Eravacycline Injection
Eravacycline is an intravenous antibiotic used to treat complicated intra-abdominal infections in adults.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 1 clinical label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
Xerava (eravacycline) is an IV antibiotic in the tetracycline family, on the U.S. market since about 2018, that treats complicated infections inside the belly in adults by blocking bacteria from making the proteins they need; it is kept for proven or strongly suspected infections, often drug-resistant ones, to protect its effectiveness. Most people tolerate it reasonably well, with nausea, vomiting, or a sore, red IV site the usual complaints. The key risks are serious allergic reactions and C. difficile diarrhea, a dangerous gut infection that can start weeks after the last dose, so report hives, trouble breathing, or persistent watery or bloody diarrhea right away.
Clinical pearls
- Tell your care team about any past reaction to doxycycline, minocycline or another tetracycline, since that allergy rules Xerava out.
- If you take warfarin or another blood thinner, expect closer clotting checks, because Xerava can strengthen its effect.
- Rifampin and similar drugs that speed up liver breakdown can lower Xerava levels, so make sure the hospital team knows.
- Avoid breastfeeding during treatment and for 4 days after the last dose.
Patient information guide A plain-language walkthrough of Eravacycline Injection, written from its FDA label.
What Eravacycline Injection is used for
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Eravacycline injection is an intravenous antibiotic approved for the following use:
- Xerava (intravenous): Treatment of complicated intra-abdominal infections (cIAI) — serious bacterial infections inside the abdomen — in adults 18 years and older, caused by susceptible bacteria including E. coli, Klebsiella pneumoniae, Enterococcus faecalis, Enterococcus faecium, Staphylococcus aureus, Streptococcus anginosus group, Bacteroides species, and several others
- Xerava is not approved for complicated urinary tract infections (cUTI)
- Xerava should only be used when a bacterial infection is proven or strongly suspected, to help prevent antibiotic resistance
How Eravacycline Injection works
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Eravacycline is a fluorocycline antibiotic — a newer member of the tetracycline family. It kills or stops the growth of bacteria by binding to the 30S ribosomal subunit, a small structure inside bacterial cells that acts like a protein-building machine. By latching onto this structure, eravacycline blocks bacteria from assembling the proteins they need to survive, grow, and multiply.
Eravacycline generally stops bacterial growth (bacteriostatic) rather than directly killing bacteria outright for gram-positive organisms like Staphylococcus aureus. It is active against a wide range of bacteria, including some that have developed resistance to other antibiotics.
Eravacycline Injection dosage
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Xerava is given only by intravenous (IV) infusion — directly into a vein — in a hospital or clinical setting. Each infusion runs over about 60 minutes and is given every 12 hours. A full course of treatment typically lasts 4 to 14 days, guided by how severe the infection is and how the patient responds.
- Patients with severe liver disease may receive a modified dosing schedule starting on Day 2
- If you are also taking a strong CYP3A inducer (like rifampin), your doctor may increase the dose to keep drug levels effective
- No dose adjustment is needed for kidney disease
Dosing details from the FDA-approved label
From the Eravacycline Injection prescribing information (“Dosage and Administration”). Doses are set by your prescriber for your product, condition, kidney function and age — never change a dose on your own.
