Daptomycin Administration Method
Daptomycin is NOT typically given as an IV push in adults; it is administered as a 30-minute IV infusion, though a 2-minute IV injection is FDA-approved as an alternative for adults only. 1
Standard Administration in Adults
The preferred method is a 30-minute IV infusion after reconstituting daptomycin to 50 mg/mL and diluting in 50 mL of 0.9% sodium chloride 1
A 2-minute IV injection is an FDA-approved alternative for adults, where the reconstituted solution (50 mg/mL) can be administered directly without further dilution 1
The 2-minute injection option provides convenience for outpatient settings and once-daily dosing regimens 2, 3
Critical Pediatric Distinction
In pediatric patients (1-17 years), daptomycin must NEVER be given as a 2-minute injection 1
Children 1-6 years require a 60-minute infusion (infusion rate 0.42 mL/minute) 1
Children 7-17 years require a 30-minute infusion (infusion rate 1.67 mL/minute) 1
Important Safety Consideration
A documented case of erythroderma (red man syndrome-like reaction) occurred with 2-minute IV push administration, presenting as facial flushing, neck redness, and warm sensation approximately 2 hours post-infusion 4
When the same patient received daptomycin as a 30-40 minute infusion instead, no adverse reactions occurred 4
This suggests that while the 2-minute push is FDA-approved, the slower 30-minute infusion may be safer and better tolerated 4
Practical Recommendation
While technically approved for 2-minute administration in adults, the 30-minute infusion should be considered the standard approach to minimize infusion-related reactions, with the 2-minute option reserved for situations where rapid administration is specifically needed 1, 4. The term "IV push" is misleading—even the rapid option takes 2 minutes, not seconds.