [December 13, 2021, 5:53pm UTC](https://forum.livingwithpsc.org/t/vanco-better-take-it-4x-or-2x-a-day/4840/7 "2021-12-13T17:53:16Z")
I’ve been dosing with ANI or FirVanQ three times a day for four years. On days when I forget the afternoon dose, I don’t double up the before bed dose and just take less that day. ---
**Author:** ![SusanG](https://sea1.discourse-cdn.com/flex019/user_avatar/forum.livingwithpsc.org/susang/32/1407_2.png) [@SusanG](https://forum.livingwithpsc.org/u/SusanG)\ **Post date:** [December 13, 2021, 5:54pm UTC](https://forum.livingwithpsc.org/t/vanco-better-take-it-4x-or-2x-a-day/4840/8 "2021-12-13T17:54:33Z")
RJM, Thanks for posting this link, going to listen now…