Alirocumab
Moderate
Textbook
Potential risk of myopathy.
Caution is recommended when daptomycin is coadministered with statins.
Source: G&G 14e · p1162
Drug reference
Daptomycin
Antibacterial · Antibiotic
AntibacterialAntibiotic
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
—
none in our sources
PREGNANCY
Manufacturer advises use only if potential benefit outweighs risk; no information available.
FDA category + note
Mechanism
Daptomycin is a lipopeptide antibacterial with a spectrum of activity similar to vancomycin but its efficacy against enterococci has not been established. It needs to be given with other antibacterials for mixed infections involving Gram-negative bacteria and some anaerobes.
Indications
Complicated skin and soft-tissue infections caused by Gram-positive bacteriaRight-sided infective endocarditis caused by Staphylococcus aureus (administered on expert advice)Methicillin-Resistant S. aureus Native-Valve Endocarditis (left-sided, if daptomycin-susceptible)Right-sided MRSA IEMethicillin-Resistant S. aureus Prosthetic-Valve Endocarditis (alternative to vancomycin)Vancomycin-unresponsive MRSA IE (high-dose, often with nafcillin or ceftaroline)Enterococcus faecium IE (high-dose, often with ampicillin or other β-lactams)Bacteremia (including right-sided endocarditis)Complicated skin infectionsInvasive MRSA infectionsEmpirical therapy when susceptibility is not knownProsthetic-valve endocarditis (if β-lactam resistant)Salvage therapy for persistent MRSA bacteremia (sometimes in combination with a β-lactam)
Dosing
- Adult
- Complicated skin and soft-tissue infections caused by Gram-positive bacteria: 4 mg/kg once daily for 7–14 days (or longer if necessary), alternatively 6 mg/kg once daily (higher dose only if associated with Staphylococcus aureus bacteraemia). Administered by slow intravenous injection or intravenous infusion.…
- Pediatric
- Child 12–23 months: 10 mg/kg once daily for up to 14 days, alternatively 12 mg/kg once daily (higher dose only if associated with Staphylococcus aureus bacteraemia). Child 2–6 years: 9 mg/kg once daily for up to 14 days, alternatively 12 mg/kg once daily (higher dose only if associated with Staphylococcus aureus bacteraemia).…
- Renal adjustment
- Adults: Use normal dose every 48 hours if eGFR less than 30 mL/minute/1.73 m2. Children: Dosage regimen has not been established; use with caution and monitor renal function regularly.
- Hepatic adjustment
- Caution in severe impairment; no specific dose adjustment information available.
Pharmacokinetics
Bioavailability
—
Protein binding
92%
Excretion
47 ± 12%
Side effects
Common
Anaemiaanxietyastheniaconstipationdiarrhoeadizzinessfeverflatulencegastrointestinal discomfortheadachehypertensionhypotensionincreased risk of infectioninsomnianauseapainskin reactionsvomiting
Serious
- Appetite decreased
- arrhythmias
- arthralgia
- electrolyte imbalance
- eosinophilia
- flushing
- glossitis
- hyperglycaemia
- muscle weakness
- myalgia
- myopathy
- paraesthesia
- renal impairment
- taste altered
- thrombocytosis
- tremor
- vertigo
- Jaundice
- Acute generalised exanthematous pustulosis (AGEP)
- antibiotic associated colitis
- chills
- cough
- infusion related reaction
- peripheral neuropathy
- respiratory disorders
- syncope
- Unexplained muscle pain, tenderness, weakness, or cramps (monitor creatine kinase; discontinue if unexplained muscular symptoms and creatine elevated markedly)
- Myopathy (elevation of CPK levels, rhabdomyolysis)
- Eosinophilic pneumonia (reversible)
- rhabdomyolysis
- eosinophilic pneumonia
Pregnancy & lactation
Pregnancy
Manufacturer advises use only if potential benefit outweighs risk; no information available.
Lactation
Present in milk in small amounts, but absorption from gastrointestinal tract negligible.
Drug interactions
Aminoglycosides
Moderate
Textbook
Potential risk of nephrotoxicity.
Caution is recommended when daptomycin is coadministered with aminoglycosides.
Source: G&G 14e · p1162
Atorvastatin + Aspirin
Moderate
Textbook
Potential risk of myopathy.
Caution is recommended when daptomycin is coadministered with statins.
Source: G&G 14e · p1162
Evolocumab
Moderate
Textbook
Potential risk of myopathy.
Caution is recommended when daptomycin is coadministered with statins.
Source: G&G 14e · p1162
Ezetimibe
Moderate
Textbook
Potential risk of myopathy.
Caution is recommended when daptomycin is coadministered with statins.
Source: G&G 14e · p1162
Lomitapide
Moderate
Textbook
Potential risk of myopathy.
Caution is recommended when daptomycin is coadministered with statins.
Source: G&G 14e · p1162
Mevastatin
Moderate
Textbook
Potential risk of myopathy.
Caution is recommended when daptomycin is coadministered with statins.
Source: G&G 14e · p1162
Nicotinic Acid
Moderate
Textbook
Potential risk of myopathy.
Caution is recommended when daptomycin is coadministered with statins.
Source: G&G 14e · p1162
Orlistat
Moderate
Textbook
Potential risk of myopathy.
Caution is recommended when daptomycin is coadministered with statins.
Source: G&G 14e · p1162
Rosuvastatin + Aspirin
Moderate
Textbook
Potential risk of myopathy.
Caution is recommended when daptomycin is coadministered with statins.
Source: G&G 14e · p1162
Atorvastatin
Moderate
Database
Potential risk of myopathy.
Caution is recommended when daptomycin is coadministered with statins.
Source: DDInter
Fluvastatin
Moderate
Database
Potential risk of myopathy.
Caution is recommended when daptomycin is coadministered with statins.
Source: DDInter
Related guidelines
Infective endocarditis prevention
ADA_DENTAL · Dentistry · 2015
Infective endocarditis prevention
NICE · Cardiology / Dentistry · 2008
Infective endocarditis prevention
AHA · Cardiology / Dentistry · 2007
Skin and soft tissue infections
IDSA · Infectious Diseases · 2010
Empirical antimicrobial use in common syndromes
ICMR · Infectious Diseases · 2019
Other Antibacterial drugs
Ask House about Daptomycin
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e, Harrison 22e, Katzung, BNF·Verified: 2026-05-13 · House clinical team