- Adults with complicated intra-abdominal infections (cIAI) - recommended adult dosage
- 1 mg/kg by intravenous infusion over approximately 60 minutes every 12 hours for a total duration of 4 to 14 days
- Duration of therapy should be guided by the severity and location of infection and the patient's clinical response
- Severe hepatic impairment (Child Pugh C)
- 1 mg/kg every 12 hours on Day 1, then 1 mg/kg every 24 hours starting on Day 2 for a total duration of 4 to 14 days
- No dosage adjustment is warranted in mild to moderate hepatic impairment (Child Pugh A and B)
- Concomitant use of a strong CYP3A inducer
- 1.5 mg/kg every 12 hours for a total duration of 4 to 14 days
- No dosage adjustment is warranted with concomitant use of a weak or moderate CYP3A inducer
Read the label’s full dosing text
2 DOSAGE AND ADMINISTRATION Administer XERAVA for injection 1 mg/kg by intravenous infusion over approximately 60 minutes every 12 hours for a total duration of 4 to 14 days. ( 2.1 ) Severe Hepatic Impairment (Child Pugh C): 1 mg/kg XERAVA every 12 hours on Day 1, then 1 mg/kg every 24 hours starting on Day 2 for a total duration of 4 to 14 days. ( 2.2 ) Concomitant Use of a Strong Cytochrome P450 (CYP) Isoenzyme 3A Inducer: 1.5 mg/kg XERAVA every 12 hours for a total duration of 4 to 14 days. ( 2.3 ) See full prescribing information for the preparation of XERAVA. ( 2.4 ) 2.1 Recommended Adult Dosage The recommended dose regimen of XERAVA is 1 mg/kg every 12 hours. Administer intravenous infusions of XERAVA over approximately 60 minutes every 12 hours. The recommended duration of treatment with XERAVA for cIAI is 4 to 14 days. The duration of therapy should be guided by the severity and location of infection and the patient's clinical response. 2.2 Dosage Modifications in Patients with Hepatic Impairment In patients with severe hepatic impairment (Child Pugh C), administer XERAVA 1 mg/kg every 12 hours on Day 1 followed by XERAVA 1 mg/kg every 24 hours starting on Day 2 for a total duration of 4 to 14 days. No dosage adjustment is warranted in patients with mild to moderate hepatic impairment (Child Pugh A and Child Pugh B) [see Use in Specific Populations ( 8.6 ) and Clinical Pharmacology ( 12.3 )]. 2.3 Dosage Modifications in Patients with Concomitant Use of a Strong Cytochrome P450 (CYP) Isoenzyme 3A Inducer With concomitant use of a strong CYP3A inducer, administer XERAVA 1.5 mg/kg every 12 hours for a total duration of 4 to 14 days. No dosage adjustment is warranted in patients with concomitant use of a weak or moderate CYP3A inducer [see Drug Interactions ( 7.1 ) and Clinical Pharmacology ( 12.3 )]. 2.4 Preparation and Administration XERAVA is for intravenous infusion only. Each vial is for a single dose only. Preparation XERAVA is supplied as a sterile yellow to orange dry powder in a single-dose vial that must be reconstituted and further diluted prior to intravenous infusion as outlined below. XERAVA does not contain preservatives. Aseptic technique must be used for reconstitution and dilution as follows: Calculate the dose of XERAVA based on the patient weight (1 mg/kg actual body weight).
Excerpted — the section continues on the label. Read the full Dosage and Administration section on DailyMed →
Eravacycline Injection side effects
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The most common side effects reported with Xerava include:
Common side effects
- Infusion site reactions (pain, redness, swelling, or phlebitis at the IV site)
- Nausea
- Vomiting
- Diarrhea
- Low blood pressure (hypotension)
- Dizziness
- Rash
- Altered taste (dysgeusia)
- Wound dehiscence (a surgical wound reopening)
- Rash or excessive sweating
When to get medical help
- Signs of a severe allergic reaction — hives, swelling of the face or throat, difficulty breathing, or feeling faint
- Persistent or severe diarrhea (which may be watery or bloody) — this could be C. difficile-associated diarrhea, a serious gut infection
- Signs of liver problems — unusual fatigue, yellowing of skin or eyes, dark urine
- Signs of abnormal pancreas function — severe stomach pain, especially with nausea or vomiting
- New or worsening shortness of breath or chest pain
- If you are pregnant, any new concerns — this drug can affect fetal bone and tooth development
More serious reactions — including life-threatening allergic reactions, severe C. difficile diarrhea, or signs of liver or pancreas problems — require immediate medical attention. Tell your care team right away if anything feels off.
