Cyclic lipopeptide (multidrug-resistant gram+)
Daptomycin is an injectable antibiotic used to treat serious skin and soft tissue infections caused by Gram-positive bacteria, including methicillin-resistant staphylococci (MRSA), and bloodstream infections (bacteraemia). It is given intravenously, usually once daily.
Also known as: Cubicin
Combining Daptomycin with Atorvastatin (statin) increases the risk of myopathy and rhabdomyolysis.
Daptomycin is associated with myopathy, with CK elevation, and the label recommends monitoring CK weekly (more frequently in patients on recent or concomitant statins) and considering the temporary suspension of agents associated with rhabdomyolysis, such as statins (HMG-CoA reductase), during daptomycin treatment. The risk is higher with high daptomycin doses, prolonged courses or renal impairment. In practice, consider interrupting atorvastatin (and other statins) during the antibiotic, monitor CK weekly and watch for muscle symptoms; the statin can be resumed after the end of treatment.
Atorvastatin + daptomycin: additive risk of myopathy/rhabdomyolysis. Stop the statin during daptomycin treatment.
Daptomycin and HMG-CoA reductase inhibitors (statins) can both cause myopathy; the additive effect potentiates muscle injury and the risk of rhabdomyolysis.
Monitor CPK, myopathy symptoms (muscle pain, weakness) and renal function.
Severe myalgia, weakness, dark urine or markedly elevated CPK require discontinuation and immediate evaluation.
Consider holding the statin during daptomycin therapy or choosing an alternative; watch for muscle symptoms.
DailyMed/FDA (NIH/NLM) — approved Daptomycin label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f4ad8613-f25e-4b82-9621-cc5ff9525d3e ; approved Atorvastatin label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=86841382-4229-4e03-958e-3ac22639efd4 — with additional reference: Prontuário Terapêutico do INFARMED, INFARMED (11th ed., 2012)
Daptomycin is given intravenously; food does not affect its pharmacokinetics.
May be administered regardless of meals.
DailyMed/FDA (NIH/NLM) — approved Daptomycin label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f4ad8613-f25e-4b82-9621-cc5ff9525d3e
No relevant pharmacokinetic interaction; usual moderation during treatment.
Moderate alcohol intake.
DailyMed/FDA (NIH/NLM) — approved Daptomycin label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f4ad8613-f25e-4b82-9621-cc5ff9525d3e
Daptomycin is eliminated renally; renal impairment requires dose adjustment.
Adjust the dose based on renal function (CrCl < 30 ml/min).
DailyMed/FDA (NIH/NLM) — approved Daptomycin label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f4ad8613-f25e-4b82-9621-cc5ff9525d3e
Daptomycin can cause myopathy/rhabdomyolysis; the risk is higher with high doses, concomitant statins or renal impairment.
Monitor CK weekly and watch for muscle symptoms.
DailyMed/FDA (NIH/NLM) — approved Daptomycin label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f4ad8613-f25e-4b82-9621-cc5ff9525d3e
There are insufficient data on daptomycin use in human pregnancy.
Use only if the benefit clearly outweighs the risk.
Insufficient data; use with caution during breastfeeding.
No specific contraception required.
DailyMed/FDA (NIH/NLM) — approved Daptomycin label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f4ad8613-f25e-4b82-9621-cc5ff9525d3e
Clinical and educational support tool. The information does not replace a medical prescription or the opinion of a qualified healthcare professional.
Calcium-dependent cyclic lipopeptide, bactericidal, active against Gram-positives (including MRSA and VRE); ~8 h half-life allows once-daily dosing; inactivated by pulmonary surfactant (do not use in pneumonia).
Inserts into the bacterial cytoplasmic membrane in a calcium-dependent manner, causing rapid, massive depolarisation with loss of membrane potential and cell death (without lysis); does not cross the outer membrane of Gram-negatives.
IV administration (30-min or 2-min infusion); linear, time-independent pharmacokinetics (4-12 mg/kg); steady-state volume of distribution ~0.1 L/kg (low — remains mostly in plasma); Cmax 57.8 mcg/mL after 4 mg/kg.
Limited metabolism (small fraction); predominantly renal excretion (~78% of the dose recovered in urine, mostly unchanged) — adjust the dose in renal impairment (CrCl <30 mL/min: 6 mg/kg every 48 h).
Elimination half-life ~8 h (7.7-8.3 h at 4-12 mg/kg); steady state reached by the third daily dose; total clearance 8-9 mL/h/kg.
Medicines from the same therapeutic group (ATC classification) or the same pharmacological class.
