What is a Patient Information Leaflet and why is it useful?

The Patient Information Leaflet (PIL) is the leaflet included in the pack with a medicine. It is written for patients and gives information about taking or using a medicine. It is possible that the leaflet in your medicine pack may differ from this version because it may have been updated since your medicine was packaged.

Below is a text only representation of the Patient Information Leaflet. The original leaflet can be viewed using the link above.

The text only version may be available in large print, Braille or audio CD. For further information call emc accessibility on 0800 198 5000. The product code(s) for this leaflet is: PL 08553/0581.


Daptomycin Dr. Reddy's 350 mg & 500 mg Powder for Solution for Injection/Infusion

Package leaflet: Information for the patient

Daptomycin 350 mg Powder for Solution for Injection/Infusion

Daptomycin 500 mg Powder for Solution for Injection/Infusion

daptomycin

Read all of this leaflet carefully before you start using this medicine because it contains important information for you.

  • Keep this leaflet. You may need to read it again.
  • If you have any further questions, ask your doctor or nurse.
  • This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
  • If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet

1. What Daptomycin is and what it is used for
2. What you need to know before you are given Daptomycin
3. How Daptomycin is given
4. Possible side effects
5. How to store Daptomycin
6. Contents of the pack and other information

1. What Daptomycin is and what it is used for

The active substance in Daptomycin powder for solution for injection/infusion is daptomycin. Daptomycin is an antibacterial that can stop the growth of certain bacteria. Daptomycin is used in adults and in children and adolescents (age from 2 to 17 years) to treat infections of the skin and the tissues below the skin. It is also used in adults to treat infections in the tissues that line the inside of the heart (including heart valves) which are caused by a bacterium called Staphyloccocus aureus and to treat infections in the blood caused by the same bacterium when associated with skin or heart infection.

Depending on the type of infection(s) that you have, your doctor may also prescribe other antibacterials while you are receiving treatment with Daptomycin.

2. What you need to know before you are given Daptomycin

You should not be given Daptomycin

  • if you are allergic to daptomycin or to sodium hydroxide or to any of the other ingredients of this medicine (listed in section 6).

If this applies to you, tell your doctor or nurse. If you think you may be allergic, ask your doctor or nurse for advice.

Warnings and precautions

Talk to your doctor or nurse before you are given Daptomycin:

  • if you have, or have previously had kidney problems. Your doctor may need to change the dose of Daptomycin (see section 3 of this leaflet)
  • occasionally, patients receiving Daptomycin may develop tender or aching muscles or muscle weakness (see section 4 of this leaflet for more information). If this happens tell your doctor. Your doctor will make sure you have a blood test and will advise whether or not to continue with Daptomycin. The symptoms generally go away within a few days of stopping Daptomycin
  • if you are very overweight. There is a possibility that your blood levels of Daptomycin could be higher than those found in persons of average weight and you may need careful monitoring in case of side effects.

If any of these applies to you, tell your doctor or nurse before you are given Daptomycin.

Tell your doctor straight away if you develop any of the following symptoms:

  • serious, acute allergic reactions have been observed in patients treated with nearly all antibacterial agents, including Daptomycin. Tell a doctor or a nurse straight away if you experience symptoms suggestive of allergic reaction, such as wheezing, difficulty breathing, swelling of the face, neck and throat, rashes and hives, fever (see section 4 of this leaflet for more information)
  • any unusual tingling or numbness of the hands or feet, loss of feeling or difficulties with movements. If this happens, tell your doctor who will decide whether you should continue the treatment
  • diarrhoea, especially if you notice blood or mucus, or if diarrhoea becomes severe or persistent
  • new or worsening fever, cough or difficulty breathing. These may be signs of a rare but serious lung disorder called eosinophilic pneumonia. Your doctor will check the condition of your lungs and decide whether or not you should continue Daptomycin treatment.

Daptomycin may interfere with laboratory tests that measure how well your blood is clotting. The results can suggest poor blood clotting when, in fact, there is no problem. Therefore it is important that your doctor takes into account that you are receiving Daptomycin. Please inform your doctor that you are on treatment with Daptomycin.

Your doctor will perform blood tests to monitor the health of your muscles both before you start treatment and frequently during treatment with Daptomycin.

Children and adolescents

Daptomycin should not be administered to children below one year of age as studies in animals have indicated that this age group may experience severe side effects.

