Daptomycin

Cyclic lipopeptide antibiotic

ATC code: J01XX09

Brand names: Daptomicina Accord, Daptomicina Hospira, Cubicin, Daptomicina Mylan

Updated 24 Sep 2026 · Methodology

Indications

Complicated skin and soft tissue infection

Second line

Complicated skin and soft tissue infections in adults, including confirmed MRSA. Per 2014 and SEIMC 2023 – alternative to vancomycin in intolerance, with MRSA MIC ≥1.5 mg/L, or with no response to vancomycin at 72 hours. Dose: 4 mg/kg IV once daily for 7–14 days. With severe renal impairment (CrCl <30) extend interval to 48 hours. Use empirically only after cultures.

Sources

ICD-10: L08.9 · ICD-11: 1B70

How to read tiers A–F

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit

Mechanism of action

Daptomycin binds the cytoplasmic membrane of gram-positive bacteria in the presence of calcium – forms transmembrane channels, causes rapid membrane depolarization and cell death without lysis. Bactericidal activity is concentration-dependent. Active against S. aureus (including MRSA), S. pyogenes, Enterococcus faecalis and faecium (including VRE), and coagulase-negative staphylococci. Inactivated by pulmonary surfactant – ineffective in pneumonia.

Safety

Contraindications

Hypersensitivity to daptomycin
Pregnancy and breastfeeding
Pneumonia as the sole diagnosis (daptomycin is inactive in lungs)

Serious adverse effects

Rhabdomyolysis and myopathy
Eosinophilic pneumonia (FDA Safety Communication 2010)
Severe cutaneous reactions (DRESS, Stevens-Johnson syndrome)
C. difficile-associated diarrhea
Acute interstitial nephritis

Common adverse effects

Elevated CK
Injection-site reactions
Nausea, diarrhea
Headache
Transaminase elevation

Pregnancy: can you take Daptomycin?

Use only when no alternative exists. Limited pregnancy experience; in severe staphylococcal infections occasionally used – jointly with infectious disease and obstetrics.

Breastfeeding: can you take Daptomycin?

Not recommended. Milk excretion data are limited. Interrupt breastfeeding for the course or switch the infant to formula.

RID, infant dose via milk: 0.1%

Calculate RID Full profile on NIH LactMed ↗

Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.

Practical notes

Monitoring

CK weekly during therapy – rhabdomyolysis risk. Discontinue if CK >5× ULN with symptoms or >10× ULN without. Do not co-administer statins during the course (myopathy risk).

Label mentions9 mentions

Verbatim lines from the interaction sections, in the language of the label

From this drug’s label

Majorestatinasclass named in the label
«Se dispone de una experiencia limitada en relación con la administración conjunta de daptomicina con otros medicamentos que puedan causar una miopatía (p.ej. inhibidores de la HMG-CoA reductasa). Sin…»
AEMPS, section 4.5 · Open on CIMA
ModerateAINEclass named in the label
«La daptomicina se elimina fundamentalmente por filtración renal, por lo que los niveles en el plasma pueden verse incrementados durante la administración simultánea de medicamentos que reducen la…»
AEMPS, section 4.5 · Open on CIMA
Moderateanticoagulantesclass named in the label
«La experiencia con la administración concomitante de daptomicina y warfarina es limitada. No se han realizado estudios de daptomicina con anticoagulantes distintos de warfarina. Debe monitorizarse la…»
AEMPS, section 4.5 · Open on CIMA
Moderatestatinsclass named in the label
«HMG-CoA Reductase Inhibitors: However, inhibitors of HMG-CoA reductase may cause myopathy, which is manifested as muscle pain or weakness associated with elevated levels of creatine phosphokinase…»
FDA, section 7 · Open on DailyMed
ModerateWarfarin
«La experiencia con la administración concomitante de daptomicina y warfarina es limitada. No se han realizado estudios de daptomicina con anticoagulantes distintos de warfarina. Debe monitorizarse la…»
AEMPS, section 4.5 · Open on CIMA
Simvastatin
«HMG-CoA Reductase Inhibitors: In healthy adult subjects, concomitant administration of daptomycin and simvastatin had no effect on plasma trough concentrations of simvastatin, and there were no…»
FDA, section 7 · Open on DailyMed

From other drugs’ labels

MajorAtorvastatin
«Daptomicina: Se han notificado casos de miopatía y/o rabdomiólisis con la administración concomitante de inhibidores de la HMG-CoA reductasa (p. ej., atorvastatina) y daptomicina. Si no se puede…»
AEMPS, section 4.5 · Open on CIMA
MajorSimvastatin
«Se debe considerar suspender temporalmente el tratamiento con simvastatina en pacientes que toman daptomicina a menos que los beneficios de la administración conjunta superen el riesgo (ver sección…»
AEMPS, section 4.5 · Open on CIMA
MajorSimvastatin
«Drug Interactions that Increase the Risk of Myopathy and Rhabdomyolysis with Simvastatin: Intervention: If treatment with daptomycin is required, consider temporarily suspending simvastatin during…»
FDA, section 7 · Open on DailyMed

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Frequently asked

What is Daptomycin used for?

Daptomycin is evaluated for the following indications with varying evidence strength: Complicated skin and soft tissue infection (evidence tier A). See the full indication matrix with dosing and citations above on this page.

What are the side effects of Daptomycin?

Common side effects of Daptomycin (≥ 1 in 100): Elevated CK, Injection-site reactions, Nausea, diarrhea, Headache, Transaminase elevation. See the Safety section for uncommon and serious reactions.

Is Daptomycin safe during pregnancy?

Use only when no alternative exists. Limited pregnancy experience; in severe staphylococcal infections occasionally used – jointly with infectious disease and obstetrics.

Is Daptomycin compatible with breastfeeding?

Not recommended. Milk excretion data are limited. Interrupt breastfeeding for the course or switch the infant to formula.

Who should not take Daptomycin?

Daptomycin is contraindicated in: Hypersensitivity to daptomycin; Pregnancy and breastfeeding; Pneumonia as the sole diagnosis (daptomycin is inactive in lungs). Full list in the Safety section.

Official sources

Direct links to regulator labels. Open in a new tab.

AEMPS / CIMALabel dated 06/11/2024
FDA / DailyMedLabel dated 08/06/2026

Other drugs in this group

Doxycycline, Erythromycin, Flucloxacillin, Fosfomycin, Gentamicin, Moxifloxacin, Azithromycin, Chloramphenicol