Eravacycline Injection warnings and precautions
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- Serious allergic reactions: Life-threatening anaphylaxis has been reported with Xerava and other tetracyclines. Do not use Xerava if you are allergic to tetracycline antibiotics. Seek emergency help immediately for hives, throat swelling, or trouble breathing.
- C. difficile-associated diarrhea (CDAD): Antibiotics can disturb the normal gut bacteria and allow C. difficile to overgrow, causing anything from mild diarrhea to a severe, life-threatening colon infection. This can occur even weeks after finishing treatment. Persistent or bloody diarrhea should be reported promptly.
- Tooth staining and bone effects in children and fetuses: Tetracyclines — including eravacycline — can permanently yellow-gray-brown stain developing teeth and slow bone growth when used during the second or third trimester of pregnancy or in children under 8.
- Tetracycline class reactions: Reactions seen with other tetracyclines — such as increased pressure inside the skull (pseudotumor cerebri), skin sensitivity to sunlight (photosensitivity), pancreatitis, and abnormal liver tests — may also occur with Xerava.
- Overgrowth of resistant organisms: Like all antibiotics, Xerava can allow non-susceptible bacteria or fungi to grow. Inform your care team if you develop new or worsening signs of infection.
Eravacycline Injection interactions
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Eravacycline has a few important drug interactions to be aware of:
- Rifampin and other strong CYP3A inducers — these drugs speed up the breakdown of eravacycline in the body, reducing its blood levels and potentially making it less effective. Your doctor may increase the Xerava dose if you are taking one of these medications.
- Blood thinners (anticoagulants, such as warfarin) — tetracyclines can reduce the activity of clotting proteins in the blood, which may make anticoagulants work stronger. Your anticoagulant dose may need to be lowered while you're on Xerava.
- Strong CYP3A inhibitors (such as itraconazole) — these can modestly increase eravacycline exposure, though no dose adjustment is currently specified in the label for this interaction.
Interactions listed in the FDA-approved label
From the Eravacycline Injection prescribing information (“Drug Interactions”): what the manufacturer studied or reported to the FDA.
- Strong CYP3A inducers: Concomitant use decreases the exposure of eravacycline, which may reduce the efficacy of XERAVA. Increase XERAVA dose in patients with concomitant use of a strong CYP3A inducer (1.5 mg/kg every 12 hours).
- Anticoagulant drugs: Because tetracyclines have been shown to depress plasma prothrombin activity, patients on anticoagulant therapy may require downward adjustment of their anticoagulant dosage. Downward adjustment of anticoagulant dosage may be required.
Read the label’s full interactions text
7 DRUG INTERACTIONS Strong CYP 3A Inducers: Co-administration decreases the exposure of eravacycline; increase XERAVA dose with concomitant use. ( 2.3 , 7.1 , 12.3 ) Anticoagulant Drugs: Downward adjustment of anticoagulant dosage may be required. ( 7.2 ) 7.1 Effect of Other Drugs on XERAVA Strong CYP3A Inducers Concomitant use of strong CYP3A inducers decreases the exposure of eravacycline, which may reduce the efficacy of XERAVA [see Clinical Pharmacology ( 12.3 )] . Increase XERAVA dose in patients with concomitant use of a strong CYP3A inducer [see Dosage and Administration ( 2.3 )] . 7.2 Effect of XERAVA on other Drugs Anticoagulant Drugs Because tetracyclines have been shown to depress plasma prothrombin activity, patients who are on anticoagulant therapy may require downward adjustment of their anticoagulant dosage.
Not a complete list. The label covers the interactions the manufacturer studied or reported, and our own interaction database does not cover every medicine either. Bring your full medication list, including vitamins and herbal products, to your pharmacist.
