Co-Administration of Daptomycin with Atorvastatin 40mg

Patient Monitoring and Education

• The American College of Cardiology recommends obtaining baseline CPK before initiating daptomycin in patients already on atorvastatin, with a strength of evidence based on multiple citations 1, 2, 3
• Patients should be educated to immediately report muscle pain, tenderness, weakness, or dark urine when on combination therapy, as recommended by the American College of Cardiology 1, 2, 3

Management of Adverse Events

• If CPK rises >1,000 U/L or ≥10x upper limit of normal with symptoms, the American College of Cardiology recommends discontinuing daptomycin immediately and evaluating for rhabdomyolysis with creatinine and urinalysis for myoglobinuria 3, 4
• In cases of mild-to-moderate muscle symptoms, the American College of Cardiology suggests discontinuing both medications temporarily, evaluating CPK, and assessing for other causes of myopathy 1, 2, 4

Temporary Statin Discontinuation

• The American College of Cardiology recommends considering temporary atorvastatin discontinuation in patients with pre-existing muscle disease or active myopathy, or when multiple additional risk factors are present 1, 2