Daptomycin


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IV Complicated skin and skin structure infections 4 mg/kg/day infused over 30 min for 7-14 days. Staphylococcus aureus bacteraemia 6 mg/kg/day infused over 30 min for 2-6 wk.
Dosage Details
Intravenous
Complicated skin and skin structure infections
Adult: 4 mg/kg once daily for 7-14 days, by infusion over 30 min or by inj over 2 min.

Intravenous
Staphylococcus aureus bacteraemia
Adult: 6 mg/kg once daily for 2-6 wk, by infusion over 30 min.
Renal Impairment
Complicated skin and skin structure infections:
Patients on haemodialysis or CAPD: 4 mg/kg once every 48 hr.
CrCl Dosage
<30 4 mg/kg once every 48 hr.
Staphylococcus aureus Bacteraemia:
Patients on haemodialysis or CAPD: 6 mg/kg once every 48 hr.
CrCl Dosage
<30 6 mg/kg once every 48 hr.
Reconstitution
Reconstitute w/ 10 mL of NaCl 0.9% inj using aseptic technique. Gently rotate the vial to wet the powd and allow it to stand for 10 min. To obtain a completely reconstituted soln, gently swirl or rotate the vial. Do not shake/agitate vial during and after reconstitution. Further dilute the reconstituted soln w/ NaCl 0.9% inj for IV infusion. The final concentration should not exceed 20 mg/mL.
Incompatibility
Dextrose-containing soln, ceftriaxone.
Contraindications
Hypersensitivity.
Special Precautions
Renal impairment. Patient w/ persisting or relapsing Staphylococcus aureus infection. Pregnancy and lactation.
Adverse Reactions
Diarrhoea, vomiting, constipation, nausea, dyspepsia, loose stools, and abdominal pain; pain in extremity, myositis, myopathy, back pain,; headache, dizziness, insomnia, anxiety, pharyngolaryngeal pain, pleural effusion; UTI, osteomyelitis, sepsis, bacteraemia, peripheral oedema, pyrexia, chest pain, asthenia, rash, pruritus, erythema, increased sweating, CK elevations, HTN, hyperkalaemia, hypokalaemia, anaemia, hypotension, angioedema, drug rash w/ eosinophilia and systemic symptoms (DRESS). Rarely, jaundice, infusion reactions, rhabdomyolysis, peripheral neuropathy.
Potentially Fatal: Anaphylaxis/hypersensitivity reactions, eosinophilic pneumonia, superinfection including Clostridium difficile-associated diarrhoea and colitis.
IV/Parenteral: B
MonitoringParameters
Closely monitor for signs and symptoms of eosinophilic pneumonia (e.g. new onset or worsening fever, dyspnoea). Serum creatine kinase should be monitored at least wkly during therapy.
Drug Interactions
Enhanced adverse/toxic effects w/ HMG-CoA reductase inhibitors (e.g. simvastatin). NSAIDs (e.g. diclofenac, ibuprofen) may reduce excretion of daptomycin and increase risk of renal impairment. Synergistic antibacterial effects against staphylococci and enterococci w/ aminoglycosides (e.g. gentamicin, tobramycin), rifampicin or β-lactam anti-infectives (e.g. penicillins, cephalosporins).
Lab Interference
False prolongation of prothrombin time (PT) and elevation of INR if certain recombinant thromboplastin reagents are used for these tests.
Action
Description: Daptomycin is a cyclic lipopeptide antibacterial derived from the fermentation of Streptomyces roseosporus. It causes bacterial cell death by binding to bacterial membranes and disrupting the membrane potential; thus inhibiting the synthesis of protein, DNA and RNA. Daptomycin exhibits rapid concentration-dependent bactericidal effects against susceptible gm+ve bacteria in vitro.
Pharmacokinetics:
Absorption: Time to peak plasma concentration: 0.5-0.8 hr (IV).
Distribution: Primarily distributed into extracellular space. Crosses the blood-brain barrier and placenta. Volume of distribution: 0.1 L/kg. Plasma protein binding: Approx 90% (mainly serum albumin).
Metabolism: Not metabolised by hepatic CYP450 isoenzymes.
Excretion: Via urine (78%, primarily as unchanged drug) and faeces (6%). Elimination half-life: Approx 8 hr.
Storage
Store between 2-8°C. Reconstituted soln: Stable for 12 hr when stored at 25°C and 24 hr between 2-8°C.
MIMS Class
References
Anon. Daptomycin. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 13/06/2014.

Buckingham R (ed). Daptomycin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 13/06/2014.

Cubicin (Daptomycin) for Injection. U.S. FDA. https://www.fda.gov/. Accessed 13/06/2014.

Cubicin Injection Powder, Lyophilized, for Solution (Cubist Pharmaceuticals Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 13/06/2014.

McEvoy GK, Snow EK, Miller J et al (eds). Daptomycin. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 13/06/2014.

Disclaimer: This information is independently developed by MIMS based on Daptomycin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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