Before taking Eravacycline Injection
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- Tetracycline allergy: Xerava is contraindicated if you have a known allergy to eravacycline, any tetracycline-class antibiotic, or any ingredient in Xerava.
- Pregnancy: Xerava can permanently stain your baby's teeth and slow bone growth if used in the second or third trimester. Talk to your doctor immediately if you are or become pregnant.
- Breastfeeding: Breastfeeding is not recommended during treatment or for 4 days after the last dose, due to the risk of tooth staining and bone effects in the infant.
- Children under 8: Xerava is not recommended for children under 8 because of the risk to developing teeth and bones. Safety and effectiveness have not been established in any pediatric patients.
- Severe liver disease (Child-Pugh Class C): The dosing schedule must be adjusted — tell your doctor if you have serious liver problems.
- Kidney disease: No dose adjustment is needed, even for end-stage renal disease.
- Older adults: No difference in safety or effectiveness was found in patients 65 and older in clinical trials. No dose adjustment is required based on age alone.
- Males concerned about fertility: Animal studies suggest eravacycline may temporarily affect sperm; long-term effects on human male fertility have not been fully studied.
Eravacycline Injection overdose
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No overdose cases were reported in Xerava's clinical trials. If an overdose is suspected, Xerava should be stopped and the patient watched closely for side effects. Hemodialysis (kidney dialysis) is not expected to meaningfully remove eravacycline from the body.
What Eravacycline Injection does in the body
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Eravacycline's effectiveness is best predicted by how much total drug exposure occurs relative to the minimum amount needed to stop the bacteria from growing — a measure called AUC/MIC. At the recommended dose, eravacycline appears to reach the level of exposure where increasing the dose further would not meaningfully improve results. In a dedicated heart-rhythm study, Xerava at 1.5 times the maximum approved dose did not cause any clinically meaningful prolongation of the QTc interval (the heart's electrical recovery time), suggesting a low risk of drug-related heart rhythm effects at therapeutic doses.
How your body processes Eravacycline Injection
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Eravacycline is given by IV infusion over about 60 minutes. It distributes widely throughout the body — with a large volume of distribution of roughly 321 liters — meaning it spreads well into tissues. It is 79–90% bound to proteins in the blood and is broken down primarily by liver enzymes (CYP3A4 and FMO). About one-third of the drug is excreted in urine and nearly half in feces. The average elimination half-life is 20 hours, meaning it takes roughly 20 hours for the body to clear half of the drug. Drug levels build up by roughly 45% with twice-daily dosing, reaching a steady state over several days. Patients with severe liver disease have significantly higher drug exposure and require a dose adjustment, while kidney disease — even severe — does not meaningfully change drug exposure.
How to store Eravacycline Injection
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stored at 2°C to 8°C (36°F to 46°F) .
Written from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
Supplements & herbs that interact with Eravacycline Injection
145 supplements and herbal products have documented interactions with Eravacycline Injection in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.
- Major · 3
- Moderate · 109
- Minor · 33
Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.
Eravacycline Injection: pharmacist answers to common questions
Quick, plain-English answers to the questions patients ask most about Eravacycline Injection — the kind of thing our pharmacy team would talk through with you at the counter.
What is Xerava used for?
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How is Xerava given, and how long will I need it?
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What side effects should I watch out for?
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Can I take Xerava if I'm pregnant or breastfeeding?
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Are there any medications I should tell my doctor about before starting Xerava?
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Is Xerava safe if I have kidney or liver disease?
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Is Eravacycline Injection available over the counter?
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When was Eravacycline Injection first available?
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Answers drafted from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
More about Eravacycline Injection on HelloPharmacist
Eravacycline Injection forms and strengths (how it comes)
Eravacycline Injection is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Need a version that does not list lactose, a gluten source, a dye or gelatin? Inactive ingredients differ by manufacturer: see Eravacycline Injection inactive ingredients by manufacturer.
