Caspogin

Indications

Caspofungin Acetate is an antifungal medicine used in hospital for serious fungal infections. It treats invasive candidiasis (Candida infection of the blood or internal organs), Candida infection of the food pipe (oesophagus), and invasive aspergillosis in patients who do not respond to or cannot take other antifungals. It is also used for suspected fungal infection in patients with fever and very low white blood cell counts.

How It Works

Caspofungin belongs to a group called echinocandins. It blocks an enzyme that fungi need to build beta-glucan, a key part of their cell wall. Without a strong wall, the fungal cells become weak and break apart. Human cells do not have this wall, so the effect is targeted at the fungus.

Dosage and Administration

Caspofungin is given as a slow infusion into a vein over about 1 hour by a doctor or nurse in hospital, usually once a day. Treatment normally starts with a higher loading dose on the first day followed by a lower daily dose. The dose and length of treatment depend on the infection, body weight, liver function and response, and are set by the doctor.

Interactions

• Ciclosporin can increase Caspofungin levels and may raise liver enzymes; liver tests are monitored.
• Caspofungin can lower Tacrolimus levels, so Tacrolimus blood levels are checked.
• Rifampicin, Efavirenz, Nevirapine, Phenytoin, Carbamazepine and Dexamethasone can lower Caspofungin levels; a higher dose may be needed.

Contraindications

Do not use if you are allergic to Caspofungin or any ingredient of the product.

Side Effects

• Fever, chills, headache, nausea, vomiting or diarrhoea
• Pain, redness or swelling of the vein at the infusion site
• Rash, itching or flushing
• Changes in liver blood tests, low potassium, low blood counts

Get urgent medical help, or tell the nurse at once, if you have difficulty breathing, swelling of the face or throat, severe rash with blistering or peeling skin, or yellowing of the skin or eyes.

Pregnancy and Lactation

There is little information on use in pregnancy; it should be used only if clearly needed. It is not known whether it passes into human breast milk, so breastfeeding is usually not recommended during treatment.

Precautions and Warnings

• Tell the doctor about liver disease, as the dose may need to be reduced.
• Liver function is checked during treatment.
• Serious allergic and skin reactions are rare but possible.

Overdose

Caspofungin is given by health professionals, so overdose is unlikely. It is not removed by dialysis; patients are monitored and given supportive care.

Therapeutic Class

Systemic antifungal (echinocandin).

Storage

Hospital medicine. Store unopened vials in a refrigerator at 2 to 8°C, as directed on the pack. Prepared solutions must be used within the time stated in the leaflet.