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Daptomycin Generic Name & Formulations
Legal Class
Rx
General Description
Daptomycin 350mg/vial, 500mg/vial; lyophilized pwd for IV inj after reconstitution (with 0.9% sodium chloride) or IV infusion after reconstitution and dilution.
Pharmacological Class
Cyclic lipopeptide.
How Supplied
Contact supplier
Manufacturer
Mechanism of Action
Daptomycin binds to bacterial cell membranes and causes a rapid depolarization of membrane potential. This loss of membrane potential causes inhibition of DNA, RNA, and protein synthesis, which results in bacterial cell death.
Daptomycin Indications
Indications
Susceptible complicated skin and skin structure infections (cSSSI) in adults and pediatrics (1–17yrs). S. aureus bacteremia in adults (including MRSA and MSSA right-sided endocarditis) and in pediatrics (1–17yrs).
Limitations of Use
Not for treatment of pneumonia or left-sided endocarditis due to S. aureus. Not studied in prosthetic valve endocarditis. Not recommended in pediatrics (<1yr) due to risk of potential effects on muscular, neuromuscular, and/or nervous systems (peripheral and/or central).
Daptomycin Dosage and Administration
Adult
Give by IV inj over 2mins or IV infusion over 30mins. cSSSI: 4mg/kg once every 24hrs for 7–14 days. S. aureus bacteremia or endocarditis: 6mg/kg once every 24hrs for 2–6 weeks. Renal impairment (CrCl <30mL/min): decrease dosing interval to once every 48hrs; coincide dose for after dialysis.
Children
<1yr: not recommended. Give by IV infusion over 60mins (1–6yrs) or 30mins (7–17yrs). cSSSI (1–<2yrs): 10mg/kg once every 24hrs; (2–6yrs): 9mg/kg once every 24hrs; (7–11yrs): 7mg/kg once every 24hrs; (12–17yrs): 5mg/kg once every 24hrs. Treat up to 14 days. S. aureus bacteremia (1–6yrs): 12mg/kg once every 24hrs; (7–11yrs): 9mg/kg once every 24hrs; (12–17yrs): 7mg/kg once every 24hrs. Treat up to 42 days. Renal impairment (CrCl <30mL/min): not established.
Daptomycin Contraindications
Not Applicable
Daptomycin Boxed Warnings
Not Applicable
Daptomycin Warnings/Precautions
Warnings/Precautions
Monitor for development of muscle pain or weakness (esp. distal extremities). Monitor CPK weekly (more frequently in those with concomitant statin therapy or elevated CPK); discontinue if CPK (≥5×ULN) and myopathy occur, or if CPK (≥10×ULN) without myopathy occurs. Renal impairment: monitor renal function and CPK more frequently than once weekly. Discontinue immediately if eosinophilic pneumonia develops; treat with systemic steroids. Discontinue if tubulointerstitial nephritis or drug reaction with eosinophilia and systemic symptoms are suspected; treat appropriately. Monitor for neuropathy; consider discontinuation if occurs. Persisting or relapsing S. aureus bacteremia/endocarditis: repeat blood cultures and evaluate. Adults with moderate baseline renal impairment: decreased efficacy observed. Severe hepatic impairment. Pregnancy. Nursing mothers.
Daptomycin Pharmacokinetics
Distribution
Plasma protein bound: 90–93% (reversibly bound in a concentration-independent manner). Volume of distribution at steady-state: ~0.1 L/kg.
Elimination
Renal (~78%), fecal (5.7%). Half-life (at 4mg/kg): 9.39 hours.
Daptomycin Interactions
Interactions
Consider suspending agents associated with rhabdomyolysis (eg, statins). May cause false prolongation of PT or elevation of INR when certain recombinant thromboplastin reagents are utilized for the assay.
Daptomycin Adverse Reactions
Adverse Reactions
Diarrhea, headache, dizziness, rash, abnormal LFTs, elevated CPK, UTIs, hypotension, dyspnea, vomiting, abdominal pain, pruritus, pyrexia, sepsis, bacteremia, chest pain, edema, pharyngolarygeal pain, increased sweating, insomnia, hypertension; hypersensitivity reactions, myopathy, rhabdomyolysis, C. difficile-associated diarrhea.
Daptomycin Clinical Trials
See Literature
Daptomycin Note
Not Applicable
Daptomycin Patient Counseling
See Literature