Use in elderly

People over the age of 65 can be given the same dose as other adults, provided their kidneys are working well.

Other medicines and Daptomycin

Tell your doctor or nurse if you are taking, have recently taken or might take any other medicines. It is particularly important that you mention the following:

  • medicines called statins or fibrates (to lower cholesterol) or ciclosporin (a medicinal product used in transplantation to prevent organ rejection or for other conditions, e.g. rheumatoid arthritis or atopic dermatitis). It is possible that the risk of side effects affecting the muscles may be higher when any of these medicines (and some others that can affect muscles) is taken during treatment with Daptomycin. Your doctor may decide not to give you Daptomycin or to stop the other medicine for a while
  • pain killing medicines called non-steroidal anti-inflammatory drugs (NSAIDs) or COX-2 inhibitors (e.g. celecoxib). These could interfere with the effects of Daptomycin in the kidney
  • oral anti-coagulants (e.g. warfarin), which are medicines that prevent blood from clotting. It may be necessary for your doctor to monitor your blood clotting times.

Pregnancy and breast-feeding

Daptomycin is not usually given to pregnant women. If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before you are given this medicine.

Do not breast-feed if you are receiving Daptomycin, because it may pass into your breast milk and could affect the baby.

Driving and using machines

Daptomycin has no known effects on the ability to drive or use machines.

3. How Daptomycin is given

Daptomycin will usually be given to you by a doctor or a nurse.

The dose will depend on how much you weigh and the type of infection being treated. The usual dose for adults is 4 mg for every kilogram (kg) of body weight once daily for skin infections or 6 mg for every kg of body weight once daily for a heart infection or a blood infection associated with skin or heart infection. In adult patients, this dose is given directly into your blood stream (into a vein), either as an infusion lasting about 30 minutes or as an injection lasting about 2 minutes. The same dose is recommended in people aged over 65 years provided their kidneys are working well.

Children and adolescents (2 to 17 years of age)

The dose for children and adolescents (2 to 17 years of age) being treated for skin infection will depend on the age of patient. The recommended doses based on age are shown below:

For age group 12 to 17 years, a dose of 5 mg/kg should be administered once every 24 hours infused over 30 minutes for up to 14 days.

For age group 7 to 11 years, a dose of 7 mg/kg should be administered once every 24 hours infused over 30 minutes for up to 14 days.

For age group 2 to 6 years, a dose of 9 mg/kg should be administered once every 24 hours infused over 60 minutes for up to 14 days.

If your kidneys do not work well, you may receive Daptomycin less often, e.g. once every other day. If you are receiving dialysis, and your next dose of Daptomycin is due on a dialysis day, you will be usually given Daptomycin after the dialysis session.

A course of treatment usually lasts for 1 to 2 weeks for skin infections. For blood or heart infections and skin infections your doctor will decide how long you should be treated.

Detailed instructions for use and handling are given at the end of the leaflet.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

The most serious side effects are described below:

Very rare serious side effects (may affect up to 1 in 10,000 people)

A hypersensitivity reaction (serious allergic reaction including anaphylaxis, angioedema, drug rash with eosinophilia and systemic symptoms (DRESS)) has been reported in some cases during administration of Daptomycin. This serious allergic reaction needs immediate medical attention. Tell your doctor or nurse straight away if you experience any of the following symptoms:

  • chest pain or tightness
  • rash with blistering, sometimes affecting the mouth and genitals
  • swelling around throat
  • rapid or weak pulse
  • wheezing
  • fever
  • shivering or trembling
  • hot flushes
  • dizziness
  • fainting
  • metallic taste

Tell your doctor straight away if you experience unexplained muscle pain, tenderness, or weakness. In very rare cases (reported in less than 1 in every 10,000 patients), muscle problems can be serious, including muscle breakdown (rhabdomyolysis), which can result in kidney damage.

Serious side effects with frequency not known (frequency cannot be estimated from the available data)

A rare but potentially serious lung disorder called eosinophilic pneumonia has been reported in patients given Daptomycin, mostly after more than 2 weeks of treatment. The symptoms can include difficulty breathing, new or worsening cough, or new or worsening fever. If you experience these symptoms, tell your doctor or nurse straight away.

If you experience raised or fluid-filled skin spots over a large area of your body, tell your doctor or nurse straight away.

