Daptomycin

Usual Dosing (Adults)

Complicated Skin and Skin Structure Infections
CUBICIN 4 mg/kg should be administered over a 30-minute period by IV infusion in 0.9% sodium chloride injection once every 24 hours for 7 to 14 days. In Phase 1 and 2 clinical studies, CPK elevations appeared to be more frequent when CUBICIN was dosed more frequently than once daily. Therefore, CUBICIN should not be dosed more frequently than once a day.

Staphylococcus aureus Bloodstream Infections (Bacteremia), Including Those with Right-Sided Endocarditis, Caused by Methicillin-Susceptible and Methicillin-Resistant Isolates
CUBICIN 6 mg/kg should be administered over a 30-minute period by IV infusion in 0.9% sodium chloride injection once every 24 hours for a minimum of 2 to 6 weeks. Duration of treatment should be based on the treating physician’s working diagnosis. There are limited safety data for the use of CUBICIN for more than 28 days of therapy. In the Phase 3 study, there were a total of 14 patients who were treated with CUBICIN for more than 28 days, 8 of whom were treated for 6 weeks or longer.

In Phase 1 and 2 clinical studies, CPK elevations appeared to be more frequent when CUBICIN was dosed more frequently than once daily. Therefore, CUBICIN should not be dosed more frequently than once a day.

Renal Dosing

Patients with Renal Impairment:
Daptomycin is eliminated primarily by the kidneys; therefore, a modification of CUBICIN dosage is recommended for patients with CLCR <30 mL/min, including patients receiving hemodialysis or continuous ambulatory peritoneal dialysis (CAPD). In patients with renal impairment, both renal function and creatine phosphokinase (CPK) should be monitored more frequently than once weekly.

Clearance method (package insert): CLCR, creatinine clearance estimated using the Cockcroft-Gault equation with actual body weight.

Creatinine Clearance (CLCR)	Dosage Regimen
Creatinine Clearance (CLCR)	cSSSI	S. aureus Bloodstream Infections
≥30 mL/min	4 mg/kg once every 24 hours	6 mg/kg once every 24 hours
<30 mL/min, including hemodialysis or CAPD	4 mg/kg once every 48 hours	6 mg/kg once every 48 hours

Hemodialysis

See above. When possible, CUBICIN should be administered following the completion of hemodialysis on hemodialysis days

Reference(s)

National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
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