৳ 5,000/unit
Pack: ৳ 5,000
৳ 5,000/unit
Pack: ৳ 5,000
At a glance
Caspofungin is an echinocandin antifungal medication used in the treatment of severe fungal infections. It inhibits the synthesis of β-1,3-D-glucan, an essential component of the fungal cell wall that is not present in mammalian cells.
Indications
- Empirical therapy for presumed fungal infections in febrile, neutropenic patients
- Candidemia and other Candida infections (intra-abdominal abscesses, peritonitis, pleural space infections)
- Esophageal candidiasis
- Invasive aspergillosis in patients refractory to or intolerant of other therapies
Pharmacology
Caspofungin is an antifungal drug belonging to the echinocandin class. It is used to treat Aspergillus and Candida infections and works by inhibiting cell wall synthesis. Echinocandin antifungals inhibit the synthesis of glucan in the cell wall, probably via the enzyme 1,3-beta glucan synthase.
Dosage
Adults (All indications except esophageal candidiasis): Day 1: 70 mg loading dose (1 hour IV infusion), then 50 mg IV daily.
Esophageal Candidiasis (Adults): 50 mg IV daily (no loading dose).
Hepatic impairment (Adults): Mild (Child-Pugh 5-6): No adjustment; Moderate (Child-Pugh 7-9): 70 mg loading, then 35 mg/day; Severe (Child-Pugh >9): Safety and efficacy not established.
Concomitant administration (CYP3A4 inducers - rifampin, nevirapine, efavirenz, carbamazepine, dexamethasone, phenytoin): Adults: 70 mg/day.
Children (3 months-17 years): BSA-based dosing: Day 1: 70 mg/m² loading, then 50 mg/m²/day (max 70 mg/day). With concomitant inducers: up to 70 mg/m²/day (max 70 mg/day).
Renal impairment: No dose adjustment needed.
Administration: Slow IV infusion (approximately 1 hour) - not IV bolus. Do not use diluents containing dextrose.
Side effects
Adults (≥10%): Diarrhea, pyrexia (fever), increased ALT/AST, increased blood alkaline phosphatase, decreased blood potassium.
Pediatric (≥10%): Pyrexia (fever), diarrhea, rash, increased ALT/AST, decreased blood potassium, hypotension, chills.
Other: Chills, decreased blood potassium, diarrhea, fever, increased alkaline phosphatase, increased liver enzymes, rash, injection site reactions (pain, swelling, redness).
Regular monitoring of liver function is recommended.
Use in pregnancy
May be unsafe during pregnancy (Category C). Animal studies have shown embryofetal toxicity (increased resorptions, peri-implantation loss, incomplete ossification). Use during pregnancy only if potential benefit justifies potential risk to the fetus.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Precautions & warnings
- Anaphylaxis has been reported; if occurs, discontinue caspofungin and administer appropriate treatment.
- Possible histamine-mediated reactions (rash, facial swelling, angioedema, pruritus, sensation of warmth, bronchospasm) may require discontinuation and/or appropriate treatment.
- Can cause abnormalities in liver enzymes; monitor liver function and evaluate risk/benefit.
- Concomitant use with cyclosporine may increase liver enzymes; limit use to patients for whom potential benefit outweighs potential risk.
- Use during pregnancy only if clearly needed (Category C).
- Caution during lactation.
Overdose effects
Overdose information is limited. Overdose may cause increased liver enzymes, gastrointestinal symptoms. Supportive care. Consult your doctor immediately if overdose is suspected.
Storage conditions
Lyophilized vials should be stored at 20-25°C.