Caspofungin Acetate (caspofungin acetate)

Dosage of caspofungin acetate is expressed in terms of the salt.

No dosing information is available for this tab.

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

Caspofungin acetate is contraindicated in patients with known hypersensitivity (e.g., anaphylaxis) to the drug or any ingredient in the formulation.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

Adverse effects reported in 5% or more of patients receiving caspofungin include pyrexia, diarrhea, chills, decreased potassium, increased alkaline phosphatase, decreased hemoglobin, hypotension, respiratory failure, increased ALT, fever, decreased hematocrit, phlebitis, vomiting, rash, increased AST, nausea, headache, increased bilirubin, septic shock, decreased leukocyte count, peripheral edema, cough, pneumonia, increased creatinine, anemia, abdominal pain, dyspnea, increased blood urea, pleural effusion, increased conjugated bilirubin, tachycardia, decreased albumin, decreased magnesium, rales, and sepsis.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

Safety and efficacy of caspofungin have not been established in neonates and infants younger than 3 months of age. Although limited pharmacokinetic data are available for this age group, the manufacturer states that data are insufficient to date to establish a safe and effective dosage for treatment of neonatal candidiasis. In addition, invasive candidiasis in neonates has a higher rate of CNS and multi-organ involvement than do such infections in older patients, and data are insufficient to date regarding distribution of caspofungin into the CNS or regarding efficacy in the treatment of meningitis and endocarditis.

Caspofungin has not been evaluated in pediatric patients for the treatment of endocarditis, osteomyelitis, or meningitis caused by Candida or for initial therapy of invasive aspergillosis. The drug also has not been evaluated for use in pediatric patients with hepatic impairment.

Safety and efficacy of caspofungin for use in infants and children 3 months to 17 years of age for treatment of invasive aspergillosis in those refractory to or intolerant of other antifungals; for treatment of candidemia and certain other invasive Candida infections (intra-abdominal abscesses, peritonitis, pleural space infections) or esophageal candidiasis; and for empiric treatment of presumed fungal infections in febrile neutropenic patients is based on adequate and well-controlled studies in adults, pharmacokinetic data in pediatric patients, and additional data from prospective studies in this age group.

The manufacturer states that the overall safety profile of caspofungin in pediatric patients is comparable to that in adults. Adverse effects reported in 7% or more of pediatric patients receiving caspofungin include pyrexia, rash, decreased potassium, increased AST, diarrhea, increased ALT, chills, hypotension, vomiting, tachycardia, mucosal inflammation, hypertension, headache, erythema, central line infection, cough, respiratory distress, hypokalemia, abdominal pain, and pruritus.

Although data are limited, some experts state that caspofungin can be considered for first-line treatment of invasive candidiasis or for alternative treatment of esophageal candidiasis in children with human immunodeficiency virus (HIV) infection.

Category C. (See Users Guide.)

There are no adequate and well-controlled studies of caspofungin acetate in pregnant women, and the manufacturer states that the drug should be used during pregnancy only if potential benefits justify potential risks to the fetus.

In animals, embryofetal toxicity (increased resorptions, increased peri-implantation loss, incomplete ossification at multiple fetal sites) has been reported with caspofungin dosages about 2 times the recommended human dosage (based on body surface area comparisons).

Caspofungin is distributed into milk in rats; it is not known whether the drug is distributed into milk in humans.

Caspofungin should be used with caution in nursing women.

Dosage adjustments are not necessary in patients 65 years of age or older.

Clinical studies of caspofungin did not include a sufficient number of patients 65 years of age or older to determine whether they respond differently than younger individuals. Although no overall differences in efficacy or safety were observed between geriatric and younger adults, the possibility that some older patients may have increased sensitivity to the drug cannot be ruled out.

Although caspofungin plasma concentrations are increased slightly in men and women 65 years of age and older compared with young healthy males, dosage adjustments are not necessary in geriatric patients.