Caspofungin

• Type: Antifungal, particularly used for aspergillosis and candidiasis
• Dosage Forms: powder for injection
• Dosage Strengths: 50mg/vial, 70mg/vial
• Routes of Administration: IV
• Common Trade Names: Cancidas

• 50-150 mg IV daily

3 months or older

• 50-70 mg/m(2) daily

• Pregnancy Rating: C
• Lactation risk: Infant risk cannot be ruled out

• Allergy to class/drug

• Half-life: 13-15 hours
• Metabolism: spontaneous degradation, hydrolysis and N-acetylation
• Excretion: Fecal, renal

• Inhibits beta (1,3)-D-glucan synthesis in fungal cell wall

• Aronoff GR, Bennett WM, Berns JS, et al, Drug Prescribing in Renal Failure: Dosing Guidelines for Adults and Children, 5th ed. Philadelphia, PA: American College of Physicians; 2007, p 61, 153.
• Betts RF, Nucci M, Talwar D, et al, “A Multicenter, Double-Blind Trial of a High-Dose Caspofungin Treatment Regimen Versus a Standard Caspofungin Treatment Regimen for Adult Patients With Invasive Candidiasis,” Clin Infect Dis, 2009, 48(12):1676-84. [PubMed 19419331]
• Cancidas (caspofungin) [prescribing information]. Whitehouse Station, NJ: Merck Sharp & Dohme; February 2019.
• Freifeld AG, Bow EJ, Sepkowitz KA, et al; Infectious Diseases Society of America. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis. 2011;52(4):e56-e93. [PubMed 21258094]10.1093/cid/cir073
• Gould FK, Denning DW, Elliott TS, et al, “Guidelines for the Diagnosis and Antibiotic Treatment of Endocarditis in Adults: A Report of the Working Party of the British Society for Antimicrobial Chemotherapy,” J Antimicrob Chemother, 2012, 67(2):269-89. [PubMed 22086858]
• Gustot T, Ter Heine R, Brauns E, Cotton F, Jacobs F, Brüggemann RJ. Caspofungin dosage adjustments are not required for patients with Child-Pugh B or C cirrhosis. J Antimicrob Chemother. 2018;73(9):2493-2496. doi: 10.1093/jac/dky189. [PubMed 29860319]
• Heintz BH, Matzke GR, Dager WE. Antimicrobial dosing concepts and recommendations for critically ill adult patients receiving continuous renal replacement therapy or intermittent hemodialysis. Pharmacotherapy. 2009;29(5):562-577. [PubMed 19397464]
• HHS Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf. Accessed August 28, 2017.