Cubicin

— THERAPEUTIC CATEGORIES —
  • Bacterial infections

Cubicin Generic Name & Formulations

General Description

Daptomycin 500mg/vial; lyophilized pwd for IV inj after reconstitution (with 0.9% sodium chloride) or IV infusion after reconstitution and dilution; preservative-free; requires refrigeration.

Pharmacological Class

Cyclic lipopeptide.

See Also

How Supplied

Single-dose vial (10mL)—1

Manufacturer

Generic Availability

Cubicin vials (YES); Cubicin RF vials (NO)

Cubicin Indications

Indications

Susceptible complicated skin and skin structure infections (cSSSI) in adults and pediatrics (1–17yrs). S. aureus bacteremia in adults (including MRSA and MSSA right-sided endocarditis) and in pediatrics (1–17yrs).

Limitations of Use

Not for treatment of pneumonia or left-sided endocarditis due to S. aureus. Not studied in prosthetic valve endocarditis. Not recommended in pediatrics (<1yr) due to risk of potential effects on muscular, neuromuscular, and/or nervous systems (peripheral and/or central).

Cubicin Dosage and Administration

Adult

Give by IV inj over 2mins or IV infusion over 30mins. cSSSI: 4mg/kg once every 24hrs for 7–14 days. S. aureus bacteremia or endocarditis: 6mg/kg once every 24hrs for 2–6 weeks. Renal impairment (CrCl <30mL/min): decrease dosing interval to once every 48hrs; coincide dose for after dialysis.

Children

<1yr: not recommended. Give by IV infusion over 60mins (1–6yrs) or 30mins (7–17yrs). cSSSI (1–<2yrs): 10mg/kg once every 24hrs; (2–6yrs): 9mg/kg once every 24hrs; (7–11yrs): 7mg/kg once every 24hrs; (12–17yrs): 5mg/kg once every 24hrs. Treat up to 14 days. S. aureus bacteremia (1–6yrs): 12mg/kg once every 24hrs; (7–11yrs): 9mg/kg once every 24hrs; (12–17yrs): 7mg/kg once every 24hrs. Treat up to 42 days. Renal impairment (CrCl <30mL/min): not established.

Cubicin Contraindications

Not Applicable

Cubicin Boxed Warnings

Not Applicable

Cubicin Warnings/Precautions

Warnings/Precautions

Monitor for development of muscle pain or weakness (esp. distal extremities). Monitor CPK weekly (more frequently in those with concomitant statin therapy or elevated CPK); discontinue if CPK (≥5×ULN) and myopathy occur, or if CPK (≥10×ULN) without myopathy occurs. Renal impairment: monitor renal function and CPK more frequently than once weekly. Discontinue immediately if eosinophilic pneumonia develops; treat with systemic steroids. Discontinue if tubulointerstitial nephritis or drug reaction with eosinophilia and systemic symptoms are suspected; treat appropriately. Monitor for neuropathy; consider discontinuation if occurs. Persisting or relapsing S. aureus bacteremia/endocarditis: repeat blood cultures and evaluate. Adults with moderate baseline renal impairment: decreased efficacy observed. Severe hepatic impairment. Pregnancy. Nursing mothers.

Cubicin Pharmacokinetics

See Literature

Cubicin Interactions

Interactions

Consider suspending agents associated with rhabdomyolysis (eg, statins). May cause false prolongation of PT or elevation of INR when certain recombinant thromboplastin reagents are utilized for the assay.

Cubicin Adverse Reactions

Adverse Reactions

Diarrhea, headache, dizziness, rash, abnormal LFTs, elevated CPK, UTIs, hypotension, dyspnea, vomiting, abdominal pain, pruritus, pyrexia, sepsis, bacteremia, chest pain, edema, pharyngolarygeal pain, increased sweating, insomnia, hypertension; hypersensitivity reactions, myopathy, rhabdomyolysis, C. difficile-associated diarrhea.

Cubicin Clinical Trials

See Literature

Cubicin Note

Not Applicable

Cubicin Patient Counseling

See Literature