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caspofungin

Generic Name: caspofungin (KAS poe FUN jin)
Brand Name: Cancidas

What is caspofungin?

Caspofungin is an antibiotic that fights infections caused by fungus.

Caspofungin is used to treat fungal infections that involve the stomach, lungs, esophagus, or other internal body areas.

Caspofungin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about caspofungin?

You should not use caspofungin if you are allergic to it.

Before receiving caspofungin, tell your doctor if you have liver disease, or if you have recently had a kidney, heart, or liver transplant.

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Use caspofungin for the full prescribed length of time. Your symptoms may improve before the infection is completely treated.

You may be given other medications to treat your infection. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice.

What should I discuss with my health care provider before receiving caspofungin?

You should not use caspofungin if you are allergic to it.

If you have any of these other conditions, you may need a dose adjustment or special tests:

  • liver disease; or

  • if you have recently had a kidney, heart, or liver transplant.

FDA pregnancy category C. It is not known whether caspofungin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether caspofungin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How is caspofungin given?

Caspofungin is injected into a vein through an IV. Caspofungin must be given slowly, and the IV infusion can take at least 1 hour to complete.

You may be shown how to use an IV at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.

Caspofungin is usually given for at least 14 days. You may need to receive this medication until it has been at least 7 days after your symptoms disappear, or 14 days after lab tests show that the infection has cleared.

Use caspofungin for the full prescribed length of time. Your symptoms may improve before the infection is completely treated.

You may be given other medications to treat your infection. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice.

Caspofungin is a powder medicine that must be mixed with a liquid (diluent) before using it. If you are using the injections at home, be sure you understand how to properly mix and store the medication.

Use only the liquid diluent that you have been given to mix with caspofungin. Liquids that contain dextrose or glucose should never be mixed with caspofungin.

Use a disposable needle only once. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Store caspofungin powder in a refrigerator. Do not freeze. You may take the powder out of the refrigerator and allow it to reach room temperature before mixing your medicine.

After mixing caspofungin with a diluent, you may store the mixture for up to 24 hours at room temperature, or up to 48 hours in a refrigerator.

What happens if I miss a dose?

Since caspofungin is usually given by a healthcare professional, it is not likely that you will miss a dose. If you are using the injections at home and you miss a dose, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving caspofungin?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Caspofungin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your doctor at once if you have a serious side effect such as:

  • pain, swelling, or vein irritation around the IV needle;

  • fever, chills, body aches, flu symptoms;

  • swelling in your hands or feet;

  • weakness, muscle cramps, pounding or uneven heart beats; or

  • nausea, stomach pain, loss of appetite, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects include:

  • vomiting, diarrhea;

  • mild skin rash or itching;

  • headache;

  • dizziness, feeling light-headed; or

  • flushing (warmth, redness, or tingly feeling).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Caspofungin dosing information

Usual Adult Dose for Aspergillosis -- Invasive:

In patients refractory to or intolerant of other therapies:
Loading dose: 70 mg IV on day 1
Maintenance dose: 50 mg IV once a day

Duration of therapy should be based on the severity of the patient's underlying disease, recovery from immunosuppression, and clinical response.

Usual Adult Dose for Candidemia:

Candidemia and the following Candida infections - intraabdominal abscesses, peritonitis, and pleural space infections:
Loading dose: 70 mg IV on day 1
Maintenance dose: 50 mg IV once a day

Duration of therapy should be dictated by the patient's clinical and microbiological response. In general, antifungal therapy should continue for at least 14 days after the last positive culture. Patients who remain persistently neutropenic may warrant a longer course of therapy pending resolution of the neutropenia.

Usual Adult Dose for Esophageal Candidiasis:

50 mg IV once a day for 7 to 14 days after symptom resolution

A 70 mg loading dose has not been studied with this indication. Because of the risk of relapse of oropharyngeal candidiasis in patients with HIV infections, suppressive oral therapy could be considered.

