Daptomycin Drug Interactions You Need to Know About

When you're being treated with Daptomycin (brand name Cubicin) for a serious infection, the last thing you want is a drug interaction making things worse. While Daptomycin has fewer interactions than many antibiotics, there are some important ones — especially with common medications like statins — that you and your doctor need to be aware of.

This guide covers the major and moderate drug interactions for Daptomycin, plus supplements, OTC medications, and what you should tell your doctor before starting treatment.

How Drug Interactions Work

A drug interaction happens when one medication affects how another works. This can happen in several ways:

• Increased toxicity — Two drugs with similar side effects can compound each other, increasing the risk of harm
• Changed drug levels — One drug may increase or decrease the blood levels of another
• Reduced effectiveness — One drug may interfere with another's ability to work properly

With Daptomycin, the most important interactions involve medications that also affect muscles or kidneys — since those are the areas where Daptomycin carries the most risk.

Major Drug Interactions

Statins (HMG-CoA Reductase Inhibitors)

This is the most clinically significant interaction with Daptomycin. Statins — medications used to lower cholesterol — carry their own risk of muscle damage (myopathy). When combined with Daptomycin, which also causes muscle toxicity, the risk is compounded.

Affected medications include:

• Atorvastatin (Lipitor)
• Simvastatin (Zocor)
• Rosuvastatin (Crestor)
• Lovastatin (Mevacor)
• Pravastatin (Pravachol)
• Fluvastatin (Lescol)
• Pitavastatin (Livalo)

What to do: Your doctor should temporarily stop your statin during Daptomycin therapy. This is a standard recommendation. Once you finish the antibiotic course, your statin can be restarted. Do not stop your statin on your own — always discuss with your doctor first.

Tobramycin

Tobramycin is an aminoglycoside antibiotic sometimes used alongside other antibiotics for serious infections. Studies suggest it may increase Daptomycin blood levels, potentially raising the risk of side effects.

What to do: If both medications are needed, your doctor will monitor you closely with more frequent lab work, including CPK and kidney function tests.

Moderate Drug Interactions

Warfarin (Coumadin)

Warfarin is a blood thinner used to prevent blood clots. While Daptomycin doesn't have a strong direct interaction with Warfarin, some case reports suggest changes in INR (a measure of blood clotting) during Daptomycin therapy.

What to do: Your doctor should monitor your INR more frequently while you're receiving Daptomycin. Dose adjustments to Warfarin may be needed.

Other Nephrotoxic Agents

Any medication that can harm the kidneys may increase your risk of renal impairment when combined with Daptomycin. Common nephrotoxic drugs include:

• NSAIDs — Ibuprofen (Advil, Motrin), Naproxen (Aleve)
• Aminoglycosides — Gentamicin, Tobramycin, Amikacin
• Vancomycin — Another antibiotic for gram-positive infections
• ACE inhibitors and ARBs — Blood pressure medications like Lisinopril or Losartan (in combination with other risk factors)
• Contrast dye — Used in CT scans and other imaging

What to do: Your doctor should monitor kidney function regularly during treatment. Stay well hydrated to support kidney health.

Cholera Vaccine (Live)

Systemic antibiotics, including Daptomycin, can interfere with the live cholera vaccine and should not be given at the same time.

Supplements and OTC Medications to Watch

While Daptomycin has no significant food interactions (since it's given IV, not orally), there are some supplements and OTC products to be aware of:

• Red yeast rice — Contains naturally occurring statins (monacolin K) and should be avoided during Daptomycin therapy for the same reasons as prescription statins
• Creatine supplements — May artificially elevate CPK levels, making it harder to monitor for Daptomycin-related muscle toxicity
• NSAIDs (Ibuprofen, Naproxen) — Can stress the kidneys; use Acetaminophen (Tylenol) instead for pain relief during treatment, unless your doctor says otherwise
• Coenzyme Q10 (CoQ10) — Sometimes taken alongside statins; discuss with your doctor whether to continue during Daptomycin treatment

Food and Drink Interactions

Because Daptomycin is administered intravenously, there are no significant food or drink interactions. You don't need to worry about taking it with or without food, avoiding grapefruit, or timing meals around your infusion.

However, general health recommendations during IV antibiotic therapy include:

• Stay hydrated — Drink plenty of water to support kidney function
• Avoid excessive alcohol — Alcohol can stress the liver and kidneys and may interfere with your body's ability to fight infection
• Eat a balanced diet — Good nutrition supports immune function and recovery

What to Tell Your Doctor Before Starting Daptomycin

Before your first dose of Daptomycin, make sure your doctor knows about:

1. All prescription medications — Especially statins, blood thinners, and other antibiotics
2. Over-the-counter medications — Including NSAIDs, antacids, and cold medicines
3. Supplements and vitamins — Especially red yeast rice, creatine, and CoQ10
4. Kidney problems — Current or past kidney disease, as this affects dosing
5. Muscle disorders — Any history of myopathy, rhabdomyolysis, or elevated CPK
6. Allergies — Any known drug allergies, especially to antibiotics
7. Pregnancy or breastfeeding — Daptomycin is Pregnancy Category B; discuss risks and benefits

For more about side effects to watch for during treatment, see our guide on Daptomycin side effects.

Final Thoughts

Daptomycin has a relatively manageable interaction profile compared to many antibiotics, but the statin interaction is one you absolutely need to know about. The key takeaway: tell your doctor about every medication and supplement you take, and don't skip your weekly CPK blood draws during treatment.

If you need help finding Daptomycin at a pharmacy, Medfinder can show you which locations have it in stock near you.