Classifications: antibiotic; echinocandin antifungal; Therapeutic: antifungal antibiotic
Pregnancy Category: C
50 mg and 70 mg powder for injection
Caspofungin is an antifungal agent that inhibits the synthesis of an integral component of the fungal cell wall of susceptible
Interferes with reproduction and growth of susceptible fungi.
Treatment of invasive aspergillosis in those refractory to or intolerant of other antifungal therapies; empirical therapy
for presumed fungal infection with febrile neutropenia; treatment of candidemia and intra-abdominal abscesses, peritonitis,
and pleural space infections due to Candida.
Treatment of esophageal candidiasis with or without oropharyngeal candidiasis (thrush).
Hypersensitivity to any component of this product; mannitol; pregnancy (category C); not studied in patients with ESRF,
or children <18 y.
Patients with moderate hepatic insufficiency; cholestasis; concomitant use of cyclosporine; lactation.
Route & Dosage
|Invasive Aspergillosis, Empirical Therapy, Candida
Adult: IV 70 mg on day 1, then 50 mg qd thereafter
- Allow vial to come to room temperature.
- A loading dose is usually administered on day 1 followed on subsequent days by a maintenance dose.
PREPARE: IV Infusion: Reconstitute a 50 mg or 70 mg vial with 10.5 mL of NS, sterile water for injection, or bacteriostatic water for injection
to yield 5 mg/mL and 7 mg/mL, respectively. Mix gently until clear. Withdraw the required dose of reconstituted solution
and add to 250 mL of NS, ?NS, or 0.225% NaCl, or RL. DO NOT use diluents or IV solutions containing dextrose.
ADMINISTER: IV Infusion: Give slowly over at least 1 h. Do not co-infuse with any other medication.
INCOMPATIBILITIES Solution/additive: Any dextrose-containing solution. Do not mix or co-infuse with any other medications.
- Store IV solution for up to 24 h at 25° C (77° F) or below or 48 h at 2°8° C (36°46°
F). Reconstituted solution should be stored at ≤25° C (≤77°
F) for 1 h prior to preparing the IV solution for infusion.
Adverse Effects (≥1%)Body as a Whole:
Anaphylaxis, chills, injection site reaction,
sensation of warmth. CNS:
Sinus tachycardia. GI: Nausea, vomiting,
diarrhea, abdominal pain. Hematologic/Lymphatic: Phlebitis, thrombophlebitis,
vasculitis, anemia. Hepatic:
Elevated liver enzymes. Metabolic:
Anorexia, hypokalemia. Musculoskeletal:
Pain, myalgia. Respiratory: Acute respiratory distress syndrome,
Rash, facial swelling, pruritus.
increases overall systematic exposure to caspofungin; inducers of drug clearance or mixed inducer/inhibitors (e.g., carbamazepine, dexamethasone, efavirenz, nelfinavir, nevirapine, phenytoin, rifampin
) can decrease caspofungin levels; caspofungin decreases the overall systematic exposure to tacrolimus.
97% protein bound. Metabolism:
Liver and plasma to inactive metabolites. Elimination:
Both in urine and feces. Half-Life:
Assessment & Drug Effects
- Monitor for S&S of hypersensitivity during IV infusion; frequently monitor IV site for thrombophlebitis.
- Monitor for and report S&S of fluid retention (e.g., weight gain, swelling, peripheral edema), especially with known cardiovascular
- Lab tests: Baseline and periodic LFTs; periodic kidney function tests, serum electrolytes, and CBC with differential, platelet
- Monitor blood levels of tacrolimus with concurrent therapy.
Patient & Family Education
- Report immediately any of the following: facial swelling, wheezing, difficulty breathing or swallowing, tightness in chest,
rash, hives, itching, or sensation of warmth.