Injection
How this form is used
- Xerava is used to treat complicated intra-abdominal infections (serious infections inside the abdomen) in adults 18 and older
- Xerava targets specific bacteria including E. coli, Klebsiella pneumoniae, Enterococcus, Staphylococcus aureus, Bacteroides species, and others confirmed or suspected to be causing the infection
- Xerava is not approved for complicated urinary tract infections
- Xerava is given as an IV infusion over approximately 60 minutes, typically every 12 hours
- Xerava must be reconstituted and diluted before infusion — it is not for direct injection and is prepared fresh by healthcare staff
- Xerava should not be mixed with other drugs in the same IV line; the line should be flushed with normal saline before and after infusion
- Xerava treatment typically lasts 4 to 14 days depending on infection severity and patient response — follow your care team's guidance
Eravacycline Injection on the U.S. market: products, makers and brands
How Eravacycline Injection appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
1 company lists 2 Eravacycline Injection product records with the FDA, mostly as injection; the earliest marketing or approval year on record is 2018. Brand names on the directory include Xerava; the rest are generics.
How widely Eravacycline Injection is used (Medicaid data)
A general measure of how commonly Eravacycline Injection is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Eravacycline Injection is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Eravacycline Injection prescribed? Of the 1,601 medications we measure, Eravacycline Injection ranks #1,430 by Medicaid prescriptions — more than 11% of them.
Utilization by Eravacycline Injection product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
eravacycline 100 MG Injection Most dispensed
Summed across the 1 of 3 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2374556
eravacycline 50 MG Injection
Summed across the 1 of 4 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2055911
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Eravacycline Injection, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 2 of 7 listed Eravacycline Injection NDCs with Medicaid activity.
Compare Eravacycline Injection products
A representative set of FDA-listed product records for Eravacycline Injection — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Injection | ||||
| 50 mg | Intravenous | Tetraphase Pharmaceuticals, Inc. | NDA | View NDC → |
| 100 mg | Intravenous | Tetraphase Pharmaceuticals, Inc. | NDA | View NDC → |
Showing 2 of 2 products — FDA National Drug Code Directory. See every product, package size and price: browse all 2 Eravacycline Injection NDCs →
Eravacycline Injection side effects reported to the FDA (FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Eravacycline Injection — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Eravacycline Injection in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
Eravacycline Injection FDA approval history
How Eravacycline Injection went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
Eravacycline Injection recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
The FDA’s enforcement reports list no Eravacycline recalls since July 2021.
✅No Eravacycline recalls on record since July 2021Source: FDA enforcement (recall) reports, via openFDA; our copy was last updated Sep 24, 2026.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.
RxCUI 2055906 1 dose form · 2 strengths
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Dose form (SCDF) Injection RxCUI 2055910In current FDA listings
Look up RxCUI 2055906 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
Eravacycline Injection supply and shortage status
Whether Eravacycline Injection is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
Eravacycline Injection brand names
Eravacycline Injection is sold under one brand name in the FDA directory — Xerava. A brand and its generic contain the same active ingredient; the brand name belongs to one company's product.
Who makes Eravacycline Injection: manufacturers and labelers
One company lists Eravacycline Injection products with the FDA. By number of product records, the largest are Tetraphase Pharmaceuticals, Inc.. Labelers include manufacturers and repackagers; the product in your bottle depends on which one your pharmacy stocks.
Eravacycline Injection drug class (RxNorm)
Eravacycline Injection belongs to the Tetracycline-class Antibacterial class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
Sources for this Eravacycline Injection page
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How this page is built
HelloPharmacist combines public FDA and NLM records and does not author the underlying clinical facts. The plain-language sections are written with AI from the FDA-approved label text and reviewed by our pharmacy team before publication. Tetraphase Pharmaceuticals, Inc. is the representative DailyMed label linked for verification and dates. This is general education, not medical advice: always talk to your doctor or pharmacist about your own medicines. How we build and review drug pages →