From the Guidelines
Yes, Daptomycin can cause rhabdomyolysis.
Rhabdomyolysis Risk with Daptomycin
- The risk of rhabdomyolysis is associated with elevated creatinine phosphokinase (CPK) levels, which have been observed in patients receiving 6 mg/kg/day of daptomycin, but not in those receiving 4 mg/kg/day 1.
- Patients should be monitored for muscle pain or weakness and have weekly CPK levels determined, with more frequent monitoring in those with renal insufficiency or who are receiving concomitant statin therapy 1.
- It is recommended that statins be stopped, if possible, while administering daptomycin to minimize the risk of rhabdomyolysis 1.
- Monitoring for daptomycin toxicity, including rhabdomyolysis, neuropathy, and eosinophilic pneumonia, is important 1.
From the FDA Drug Label
- 2 Myopathy and Rhabdomyolysis Myopathy, defined as muscle aching or muscle weakness in conjunction with increases in creatine phosphokinase (CPK) values to greater than 10 times the upper limit of normal (ULN), has been reported with the use of daptomycin for injection. Rhabdomyolysis, with or without acute renal failure, has been reported [see Adverse Reactions (6. 2)] .
Yes, Daptomycin can cause rhabdomyolysis, as stated in the drug label 2. Patients receiving daptomycin should be monitored for the development of muscle pain or weakness, and CPK levels should be monitored weekly.
From the Research
Daptomycin and Rhabdomyolysis
- Daptomycin is associated with an increased risk of rhabdomyolysis, a serious complication characterized by muscle breakdown and release of muscle fibers into the bloodstream 3, 4, 5, 6, 7.
- Studies have reported that daptomycin can cause elevations in serum creatine kinase (CK) levels, a marker of muscle damage, and in some cases, lead to frank rhabdomyolysis 3, 5, 6, 7.
- The risk of rhabdomyolysis with daptomycin is increased in patients with certain risk factors, such as obesity, older age, and concomitant use of statins 3, 4.
Incidence of Rhabdomyolysis with Daptomycin
- The incidence of rhabdomyolysis with daptomycin has been reported to be around 0.8% to 5.5% of patients treated with the antibiotic 3, 4.
- A study using the FDA Adverse Event Reporting System (FAERS) found that daptomycin had the greatest proportion of rhabdomyolysis reports among all antibiotics, with a reporting odds ratio (ROR) of 17.94 (95% CI: 14.08-22.85) 4.
Clinical Presentation and Management
- Patients with daptomycin-induced rhabdomyolysis may present with elevated CK levels, muscle weakness, and renal impairment 5, 6, 7.
- Management of daptomycin-induced rhabdomyolysis typically involves discontinuation of the antibiotic and supportive care, including hydration and monitoring of renal function 5, 6, 7.
- In some cases, patients may require temporary discontinuation of statins or other medications that may exacerbate muscle damage 3.