Daptomycin Pharmacology

Real Life Pharmacology - Pharmacology Education for Health Care Professionals

Eric Christianson, PharmD; Pharmacology Expert and Clinical Pharmacist

Education, Health & Fitness, Medicine

5 • 716 Ratings

🗓️ 16 October 2025

⏱️ 15 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode of Real Life Pharmacology, we take a deep dive into daptomycin, a lipopeptide antibiotic primarily used for serious Gram-positive infections, including MRSA and VRE. Daptomycin works by binding to bacterial cell membranes in a calcium-dependent manner, causing rapid depolarization and cell death.

One key limitation is that daptomycin should never be used for pneumonia because pulmonary surfactant inactivates the drug. Clinically, it’s often reserved for bacteremia, endocarditis, or complicated skin and soft tissue infections.

From a pharmacokinetic standpoint, daptomycin is given intravenously and primarily eliminated unchanged by the kidneys, so dose adjustments are necessary in renal impairment.

Monitoring creatine kinase (CK) levels is crucial, as one of the major adverse effects is myopathy and, rarely, rhabdomyolysis. Patients on statins have a higher risk of muscle toxicity, and clinicians should consider holding or monitoring statin therapy closely.

Eosinophilic pneumonia is another rare but serious adverse reaction that can develop after prolonged therapy. Daptomycin has minimal drug interactions, making it an appealing option when other agents pose risks. Overall, it’s a powerful antibiotic when used appropriately, but requires careful monitoring for muscle and respiratory-related side effects.

Transcript

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0:00.0	Hey, all, welcome back to the real-life pharmacology podcast. I'm your host, pharmacist, Eric Christensen.
0:05.9	Thank you so much for listening today. Uh, the drug of the day today is going to be
0:10.4	Daptimicin. Uh, before we get into that, make sure to go check out real life pharmacology.com.
0:17.8	We've got a free 31 page PDF for subscribers.
0:21.7	Simply an email, we'll get you access to that.
0:24.0	So go take advantage of that for sure.
0:26.8	There's tons of stuff in there that I've seen in clinical practice,
0:31.7	as well as a lot of common things that show up on pharmacology exams
0:36.9	and board exams throughout your career.
0:38.7	So definitely go take advantage of that.
0:41.6	31 page PDF on the top 200 drugs.
0:45.3	All right, the drug of the day today, as I alluded to, is Daptomycin.
0:49.7	Brand name of this medication is Cubison.
0:53.5	This is an antibiotic for infection. It's classified as a cyclic
1:00.2	lipopeptide antibiotic. Mechanistically, this medication causes calcium-dependent depolarization of the bacterial cell membrane.
1:14.4	And this is more specific to gram-positive bacteria.
1:21.5	So that's primarily what Daptimicin is going to focus on and obviously be helpful in treating.
1:31.1	So by essentially inserting itself into that bacterial cell membrane, this generates an ion
1:39.6	conducting channel that interrupts or disrupts the integrity of that bacterial cell membrane.
1:48.7	This causes intracellular components to be released, such as potassium, causes that depolarization,
1:57.6	and ultimately can kill, disrupt the bacteria.
2:03.8	Okay, so as I alluded to, gram-positive organisms in clinical practice,
	...

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