Caspofungin

Restricted
C. diff Risk

Low

Oral Bioavailability

NA

Approximate Cost

$100/day

Spectrum Of Activity

Dosing

1 to 3 months oldGreater than 3 months- less than 18 years of ageGreater than 3 months- less than 18 years of age18 years of age and over18 years of age and over25 mg/m²/dose IV q24hLoading dose:
70 mg/m²/dose IV x 1 dose
Maximum loading dose: 70 mg/dose

Maintenance dose :
50 mg/m²/dose IV q24h
Maximum maintenance dose: 50 mg/dose If clinical response is inadequate or in patients who are receiving enzyme inducers (prolonged dexamethasone, phenytoin, rifampin)
May increase maintenance dose to 70 mg/m²/dose IV q24h
Maximum : 70 mg/dose Loading dose: 70 mg IV X 1 dose
Maintenance dose: 50 mg IV q24hIf clinical response is inadequate or in patients who are receiving enzyme inducers (prolonged dexamethasone, phenytoin, rifampin)
70 mg IV q24h

25 mg/m²/dose IV q24h

No dosage adjustment required in patients with renal impairment

General Information

Common Usage

Therapy of suspected and confirmed invasive fungal infections

Drug Monitoring

  • Periodic liver function tests

  • Renal function tests

  • CBC with differential

Adverse Effects

  • Increased liver enzymes, elevated bilirubin

  • GI upset, diarrhea

  • Pruritis, fever (most common in pediatrics)

Major Interactions

Cyclosporin and tacrolimus (drug level monitoring recommended)

Additional Information

Pentrates poorly into CSF and urine.

Pharmacology

Antimicrobial class: Echinocandin