Daptomycin and Rosuvastatin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Rosuvastatin
Daptomycin
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased risk of myopathy or rhabdomyolysis
Interaction Deep Dive
Both daptomycin and an HMG-CoA reductase inhibitor may cause myopathy1. In a meta-analysis of 7 studies (4548 patients), there was no difference in the incidence of daptomycin-related myopathy in patients treated with daptomycin with or without concomitant statin therapy, however, in a subgroup analysis, the incidence of rhabdomyolysis in the daptomycin plus statin group was significantly higher compared with the daptomycin only group 2. Cases of rhabdomyolysis have been reported with concomitant use of daptomycin and simvastatin 5 or simvastatin/ezetimibe 63. Temporarily discontinue HMG-CoA reductase inhibitors in patients starting daptomycin. In patients who continue on both drugs concomitantly, consider more frequent monitoring of CPK levels, and monitor for symptoms of myopathy. Additionally, monitor CPK more frequently in patients with renal insufficiency or who develop unexplained elevations in CPK. Discontinue daptomycin in patients who develop symptoms of myopathy and CPK elevations of greater than 1000 units/L, or in patients without symptoms who have CPK elevations of greater than 2000 units/L 1.
Why it happens (mechanism)
Additive effects of myopathy
Literature reports
4 reports — tap to read
a) In a meta-analysis of 7 studies (4548 patients), there was no difference in the incidence of daptomycin-related myopathy in patients treated with daptomycin with or without concomitant statin therapy (OR, 1.72; 95% CI, 0.95 to 3.12). In a subgroup analysis, the incidence of rhabdomyolysis in the daptomycin plus statin group was significantly higher compared with the daptomycin only group (OR, 3.83; 95% CI, 1.43 to 10.26). A disproportionality analysis using the US Food and Drug Administration Adverse Events Reporting System (FAERS) to further confirm the results of the meta-analysis confirmed the use of statin did significantly increase the reporting OR (ROR) for daptomycin-related myopathy (ROR, 5.69; 95% CI, 4.31 to 7.51) and rhabdomyolysis (ROR, 5.77; 95% CI, 4.33 to 7.68). Higher daptomycin dosing (8 mg/kg/day or greater) was not associated with increased incidence of daptomycin-related musculoskeletal adverse events compared with standard dosing 2.
b) No symptoms of skeletal myopathy were reported in 10 healthy subjects administered simvastatin and daptomycin 4 mg/kg/day for 14 days in a phase 1, placebo-controlled trial. However, CPK elevations of more than 500 units/L were experienced in 5 out of 22 patients on daptomycin who had received prior or concomitant HMG-CoA reductase inhibitor in a phase 3 Staphylococcus aureus bacteremia/endocarditis trial. In this study, overall, CPK elevations were reported in 6.7% (8/120) of daptomycin-treated patients compared with less than 1% (1/116) of comparator-treated patients 1.
c) Symptoms of rhabdomyolysis and progression of renal failure developed within 16 days of starting daptomycin in a patient on simvastatin and extended-release niacin, with subsequent resolution after discontinuation of daptomycin. The patient with a CrCl of 24.6 mL/min, initially received daptomycin IV 7.2 mg/kg daily with subsequent renal adjustment 4 days later to 7.2 mg/kg every 48 hr. The patient's usual medications included simvastatin (80 mg/day), extended-release niacin (500 mg/day), and esomeprazole (20 mg/day), which were continued during hospitalization. On day 16 of daptomycin therapy, the patient experienced weakness, diffuse aches in the proximal thighs and arms, and had a CPK of 8995 International Units/L. The serum creatinine peaked at 3.4 mg/dL. Within 6 days of stopping daptomycin the serum creatinine returned to baseline and, within 7 days, the CPK concentrations decreased to 125 International Units/L. The patient successfully completed a course of linezolid IV followed by oral minocycline 3.
d) In a case report, myopathy and increased CPK concentration were observed after 15 days of daptomycin therapy in a 73-year-old man who was concurrently receiving rosuvastatin, apixaban, ivabradine, metformin, ginkgo biloba, and trimetazidine. The patients medical history included coronary artery disease, hyperthyroidism, and benign prostatic hyperplasia and he was hospitalized for infective endocarditis. Empirical treatment was started and on day 8 of admission, daptomycin was initiated. On day 23, the CPK concentration was 2416 units/L (baseline 22 units/L on day 2 of admission) with no significant change in renal function and he was experiencing moderate muscle pain and fatigue. A drug interaction was suspected between daptomycin and rosuvastatin which may have caused myopathy and increase in CPK concentrations, therefore both were discontinued and linezolid was started instead of daptomycin. After 3 days, the patient's symptoms improved and after 6 days the CPK levels returned to normal 4.
Common questions
Can I take Daptomycin and Rosuvastatin together?
Increased risk of myopathy or rhabdomyolysis Always confirm with your pharmacist or prescriber before making any change.
How serious is the Daptomycin and Rosuvastatin interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Daptomycin or Rosuvastatin need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (6)
- Product Information: Cubicin(R) IV injection, daptomycin IV injection. Cubist Pharmaceuticals, Inc. Lexington, MA, 2010.
- Chuma M, Nakamoto A, Bando T, et al: Association between statin use and daptomycin-related musculoskeletal adverse events: a mixed approach combining a meta-analysis and a disproportionality analysis. Clin Infect Dis 2022; 75(8):1416-1422. PubMed
- Odero RO, Cleveland KO, & Gelfand MS: Rhabdomyolysis and acute renal failure associated with the co-administration of daptomycin and an HMG-CoA reductase inhibitor. J Antimicrob Chemother 2009; 63(6):1299-1300. DOI
- Durmus M, Bahcecioglu OF, & Gok S: Daptomycin in combination with rosuvastatin induced blood creatine phosphokinase elevation. Eur J Hosp Pharm 2021; 28(4):234-236. PubMed
- Product Information: ZOCOR(R) oral tablets, simvastatin oral tablets. Merck Sharp & Dohme Corp (per manufacturer), Whitehouse Station, NJ, 2019. DailyMed
- Product Information: VYTORIN(R) oral tablets, ezetimibe simvastatin oral tablets. Merck Sharp & Dohme Corp (per manufacturer), Whitehouse Station, NJ, 2019. DailyMed
Keep reading about Rosuvastatin
Keep reading about Daptomycin
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