Daptomycin (Cubicin)_Dosage, benefits & legal status
Also known as Cubicin, Cubicin RF, LY146032, MK-3009
An approved IV antibiotic that collapses bacterial membranes, and proof that an antimicrobial peptide can become a mainstream drug.
Common vial size is what vendors typically sell, not a recommendation. Enter your own vial in the calculator.
What is Daptomycin (Cubicin)?
Plain language first. The technical label stays, but it never stands alone.Overview
It binds the membranes of Gram-positive bacteria such as MRSA, drains their electrical charge and kills them. It is given into a vein once a day for complicated skin infections and Staphylococcus aureus bloodstream infections. It does not work for pneumonia.
Daptomycin is a 13-amino-acid ring-and-tail molecule with a ten-carbon fatty acid on the front, made by the soil bacterium Streptomyces roseosporus. Lilly found it in the 1980s, Cubist developed it, and the FDA approved it as Cubicin in 2003; Merck owns the brand. Drugs@FDA now lists the brand as discontinued in the US, while generics are widely sold.
What it's used for
A prescription IV antibiotic for complicated skin infections and S. aureus bloodstream infections, including MRSA. Muscle enzymes are checked weekly.
How does Daptomycin (Cubicin) work?
What it does in the body, and where.Daptomycin is built by a bacterial enzyme assembly line, not a ribosome: thirteen amino acids, three of them D-forms and three non-standard, with a ten-residue lactone ring and a decanoyl fatty acid on the front.
- 01Membrane bindingThe US label says it binds bacterial cell membranes and causes rapid depolarisation. The EU label adds that it needs calcium ions to bind.
- 02ShutdownLosing membrane potential stops DNA, RNA and protein synthesis, and the cell dies with little bursting. It works on Gram-positive bacteria only.
- 03Not in the lungsLung surfactant binds and inactivates it; a 2005 study linked this to its failure in pneumonia trials.
A schematic of the compound's mechanism, not a diagnostic image.
What else is it used for?
Each group carries its own evidence level.Approved means regulators have cleared it for that purpose. Investigational means it is in trials. Early research means it is being studied and is not established.
Bloodstream infection
FDA-approved- Human trial246 adults, open-label: success 44.2% against 41.7%; MRSA 44% against 32%, MSSA 45% against 49%.
- Human trialPersisting or relapsing infection in 16% on daptomycin against 10% on comparators, some with rising MICs.
Pneumonia
tested-and-failed- Human trialPhase 3 community-acquired pneumonia trials failed, with higher death and cardiorespiratory event rates on daptomycin.
- Lab studyLung surfactant inhibited it in lab tests.
It is not a pneumonia drug: both labels say so, and eosinophilic pneumonia is a side effect, not a use. 'Calcium-dependent membrane insertion' is EU and research wording; the US label says only that it binds membranes and depolarises them. Its ring is ten amino acids, not ten atoms. Older drawings show residue 2 as L-asparagine; it was reassigned to D-asparagine in 2005. Sources differ on why Lilly dropped it: poor results with twice-daily dosing, or muscle effects in animals. The Cubicin brand is listed as discontinued in the US, while generics are sold.
The published record
Papers and trials about Daptomycin (Cubicin)
328 papers tagged human · 170 not reviews or lab · 15 clinical trial publications
122 registered trials · 33 with posted results
Furthest stage reached: Approved in the US
Counted from Europe PMC indexing, not read by a person; a human tag can land on reviews, commentary or lab papers; clinical trial publications is the narrower count. 500 papers and 100 trials indexed in detail.
At a glance
Four things to know about Daptomycin (Cubicin)
Evidence
FDA-approved
Category
Immune support
Common vial
Varies
Half-life
About 8 hours
How much, and do you cycle it?
The range, and whether you take breaks.4 to 6 mg/kg once daily (adults, label), once daily. A course of treatment FDA label
7 to 14 days for skin infections and 2 to 6 weeks for bloodstream infections, like any antibiotic course.
