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Cancidas Side Effects

Generic name: caspofungin

Medically reviewed by Last updated on May 12, 2023.

Note: This document contains side effect information about caspofungin. Some dosage forms listed on this page may not apply to the brand name Cancidas.

Applies to caspofungin: intravenous powder for solution.

Serious side effects of Cancidas

Along with its needed effects, caspofungin (the active ingredient contained in Cancidas) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking caspofungin:

More common

Less common

Incidence not known

Other side effects of Cancidas

Some side effects of caspofungin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Incidence not known

For Healthcare Professionals

Applies to caspofungin: intravenous powder for injection.


Infusion-related adverse reactions were defined as a systemic event (e.g., pyrexia, chills, flushing, hypotension, hypertension, tachycardia, dyspnea, tachypnea, rash, anaphylaxis) that developed during the study therapy infusion and 1 hour after infusion.[Ref]

Very common (10% or more): Infusion-related adverse reactions (e.g., flushing, fever, chills, hypotension, hypertension, tachycardia, dyspnea, tachypnea, rash, anaphylaxis; up to 35%), pyrexia/fever (up to 27%), chills (up to 23%), decreased blood potassium (up to 23%), increased blood alkaline phosphatase (up to 22%), peripheral edema (up to 11%)

Common (1% to 10%): Decreased blood albumin, decreased blood magnesium, mucosal inflammation, pain, decreased total serum protein, facial edema, influenza-like illness, flushing, decreased serum calcium, warm sensation, decreased serum sodium

Uncommon (0.1% to 1%): Increased serum potassium, decreased serum bicarbonate, increased blood calcium, hot flush, feeling cold, feeling hot, tenderness, chest discomfort, chest pain, feeling of body temperature change, induration, malaise, fatigue, edema , increased blood sodium, decreased blood chloride, increased blood chloride, increased immunosuppressant drug level

Frequency not reported: Asthenia, bacteremia, sepsis, central line infection, decreased blood phosphorus, increased blood phosphorus, septic shock, aspergillosis

Postmarketing reports: Swelling, peripheral edema[Ref]


Very common (10% or more): Diarrhea (up to 27%), vomiting (up to 17%), nausea (up to 15%)

Common (1% to 10%): Abdominal pain

Uncommon (0.1% to 1%): Abdominal distension, upper abdominal pain, dry mouth, constipation, dyspepsia, stomach discomfort, ascites, dysphagia, flatulence

Postmarketing reports: Pancreatitis[Ref]


Very common (10% or more): Phlebitis (up to 25%), hypotension (up to 20%), phlebitis/thrombophlebitis (up to 15.7%), infused vein complications (up to 12%)

Common (1% to 10%): Tachycardia, hypertension

Uncommon (0.1% to 1%): Palpitations, arrhythmia, atrial fibrillation, congestive cardiac failure, increased blood pressure

Frequency not reported: Bradycardia, cardiac arrest, myocardial infarction[Ref]


Very common (10% or more): Decreased hemoglobin (up to 21%), decreased hematocrit (up to 18%), decreased WBC count (up to 12%), anemia (up to 11%)

Common (1% to 10%): Increased eosinophils/eosinophil count, decreased platelet count, increased lymphocytes, increased/prolonged prothrombin time

Uncommon (0.1% to 1%): Thrombocytopenia, coagulopathy, leukopenia, decreased lymphocyte count, increased WBC count, decreased neutrophil count, shortened prothrombin time, prolonged activated partial thromboplastin time, increased INR

Frequency not reported: Febrile neutropenia, neutropenia[Ref]

A 68-year-old male experienced reversible severe thrombocytopenia coincident with this drug. He was admitted for shortness of breath, coughing, abdominal pain, and intermittent fever, which had persisted for 10 days. Two blood cultures obtained on admission revealed Candida albicans. He was given 70 mg for 1 day, then 50 mg per day. One week after receiving this drug, his platelet count dropped precipitously from 136 x 10(3)/mm3 to 24 x 10(3)/mm3, reaching a nadir at 3 x 10(3)/mm3 in 2 days. The drug was discontinued, and his platelet count returned to a level above 150 x 10(3)/mm3 within 10 days.[Ref]


Very common (10% or more): Respiratory failure (up to 20%)

Common (1% to 10%): Dyspnea, rales, cough, pneumonia, tachypnea

Uncommon (0.1% to 1%): Nasal congestion, pharyngolaryngeal pain, bronchospasm, paroxysmal nocturnal dyspnea, hypoxia, wheezing, abnormal breath sounds

Frequency not reported: Epistaxis, pulmonary edema, adult respiratory distress syndrome, radiographic infiltrates, pleural effusion[Ref]


Very common (10% or more): Increased ALT (up to 18%), increased AST (up to 16%), increased blood bilirubin/total bilirubin (up to 13%)

Common (1% to 10%): Increased conjugated bilirubin/direct bilirubin, elevated liver values (ALT, AST, blood alkaline phosphatase, conjugated bilirubin, blood bilirubin)

Uncommon (0.1% to 1%): Cholestasis, hepatomegaly, hepatotoxicity, hyperbilirubinemia, jaundice, abnormal hepatic function, liver disorder, increased GGT

Frequency not reported: Hepatic failure, clinically significant hepatic dysfunction, hepatitis

Postmarketing reports: Hepatic necrosis, hepatic dysfunction, increased GGT[Ref]

