Caspofungin Side Effects

Medically reviewed by Drugs.com. Last updated on Jan 28, 2025.

Applies to caspofungin: intravenous powder for solution.

Precautions

It is very important that your doctor check the progress of you or your child while you are taking this medicine to make sure the medicine is working properly. Blood tests may be needed to check for unwanted effects.

Check with your doctor right away if you or your child have pain or tenderness in the upper stomach, dark urine, pale stools, nausea, vomiting, loss of appetite, or yellow skin or eyes. These could be symptoms of a serious liver problem.

This medicine may cause a serious type of allergic reaction, called anaphylaxis, which can be life-threatening and requires immediate medical attention. Call your doctor right away if you or your child have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after receiving this medicine.

Serious skin reactions can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or a skin rash, sores or ulcers on the skin, or fever or chills with this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Serious side effects of caspofungin

Along with its needed effects, caspofungin 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:

Other side effects of caspofungin

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:

For healthcare professionals

Applies to caspofungin: intravenous powder for injection.

Other adverse events

• 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]

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]

Gastrointestinal

• 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]

Cardiovascular

• 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]

Hematologic

• 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]

Respiratory

• 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]

Hepatic

• 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]

Dermatologic

• 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]

Renal

• 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]

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]

Genitourinary

• 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]

Hypersensitivity

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

Metabolic

• 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]

Local

• 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]

Psychiatric

• Common (1% to 10%): Insomnia
• Uncommon (0.1% to 1%): Anxiety, disorientation
• Frequency not reported: Confusional state, depression^[Ref]

Musculoskeletal

• Common (1% to 10%): Arthralgia, myalgia, musculoskeletal pain
• Uncommon (0.1% to 1%): Back pain, pain in extremity, bone pain, muscular weakness^[Ref]

Ocular

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

See also:

Further information

Caspofungin side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

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