DAPTOMYCIN (daptomycin)

There are 0 contraindications.

There are 5 severe contraindications. Adequate patient monitoring is recommended for safer drug use.

Severe List
Chronic kidney disease stage 4 (severe) GFR 15-29 ml/min
Chronic kidney disease stage 5 (failure) GFr<15 ml/min
Clostridioides difficile infection
Eosinophilic pneumonia
Myopathy with CK elevation

There are 1 moderate contraindications. Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.

Moderate List
Peripheral neuropathy

There are 49 severe adverse reactions.

More Frequent	Less Frequent
Abnormal hepatic function tests Dyspnea	Acute cognitive impairment Anemia Candidiasis Chest pain Edema Fungal infection Hypertension Hypotension Increased creatine kinase level Renal failure Skin rash Urinary tract infection

Rare/Very Rare

Acute generalized exanthematous pustulosis Altered mental status Anaphylaxis Angioedema Atrial fibrillation Atrial flutter Bacterial sepsis Blistering skin Bullous dermatitis Clostridioides difficile infection DRESS syndrome Dyskinesia Dysphagia Eosinophilia Eosinophilic pneumonia Erythema Fever Hallucinations Hyperkalemia Hypersensitivity drug reaction Hypomagnesemia Interstitial nephritis Jaundice Leukocytosis Lymphadenopathy Metabolic alkalosis Muscle weakness Myopathy Rhabdomyolysis Stevens-johnson syndrome Supraventricular arrhythmias Thrombocytopenic disorder Thrombocytosis Toxic epidermal necrolysis Vesicular rash

There are 33 less severe adverse reactions.

More Frequent	Less Frequent
Diarrhea Headache disorder	Anorexia Dizziness Hyperhidrosis Insomnia Pruritus of skin

Rare/Very Rare
Abdominal distension Acute abdominal pain Blurred vision Chills Cough Cramps Dysgeusia Eczema Fatigue Flushing General weakness Gingival pain Myalgia Nausea Ocular irritation Paresthesia Peripheral neuropathy Proteinuria Stomatitis Tinnitus Urticaria Vertigo Visual changes Vomiting Vulvovaginal candidiasis Xerostomia

Category B. (See Users Guide.) There are no adequate and well-controlled studies evaluating daptomycin in pregnant women. Daptomycin should be used during pregnancy only if potential benefits to the woman outweigh possible risks to the fetus.

Daptomycin is distributed into human milk, but has poor oral bioavailability. In a case study involving a nursing woman receiving daptomycin (6.7 mg/kg IV once daily for 28 days), the highest daptomycin concentration measured in breast milk was 45 ng/mL and the calculated maximum daily daptomycin dose for a nursing infant (assuming mean milk consumption of 150 mL/kg daily) was 0.1% of the maternal dose. Daptomycin should be used with caution in nursing women.

When the total number of patients studied in phase 3 clinical trials of daptomycin for the treatment of complicated skin and skin structure infections are considered, 27% were 65 years of age or older and 12% were 75 years of age or older. In a phase 3 clinical trial of daptomycin for the treatment of bacteremia and endocarditis, 25% of patients were 65 years of age or older and 16% were 75 years of age or older. There was some evidence from these studies that clinical success rates were lower and treatment-emergent adverse effects were more common in geriatric patients 65 years of age or older compared with younger adults.

Although daptomycin exposures are higher in healthy geriatric adults than in healthy young adults, adjustment of daptomycin dosage is not necessary in geriatric patients based solely on age. However, age-related decreases in renal function should be considered when selecting dosage in geriatric patients. (See Dosage and Administration: Special Populations.)