Usual Adult Dose for Febrile Neutropenia:

Empirical therapy for presumed fungal infections:
Loading dose: 70 mg IV on day 1
Maintenance dose: 50 mg IV once a day

Duration of treatment should be based on the patient's clinical response. Empirical therapy should continue until resolution of neutropenia. Patients found to have a fungal infection should be treated for a minimum of 14 days; treatment should continue for at least 7 days after both neutropenia and clinical symptoms are resolved. If the 50 mg dose is well tolerated but does not provide an adequate clinical response, the daily dose can be increased to 70 mg.

Usual Pediatric Dose for Candidemia:

Candidemia and the following Candida infections - intraabdominal abscesses, peritonitis, and pleural space infections:
3 months or older:
Loading dose: 70 mg/m2 IV on day 1
Maintenance dose: 50 mg/m2 IV once a day

The maximum loading dose and the daily maintenance dose should not exceed 70 mg, regardless of the patient's calculated dose. If the 50 mg/m2 daily dose is well tolerated but does not provide adequate clinical response, the daily dose can be increased to 70 mg/m2 daily (not to exceed 70 mg).

Duration of therapy should be dictated by the patient's clinical and microbiological response. In general, antifungal therapy should continue for at least 14 days after the last positive culture. Patients who remain persistently neutropenic may warrant a longer course of therapy pending resolution of the neutropenia.

Usual Pediatric Dose for Aspergillosis -- Invasive:

In patients refractory to or intolerant of other therapies:
3 months or older:
Loading dose: 70 mg/m2 IV on day 1
Maintenance dose: 50 mg/m2 IV once a day

The maximum loading dose and the daily maintenance dose should not exceed 70 mg, regardless of the patient's calculated dose. If the 50 mg/m2 daily dose is well tolerated but does not provide adequate clinical response, the daily dose can be increased to 70 mg/m2 daily (not to exceed 70 mg).

Duration of therapy should be based on the severity of the patient's underlying disease, recovery from immunosuppression, and clinical response.

Usual Pediatric Dose for Esophageal Candidiasis:

3 months or older:
Loading dose: 70 mg/m2 IV on day 1
Maintenance dose: 50 mg/m2 IV once a day for 7 to 14 days after symptom resolution

The maximum loading dose and the daily maintenance dose should not exceed 70 mg, regardless of the patient's calculated dose. If the 50 mg/m2 daily dose is well tolerated but does not provide adequate clinical response, the daily dose can be increased to 70 mg/m2 daily (not to exceed 70 mg).

Because of the risk of relapse of oropharyngeal candidiasis in patients with HIV infections, suppressive oral therapy could be considered.

Usual Pediatric Dose for Febrile Neutropenia:

Empirical therapy for presumed fungal infections:
3 months or older:
Loading dose: 70 mg/m2 IV on day 1
Maintenance dose: 50 mg/m2 IV once a day

The maximum loading dose and the daily maintenance dose should not exceed 70 mg, regardless of the patient's calculated dose. If the 50 mg/m2 daily dose is well tolerated but does not provide adequate clinical response, the daily dose can be increased to 70 mg/m2 daily (not to exceed 70 mg).

Duration of treatment should be based on the patient's clinical response. Empirical therapy should continue until resolution of neutropenia. Patients found to have a fungal infection should be treated for a minimum of 14 days; treatment should continue for at least 7 days after both neutropenia and clinical symptoms are resolved.

What other drugs will affect caspofungin?

The following drugs can interact with caspofungin. Tell your doctor if you are using any of these:

  • cyclosporine (Neoral, Sandimmune, Gengraf);

  • tacrolimus (Prograf);

  • rifampin (Rifadin, Rifamate, Rimactane);

  • efavirenz (Sustiva);

  • nevirapine (Viramune);

  • phenytoin (Dilantin);

  • dexamethasone (Decadron, Hexadrol); or

  • carbamazepine (Carbatrol, Tegretol).

This list is not complete and other drugs may interact with caspofungin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about caspofungin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.02. Revision Date: 2010-12-15, 5:01:39 PM.

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