Daptomycin and Myopathy

A is getting daptomycin outpatient for MRSA endocarditis. After 2 weeks, he has muscle pain and CK= 500. Daptomycin is stopped. What home medication could have increased his risk of myopathy and rhabdomyolysis?

A) Amlodipine
B) Apixaban
C) Atorvastatin
D) All of the above

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Best Answer

Atorvastatin

Explanation: BOTH daptomycin and statins can increase risk of myopathy and when used in combination, risk will ⬆️ compared to using either drug alone. So should we hold statins when treating patients with daptomycin? 🤔

Potentially! If regular CK monitoring is not feasible, clinicians should consider holding the statin while on daptomycin therapy. If a patient can get regular CK levels and self-monitor for symptoms, benefit of continuing both drugs may outweigh risk ⚖️

Monitoring for and mitigating risk of drug interactions should always be part of choosing an optimal antibiotic plan!