Caspofungin: Difference between revisions
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==Administration== | ==Administration== | ||
*Type: [[Antifungal]], particularly used for [[aspergillosis]] and [[candidiasis]] | *Type: [[Antifungal]], particularly used for [[aspergillosis]] and [[candidiasis]] | ||
*Dosage Forms: | *Dosage Forms: powder for injection | ||
*Dosage Strengths: 50mg/vial, 70mg/vial | |||
*Routes of Administration: IV | *Routes of Administration: IV | ||
*Common Trade Names: | *Common Trade Names: Cancidas | ||
==Adult Dosing== | ==Adult Dosing== | ||
| Line 25: | Line 26: | ||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*Erythema multiforme, Stevens-Johnson syndrome | *[[Erythema multiforme]], [[Stevens-Johnson syndrome]] | ||
*Pancreatitis, hepatic failure | *[[Pancreatitis]], [[hepatic failure]] | ||
*Sepsis | *[[Sepsis]] | ||
*Nephrotoxicity | *[[Nephrotoxicity]] | ||
*Pleural effusion, respiratory distress | *[[Pleural effusion]], respiratory distress | ||
*Angioedema | *[[Angioedema]] | ||
===Common=== | ===Common=== | ||
*Hypotension | *[[Hypotension]] | ||
*Rash | *[[Rash]] | ||
*Diarrhea | *[[Diarrhea]] | ||
*Histaminergic reaction (flushing, warmth, pruritus) | *[[Histaminergic reaction]] (flushing, warmth, pruritus) | ||
* | *Abnormal [[LFTs]] | ||
*Fever | *[[Fever]] | ||
==Pharmacology== | ==Pharmacology== | ||
| Line 50: | Line 52: | ||
==See Also== | ==See Also== | ||
*[[Antifungals]] | |||
*[[Fungal Infections]] | |||
==References== | ==References== | ||
*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. | |||
<references/> | <references/> | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] [[Category:ID]] | ||
Latest revision as of 03:30, 8 March 2021
Administration
- 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
Adult Dosing
- 50-150 mg IV daily
Pediatric Dosing
3 months or older
- 50-70 mg/m(2) daily
Special Populations
- Pregnancy Rating: C
- Lactation risk: Infant risk cannot be ruled out
Renal Dosing
- Adult:
- Pediatric:
Hepatic Dosing
- Adult:
- Pediatric:
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
- Erythema multiforme, Stevens-Johnson syndrome
- Pancreatitis, hepatic failure
- Sepsis
- Nephrotoxicity
- Pleural effusion, respiratory distress
- Angioedema
Common
- Hypotension
- Rash
- Diarrhea
- Histaminergic reaction (flushing, warmth, pruritus)
- Abnormal LFTs
- Fever
Pharmacology
- Half-life: 13-15 hours
- Metabolism: spontaneous degradation, hydrolysis and N-acetylation
- Excretion: Fecal, renal
Mechanism of Action
- Inhibits beta (1,3)-D-glucan synthesis in fungal cell wall
Comments
See Also
References
- 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.