Alternate Name(s):
CUBICIN RF
Classification:
Antibiotic, miscellaneous
Original Date:
September 2016
Revised Date:
July 2020
Indications:
- Treatment of susceptible strains of gram positive organisms - generally restricted to treatment of severe infections where there is vancomycin resistance or intolerance, including endocarditis, methicillin-resistant Staph. aureus (MRSA) bacteremia, osteomyelitis or septic arthritis
- Not indicated for the treatment of pneumonia.
Reconstitution and Stability:
- Available as 500 mg lyophilized powder per vial.
- Reconstitute with 10 mL sterile water for injection to make a 50 mg/mL solution. Rotate or swirl the vial for a few minutes to dissolve the contents.
- Reconstituted vial stable for 6 hours.
- Stable in a minibag for up to 24 hours in the refrigerator.
Compatibility:
- Solutions compatible: 0.9% NaCl
- Y-site compatility: (if mixed with 0.9% NaCl) - aztreonam, ceftazidime, ceftriaxone, dopamine, fluconazole, gentamicin, heparin, levofloxacin, lidocaine.
- Incompatible: dextrose solutions
Administration:
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | NO |
| IM | NO |
| IV Direct |
NO
|
|
IV Intermittent Infusion |
YES Doses < 250 mg: Dilute to 5 mg/mL of 0.9%NaCl Doses > 250 mg: Further dilute in 50 mL 0.9%NaCl bag |
| IV Continuous Infusion | NO |
Dosage:
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
Pediatric:
Bacteremia due to susceptible S aureus or vancomycin resistant gram positive infections:
- Age 1 - 6 years: 12 mg/kg/dose q 24 hours
- Age 7 - 11 years: 9 mg/kg/dose q 24 hours
- Age 12 - 17 years: 7 mg/kg/dose q24 hours
Complicated skin and skin structure infections:
- Age 1 - < 2 years: 10 mg/kg/dose q 24 hours
- Age 2 - 6 years: 9 mg/kg/dose q 24 hours
- Age 7 - 11 years: 7 mg/kg/dose q 24 hours
- Age 12 - 17 years: 5 mg/kg/dose q 24 hours
Adult:
- 4 - 10 mg/kg/dose Q24H
Potential hazards of parenteral administration:
- Immediate (within 1-2 days of receiving drug):
- Hypersensitivity or anaphylaxis; nausea, vomiting, diarrhea - Prompt (within 1-3 weeks):
- Myopathy, increase creatine phosphokinase (CPK), rhabdomyolysis (increased risk with renal dysfunction); peripheral neuropathy; C. difficile associated diarrhea, eosinophilic pneumonia, anemia
Notes:
- Infectious diseases service consult required prior to use
- Monitor CPK at baseline and once weekly while on therapy.
- May cause false prolongation of PT & false increase in INR due to potential reaction with some of the reagents. Draw PT or INR just prior to next dose of DAPTOmycin to try to minimize effect.
- Do not use for pneumonia as daptomycin is inactivated by pulmonary surfactants
References:
- Cubicin Product Monograph, accessed October 2019
- Lexi-comp online – accessed March 2018