About 8 hoursFDA label
Adults at steady state across 4 to 12 mg/kg. 90 to 93% bound to plasma proteins; about 78% of a dose leaves in urine. Shorter in children (4.6 to 7.5 hours) and longer in kidney impairment.
Source: Cubicin prescribing information section 12.3
You can compare this against the whole library to see where it sits.
How do I dose and price it?
Enter your vial and your dose. Pick a mix. We show the draw and the cost.The vial holds a fixed amount of drug. Adding more water does not make more drug, it just spreads it thinner, so you draw a bigger number on the syringe for the same dose.
Adults: 4 mg/kg once daily for 7 to 14 days for complicated skin infections, or 6 mg/kg once daily for 2 to 6 weeks for S. aureus bloodstream infections, as a 2-minute injection or 30-minute infusion. Children aged 1 to 17 receive 5 to 12 mg/kg by age band as an infusion only. Every 48 hours below a creatinine clearance of 30 or on dialysis. A hospital drug dosed by weight, so no vial draw applies.
How do you store it?
Before mixing, and after.Dry powder in the freezer or fridge. Once mixed, fridge, and use within about a month.
Unmixed lyophilized Daptomycin (Cubicin) keeps for a long time cold. Once you add water the clock starts: most reconstituted vials hold up for roughly 28 to 30 days at fridge temperature. Keep it out of light, and do not freeze it after mixing.
What are the side effects and cautions?
Known cautions and warnings for this compound.Solubility, computed: 54% charged residues, 23% hydrophobic. Water usually sufficient.
A first-pass rule from peptide manufacturers' guidance. It does not account for disulfide bridges, salt form or how the powder was dried, and it predicts what should be easy rather than what will happen in your vial.
Who should avoid it
- Known allergy to daptomycin
- Pneumonia: not effective, because lung surfactant inactivates it
- Children under 12 months: not recommended
- Statins: consider pausing them, since both can damage muscle
- Kidney impairment: trial success was lower in moderate impairment, and the dose is given every 48 hours below a creatinine clearance of 30
Stop and get help
- Muscle pain or weakness, especially with dark urine
- New fever, cough or breathlessness, typically 2 to 4 weeks in, a possible eosinophilic pneumonia
- A spreading rash with fever or swollen glands (DRESS)
- Numbness or tingling in the hands or feet
Common effects
- Diarrhoea 5%, headache 5% and rash 4% in skin-infection trials, similar to comparators
- Raised CPK in 7% against 1% in the bloodstream-infection trial
- Insomnia, sore throat, chest pain and swelling in 7 to 9% of bloodstream-infection patients
- Stopped for side effects in under 3% (skin) and about 17% (bloodstream, similar to the comparator)
Where this page says nothing is established, that means nobody has studied it, not that a compound is safe.
Is Daptomycin (Cubicin) approved?
And where the numbers on this page come from.Yes. Daptomycin (Cubicin) is FDA approved and available on prescription in the United States. It is also approved in the European Union.
- Approval statusFDA-approved
- RouteInto a vein (2-minute injection or 30-minute infusion)
- Checked12 October 2026
- Approved outside the USEuropean Union: Authorised in the EU on 19 January 2006 (EMEA/H/C/000637), holder Merck Sharp & Dohme, including right-sided infective endocarditis in adults. Also approved in the US.This does not change the United States position above.
- DoseFrom the drug label. The manufacturer tested this range and a regulator reviewed it.
- Vial sizeFrom what vendors typically list; not a recommendation.