Reported elevations in ALT and AST were accompanied by the use of cyclosporine in some of the patients enrolled in the clinical trials.[Ref]


Very common (10% or more): Rash (up to 16%)

Common (1% to 10%): Erythema, hyperhidrosis/sweating/perspiration/diaphoresis, pruritus

Uncommon (0.1% to 1%): Erythema multiforme, macular rash, maculopapular rash, pruritic rash, urticaria, allergic dermatitis, generalized pruritus, erythematous rash, generalized rash, morbilliform rash, skin lesion

Frequency not reported: Petechiae, decubitus ulcer

Postmarketing reports: Erythema multiforme, toxic epidermal necrolysis, Stevens-Johnson syndrome, skin exfoliation[Ref]

Nervous system

Very common (10% or more): Headache (up to 15%)

Common (1% to 10%): Paresthesia, tremor, dizziness

Uncommon (0.1% to 1%): Dysgeusia, somnolence, hypoesthesia

Frequency not reported: Convulsion[Ref]


Nephrotoxicity was defined as doubling of serum creatinine compared to baseline or an increase of at least 1 mg/dL in serum creatinine if baseline level was above the upper limit of normal.[Ref]

Very common (10% or more): Increased blood creatinine (up to 11%)

Common (1% to 10%): Increased blood urea nitrogen, nephrotoxicity

Uncommon (0.1% to 1%): Renal insufficiency, renal failure, acute renal failure

Frequency not reported: Clinical renal events

Postmarketing reports: Clinically significant renal dysfunction[Ref]


Very common (10% or more): Urine positive for RBCs (up to 10%)

Common (1% to 10%): Increased urine WBCs, increased urine protein, increased urine RBCs

Uncommon (0.1% to 1%): Increased urine pH, protein present in urine, blood present in urine, urinary casts, urine positive for WBCs

Frequency not reported: Urinary tract infection, hematuria[Ref]


Frequency not reported: Hypersensitivity reactions, anaphylaxis, possible histamine-mediated symptoms (including rash, facial swelling, angioedema, pruritus, sensation of warmth, bronchospasm)[Ref]


Common (1% to 10%): Hypokalemia, increased blood glucose, hypomagnesemia, anorexia

Uncommon (0.1% to 1%): Increased serum uric acid, fluid overload, electrolyte imbalance, hyperglycemia, hypocalcemia, metabolic acidosis, decreased blood uric acid, decreased carbon dioxide

Frequency not reported: Decreased appetite, hypoalbuminemia

Postmarketing reports: Hypercalcemia[Ref]


Common (1% to 10%): Injection site phlebitis, injection site swelling, injection site erythema, infusion site pruritus

Uncommon (0.1% to 1%): Catheter site pain, infusion site erythema, infusion site induration, infusion site pain, infusion site swelling, infusion site extravasation, infusion site irritation, infusion site phlebitis, infusion site rash, infusion site urticaria, injection site edema, injection site pain[Ref]


Common (1% to 10%): Insomnia

Uncommon (0.1% to 1%): Anxiety, disorientation

Frequency not reported: Confusional state, depression[Ref]


Common (1% to 10%): Arthralgia, myalgia, musculoskeletal pain

Uncommon (0.1% to 1%): Back pain, pain in extremity, bone pain, muscular weakness[Ref]


Uncommon (0.1% to 1%): Ocular icterus, blurred vision, eyelid edema, increased lacrimation[Ref]


1. (2001) "Product Information. Cancidas (caspofungin)." Merck & Co., Inc

2. Walsh TJ, Teppler H, Donowitz GR, et al. (2004) "Caspofungin versus liposomal amphotericin B for empirical antifungal therapy in patients with persistent fever and neutropenia." N Engl J Med, 351, p. 1391-402

3. Maertens J, Raad I, Petrikkos G, et al. (2004) "Efficacy and safety of caspofungin for treatment of invasive aspergillosis in patients refractory to or intolerant of conventional antifungal therapy." Clin Infect Dis, 39, p. 1563-71

4. Cerner Multum, Inc. "UK Summary of Product Characteristics."

5. Cappelletty D, Eiselstein-McKitrick K (2007) "The echinocandins." Pharmacotherapy, 27, p. 369-88

6. Cerner Multum, Inc. "Australian Product Information."

7. Thompson GR 3rd, Cadena J, Patterson TF (2009) "Overview of antifungal agents." Clin Chest Med, 30, 203-15, v

8. Villanueva A, Arathoon EG, Gotuzzo E, Berman RS, DiNubile MJ, Sable CA (2001) "A Randomized Double-Blind Study of Caspofungin versus Amphotericin for the Treatment of Candidal Esophagitis." Clin Infect Dis, 33, p. 1529-35

9. Lynch J, Wong-Beringer A (2004) "Caspofungin: a potential cause of reversible severe thrombocytopenia." Pharmacotherapy, 24, p. 1408-11

10. Keating GM, Jarvis B (2001) "Caspofungin." Drugs, 61, p. 1121-9

11. Lee MC, Ni YW, Wang CH, Lee CH, Wu TW (2010) "Caspofungin-induced severe toxic epidermal necrolysis." Ann Pharmacother, 44, p. 1116-8

12. Kauffman CA (2004) "New antifungal agents." Semin Respir Crit Care Med, 25, p. 233-9

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.