Classifications: antibiotic; lipopeptide; Therapeutic: antibiotic; lipopeptide
Pregnancy Category: B
500 mg vial
Daptomycin is cyclic lipopeptide antibiotic. It binds to bacterial membranes of gram-positive bacteria causing rapid depolarization
of the membrane potential leading to inhibition of protein, DNA, and RNA synthesis and bacterial cell death.
Daptomycin is effective against a broad spectrum of gram-positive organisms, including both susceptible and resistant strains
of S. aureus.
Complicated skin and skin structure infections, bacteremia.
Pseudomembranous colitis. Safe use in infants or children <18 y is not known.
Severe renal or hepatic impairment, end-stage renal impairment; peripheral neuropathy; GI disease; history of rhabdomyolysis,
myopathy; elderly; pregnancy (category B), lactation.
Route & Dosage
Adult: IV 4 mg/kg q24h x 714 d
Bacteremia (S. aureus)
Adult: IV 6 mg/kg x 26 wk
Skin infection: Clcr <30 mL/min: 4 mg/kg q48h; bacteremia: Clcr <30 mL/min: 6 mg/kg q48h
Hemodialysis: Dose by Clcr, administer after dialysis
PREPARE: IV Infusion: Reconstitute the 250 mg vial or the 500 mg vial with 5 mL or 10 mL, respectively, of NS to yield 50 mg/mL. Further dilute
the 50 mg/mL solution in 50100 mL of NS.
ADMINISTER: IV Infusion: Infuse over 30 min; if same IV line is used for infusion of other drugs, flush line before/after with NS.
INCOMPATIBILITIES Solution/additive: Dextrose-containing solutions.
- Store unopened vials in 2°8° C (36°46° F). Avoid excessive heat. May store reconstituted,
single-use vials or IV solution for 12 h at room temperature or 48 h if refrigerated.
Adverse Effects (≥1%)Body as a Whole:
Injection site reactions, fever, fungal infections. CNS:
, dizziness. CV:
Hypotension, hypertension. GI: Constipation
, nausea, vomiting, diarrhea, abnormal liver function tests. Hematologic:
Elevated CPK. Musculoskeletal:
Limb pain, arthralgia. Respiratory:
Rash, pruritus. Urogenital:
UTIs, renal failure.
Significant reactions not identified.
Primarily renal. Half-Life:
Assessment & Drug Effects
- Monitor for and report: muscle pain or weakness, especially with concurrent therapy with HMG-CoA reductase inhibitors (statin
drugs); S&S of peripheral neuropathy, superinfection such as candidiasis.
- Lab tests: Perform C&S before treatment is begun; baseline renal function tests; weekly CPK levels; PT/INR during first
few days of daptomycin therapy with concurrent warfarin use; daily blood glucose monitoring in diabetics; serum electrolytes
if S&S of hypokalemia or hypomagnesemia (see Appendix F) appear.
- Withhold drug and notify physician if S&S of myopathy develop with CPK elevation >1000 U/L (5
x ULN), or if CPK level is ≥10 x ULN.
Patient & Family Education
- Report any of the following to the physician: muscle pain, weakness or unusual tiredness; numbness or tingling; difficulty
breathing or shortness of breath; severe diarrhea or vomiting; skin rash or itching.