Ciclosporin increases the AUC of
caspofungin by 35% and causes increases in AST and ALT of up to 3-fold. Retrospective studies found no serious
hepatic adverse events with the combination, but 2 of 40 patients had discontinued therapy because of abnormalities in
hepatic enzymes. However, other studies suggest adverse
hepatic events are increased by the combination.
The manufacturer advises that
ciclosporin and
caspofungin should only be used if the benefits outweigh the risks of treatment, and if they are used, close monitoring of liver enzymes is recommended.