Drug Index



Mechanism :

Caspofungin acetate inhibits the synthesis of b (1,3)-D-glucan, an essential component of the cell wall of susceptible Aspergillus species and Candida species. b (1,3)-D-glucan is not present in mammalian cells. Caspofungin has shown activity against Candida species and in regions of active cell growth of the hyphae of Aspergillus fumigatus.

Indication :

• Treatment of candidemia and invasive candidiasis.

• Treatment of invasive aspergillosis in patients who are refractory to or intolerant of other therapies.

Contraindications :

Caspofungin is contraindicated in patients with hypersensitivity to any component of this product.

Dosing :

>3 months: Loading dose: 70 mg/sqm/day on day 1, max 70 mg, followed by 50 mg/sqm/day, Max: 50 mg OD.

Duration of treatment should be based on the patients clinical response.

Adverse Effect :

Histamine-mediated symptoms of rash, facial swelling, pruritus, sensation of warmth, or bronchospasm, anaphylaxis.

Interaction :

For patients receiving both therapies, standard monitoring of tacrolimus blood concentrations and appropriate tacrolimus dosage adjustments are recommended.
Cyclosporine (one 4 mg/kg dose or two 3 mg/kg doses): Increased the AUC of caspofungin by approximately 35% There were transient increases in liver ALT and AST when co-administered.
Rifampin: A drug-drug interaction study with rifampin in healthy volunteers has shown a 30% decrease in caspofungin trough concentrations.
Inducers of drug clearance: Co-administration of other inducers of drug clearance (efavirenz, nevirapine, phenytoin, dexamethasone, or carbamazepine) may result in clinically meaningful reductions in caspofungin concentrations. Use of a daily dose of 70 mg should be considered.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<10Dose as in normal renal function

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot dialysed. Dose as in normal renal function
HDNot dialysed. Dose as in normal renal function
HDF/High fluxUnlikely to be dialysed. Dose as in normal renal function
CAV/VVHDNot dialysed. Dose as in normal renal function

Hepatic Dose :

Mild hepatic impairment: No dose adjustment needed.
Moderate hepatic impairment: No change in loading dose needed. Give maintenance dose of 35 mg/sqm/day.
Severer hepatic impairment: No data available.
04/10/2020 10:55:41 Caspofungin
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