Caspofungin

Type of Medication: Antifungal

Indications: Systemic fungal infections usually in patients intolerant or unresponsive to amphotericin

Side Effects: nausea, vomiting, abdominal pain, diarrhoea, tachycardia, flushing, dyspnoea: fever , headache, anaemia, hypokaleamia, hypomagnesaemia; rash, puritis, sweating; injection site reactions; less commonly hypercalcaemia; also reported hepatic dysfunction, ARDS, hypersensitivity reactions including anaphylaxis

Route of administration: Adult (Intravenous) 

Dose: 70 mg once a day on day 1, followed by 50 mg once a day thereafter (If > 80 kg follow with 70 mg once a day). 
Administration: Administer in 250 mls of sodium chloride 0.9% or dextrose 5 % over 60 minutes. If required 35- 50 mg doses can be administered in 100 mls of infusion fluid. 

Route of administration:  Paediatric (Intravenous) 

Dose:12-18 years: 70 mg once a day on day 1 , followed by 50 mg once a day thereafter,( if >80 kg follow with 70 mg once a day). 
Administration: Not licensed for use in children. Administration as per adults. 

Examples of some Drug Interactions

Interacting drug: Carbamazepine

possibly reduces plasma concentration – consider increasing the dose of caspofungin

Interacting drug: Ciclosporin

increases plasma concentration of caspofungin, monitor liver enzymes

Interacting drug: Dexamethasone

possibly reduces plasma concentration – consider increasing the dose of caspofungin

Interacting drug: Phenytoin

possibly reduces plasma concentration – consider increasing the dose of caspofungin

Interacting drug: Rifampicin

Plasma concentration of caspofungin initially increased then reduced (consider increasing the dose of caspofungin).

Interacting drug: Tacrolimus

Reduces plasma concentration of tacrolimus