{"id":1705,"date":"2023-06-25T17:32:51","date_gmt":"2023-06-25T17:32:51","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/caspofungin\/"},"modified":"2023-06-25T19:41:41","modified_gmt":"2023-06-25T19:41:41","slug":"caspofungin","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/caspofungin\/","title":{"rendered":"Caspofungin"},"content":{"rendered":"

<\/p>\n

Caspofungin<\/h1>\n

CLINICAL USE<\/h3>\n
  • Invasive aspergillosis in adult patients who are refractory to or intolerant of amphotericin B and\/or itraconazole<\/li>\n
  • Invasive candidiasis<\/li>\n
  • Empirical treatment of systemic fungal infections in patients with neutropenia
    \n

    DOSE IN NORMAL RENAL FUNCTION<\/h3>\n

    70 mg loading dose on day 1 followed by 50 mg daily, thereafterIf patient weighs >80 kg use 70 mg daily<\/p>\n

    PHARMACOKINETICS<\/h3>\n<\/li>\n
  • Molecular weight                           :1213.4 (as acetate)<\/li>\n
  • %Protein binding                           :97<\/li>\n
  • %Excreted unchanged in urine     : 1.4<\/li>\n
  • Volume of distribution (L\/kg)       :No data<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      :12\u201315 days\/Increased but not significantly.
    \n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n<\/li>\n
  • 20 to 50     : Dose as in normal renal function<\/li>\n
  • 10 to 20     : Dose as in normal renal function<\/li>\n
  • <10           : Dose as in normal renal function
    \n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                :Not dialysed. Dose as in normal renal function<\/li>\n
  • HD                     :Not dialysed. Dose as in normal renal function<\/li>\n
  • HDF\/high flux   :Unlikely to be dialysed. Dose as in normal renal function<\/li>\n
  • CAV\/VVHD      :Not dialysed. Dose as in normal renal function
    \n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs<\/li>\n

  • Ciclosporin: monitor liver enzymes as transient increases in ALT and AST have been reported with concomitant administration. Avoid co-administration if possible. Increases AUC of caspofungin by 35%<\/li>\n
  • Tacrolimus: reduces tacrolimus trough concentration by 26%
    \n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    10.5 mL water for injection<\/p>\n

    Route<\/h4>\n

    IV infusion<\/h4>\n

    Rate of Administration<\/h4>\n

    Approximately 1 hour<\/p>\n

    Comments<\/h4>\n<\/li>\n
  • Caspofungin is unstable in fluids containing glucose; add to 250 mL sodium chloride 0.9% or lactated Ringer\u2019s solution<\/li>\n
  • If patient is fluid restricted, doses of 35 or 50 mg may be added to 100 mL infusion fluid
    \n

    OTHER INFORMATION<\/h4>\n<\/li>\n
  • In established renal failure the AUC is increased by 30\u201349% but a change in dosage schedule is not required<\/li>\n
  • Plasma concentrations of caspofungin decline in a polyphasic manner. A short \u03b1-phase occurs immediately post infusion, followed by a \u03b2-phase with a half-life of 9\u201311 hours. An additional \u03b3-phase also occurs with a half-life of 40\u201350 hours. Distribution rather than excretion or biotransformation is the dominant mechanism influencing plasma clearance<\/li>\n
  • Caspofungin has been used at a dose of 50 mg daily in combination with IV amphotericin B to successfully treat fungal peritonitis<\/li>\n","protected":false},"excerpt":{"rendered":"

    Caspofungin CLINICAL USE Invasive aspergillosis in adult patients who are<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-1705","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1705","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=1705"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1705\/revisions"}],"predecessor-version":[{"id":2840,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1705\/revisions\/2840"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=1705"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=1705"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=1705"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}