The most frequently reported side effects are described below:

Common side effects (may affect up to 1 in 10 people)

  • fungal infections such as thrush
  • urinary tract infection
  • decreased number of red blood cells (anaemia)
  • dizziness, anxiety, difficulty in sleeping
  • headache
  • fever, weakness (asthenia)
  • high or low blood pressure
  • constipation, abdominal pain
  • diarrhoea, feeling sick (nausea) or being sick (vomiting)
  • flatulence
  • abdominal swelling or bloating
  • skin rash or itching
  • pain, itchiness or redness at the site of infusion
  • pain in arms or legs
  • blood testing showing higher levels of liver enzymes or creatine phosphokinase (CPK)

Other side effects which may occur following Daptomycin treatment are described below:

Uncommon side effects (may affect up to 1 in 100 people)

  • blood disorders (e.g increased number of small blood particles called platelets, which may increase the tendency for blood clotting, or higher levels of certain types of white blood cells)
  • decreased appetite
  • tingling or numbness of the hands or feet, taste disturbance
  • trembling
  • changes in heart rhythm, flushes
  • indigestion (dyspepsia), inflammation of the tongue
  • itchy rash of skin
  • muscle pain, cramping, or weakness, inflammation of the muscles (myositis), joint pain
  • kidney problems
  • inflammation and irritation of the vagina
  • general pain or weakness, tiredness (fatigue)
  • blood test showing increased levels of blood sugar, serum creatinine, myoglobin, or lactate dehydrogenase (LDH), prolonged blood clotting time or imbalance of salts
  • itchy eyes.

Rare side effects (may affect up to 1 in 1,000 people)

  • yellowing of the skin and eyes
  • prothrombin time prolonged

Frequency not known (frequency cannot be estimated from the available data)

Antibacterial-associated colitis, including pseudomembranous colitis (severe or persistent diarrhoea containing blood and/or mucus, associated with abdominal pain or fever), easy bruising, bleeding gums, or nosebleeds.

Reporting of side effects

If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme, website www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.

5. How to store Daptomycin

Keep this medicine out of the sight and reach of children.

Store in a refrigerator (2°C-8°C).

After reconstitution: Chemical and physical in-use stability of the reconstituted solution in the vial has been demonstrated for 12 hours at 25°C and up to 48 hours at 2°C-8°C. Chemical and physical stability of the diluted solution in infusion bags is established as 12 hours at 25°C or 24 hours at 2°C-8°C.

For the 30-minute intravenous infusion, the combined storage time (reconstituted solution in vial and diluted solution in infusion bag; see section 6.6) at 25°C must not exceed 12 hours (or 24 at 2°C-8°C).

For the 2-minute intravenous injection, the storage time of the reconstituted solution in the vial (see section 6.6) at 25°C must not exceed 12 hours (or 48 at 2°C-8°C).

However, from a microbiological point of view the product should be used immediately. No preservative or bacteriostatic agent is present in this product. If not used immediately, in-use storage times are the responsibility of the user and would not normally be longer than 24 hours at 2°C-8°C, unless reconstitution/dilution has taken place in controlled and validated aseptic conditions.

Do not use this medicine after the expiry date which is stated on the carton and label after EXP. The expiry date refers to the last day of that month.

Do not use this medicine if you notice visible signs of deterioration.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What Daptomycin contains

The active substance is daptomycin.

Daptomycin 350 mg: One vial of powder contains 350 mg daptomycin. One ml provides 50 mg of daptomycin after reconstitution with 7 ml of sodium chloride 9 mg/ml (0.9%) solution.

Daptomycin 500 mg: One vial of powder contains 500 mg daptomycin. One ml provides 50 mg of daptomycin after reconstitution with 10 ml of sodium chloride 9 mg/ml (0.9%) solution.

The other ingredient is sodium hydroxide.

What Daptomycin looks like and contents of the pack

Daptomycin powder for solution for injection/infusion is supplied as a pale yellow to light brown cake or powder in a glass vial. It is mixed with a solvent to form a liquid before it is administered.

Daptomycin is available in packs containing 1 vial.

Marketing Authorisation Holder and Manufacturer

Dr. Reddy’s Laboratories (UK) Ltd.
6 Riverview Road
Beverley
East Yorkshire
HU17 0LD
United Kingdom

This leaflet was last revised in 07/2018