- SourcesCubicin prescribing information (revised 5/2025)Cubicin prescribing information (2016), bloodstream infection trialCubicin RF prescribing information (DailyMed, revised 3/2025)Fowler VG et al., New England Journal of Medicine 2006;355:653-665Arbeit RD et al., Clinical Infectious Diseases 2004;38:1673-1681Silverman JA et al., Journal of Infectious Diseases 2005;191:2149-2152Miao V et al., Microbiology 2005;151:1507-1523Drugs@FDA, NDA 021572EMA, Cubicin EPAR
What has happened recently
FDA-approved on 12 September 2003 (NDA 021572) as a new molecular entity with priority review; S. aureus bloodstream infections were added in 2006 and children in 2017. A sucrose reformulation, Cubicin RF, was approved in 2016. Generic daptomycin launched in the US from 2016 after the main patent expired; Drugs@FDA now lists the Cubicin brand products as discontinued, and DailyMed lists Merck's Cubicin RF as export only. The EU authorised Cubicin on 19 January 2006 (Merck Sharp & Dohme).
You can compare this against the whole library, or read how to check a seller.
What else is like Daptomycin (Cubicin)?
Others in Immune support, side by side.If you're weighing Daptomycin (Cubicin), it's worth reading Dynobactin A, Enfuvirtide (Fuzeon), and Icatibant (Firazyr) in the same class.
An approved IV antibiotic that collapses bacterial membranes, and proof that an antimicrobial peptide can become a mainstream drug.
- Dose
- 4 to 6 mg/kg once daily (adults, label)
- How often
- Once daily
An experimental peptide antibiotic against Gram-negative bacteria, found by computer and tested only in mice.
- Dose
- No human dose; mouse dose not retrieved
- How often
- Not established
A pioneering anti-HIV peptide that stops the virus fusing with cells, now discontinued in the US.
- Dose
- 90 mg twice daily (label)
- How often
- Twice daily
A self-injected decapeptide for acute swelling attacks in hereditary angioedema, generic in the US since 2019.
- Dose
- 30 mg per attack (label)
- How often
- As needed, up to 3 doses in 24 hours
Guides for this compound
- How to Reconstitute a Peptide
Mix peptide powder with bacteriostatic water, step by step.
- How to Read an Insulin Syringe
Read the units, convert to millilitres, and draw the exact dose.
- mcg vs mg: The Peptide Dosing Mistake to Avoid
Your vial says mg and your protocol says mcg. Here is the conversion and how to check it.
Sources
- Cubicin prescribing information (revised 5/2025)(2025)Cyclic lipopeptide from Streptomyces roseosporus, C72H101N17O26, MW 1620.67. Skin-infection trials: success matched comparators. Half-life 7.7 to 8.3 hours. Not indicated for pneumonia. Warnings for myopathy, eosinophilic pneumonia, DRESS and neuropathy.
- Cubicin prescribing information (2016), bloodstream infection trial(2016)246 adults with S. aureus bacteraemia: success 44.2% against 41.7% at 6 weeks after treatment; persisting or relapsing infection 16% against 10%.
- Cubicin RF prescribing information (DailyMed, revised 3/2025)(2025)Adult and paediatric dosing by indication and age; every 48 hours in severe kidney impairment.
- Fowler VG et al., New England Journal of Medicine 2006;355:653-665(2006)Daptomycin non-inferior to standard therapy for S. aureus bacteraemia and right-sided endocarditis; clinically significant kidney dysfunction 11.0% against 26.3%.
- Arbeit RD et al., Clinical Infectious Diseases 2004;38:1673-1681(2004)1,092 patients with complicated skin infections: clinical success 83.4% against 84.2% in evaluable patients.
- Silverman JA et al., Journal of Infectious Diseases 2005;191:2149-2152(2005)Daptomycin failed non-inferiority in severe community-acquired pneumonia; pulmonary surfactant inhibited it.
- Miao V et al., Microbiology 2005;151:1507-1523(2005)Non-ribosomal peptide synthetase gene cluster in S. roseosporus; residue 2 reassigned as D-asparagine.
- Drugs@FDA, NDA 021572(2026)Approved 12 September 2003; bacteraemia added 2006; Cubicin RF 2016. Brand products now listed as discontinued, not for safety or effectiveness reasons.
- EMA, Cubicin EPAR(2026)Authorised 19 January 2006; holder Merck Sharp & Dohme.
Beyond these, 600 records are indexed. Browse the records