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(If a 70-mg vial is unavailable, see below: Alternative Infusion Preparation Methods, Preparation of 70-mg dose from two 50-mg vials.) Empirical therapy should be continued until resolution of neutropenia.
In a separate compassionate use study, 4 patients with hepatosplenic candidiasis received prolonged therapy with CANCIDAS following other long-term antifungal therapy; three of these patients had a favorable response. 2010 Jul;26(7):1761-8. doi: 10.1185/03007995.2010.487796.Clin Infect Dis.
--Resolution of fever during period of neutropenia CANCIDAS was similar to AmBisome for this component of the primary endpoint with 41.2 percent or 229 patients experiencing resolution of fever on CANCIDAS versus 41.4 percent or 223 patients taking AmBisome. In addition, the proportion of patients with a favorable endoscopic response was comparable (85.2% and 86.2% for CANCIDAS and fluconazole, respectively). Also reported was an isolated, serious adverse experience of hyperbilirubinemia considered possibly related to CANCIDAS. Caspofungin is not dialyzable. Drug-related clinical adverse experiences occurring in (>=)2% of the patients in either treatment group are presented in Table 8. This study, recently published in The New England Journal of Medicine, showed that CANCIDAS was as effective as AmBisome for empiric therapy of presumed fungal infections in these patients. Overall, the expert panel determined that 41% (26/63) of patients receiving at least one dose of CANCIDAS had a favorable response. --Treatment of Invasive Aspergillosis in patients who are refractory to or intolerant of other therapies (i.e., amphotericin B, lipid formulations of amphotericin B, and/or itraconazole). Plasma concentrations of radioactivity and of caspofungin were similar during the first 24 to 48 hours postdose; thereafter drug levels fell more rapidly. Plasma concentrations of caspofungin in healthy older men and women ((>=)65 years of age) were increased slightly (approximately 28% AUC) compared to young healthy men after a single 70-mg dose of caspofungin.
There is no clinical experience in patients with severe hepatic insufficiency (Child-Pugh score >9). Am J Med 1994; 97:135-144.
and you may need to create a new Wiley Online Library account.Enter your email address below and we will send you your usernameIf the address matches an existing account you will receive an email with instructions to retrieve your username No clinical data exists regarding the use of caspofungin in patients with severely impaired liver function.Reactions due to histamine release (rash, facial swelling, pruritus, sensation of warmth and one case of anaphylaxis) have been seen.
In a 14-day multiple-dose study (70 mg on Day 1 followed by 50 mg daily thereafter), plasma concentrations in patients with mild hepatic insufficiency were increased modestly (19 to 25% in AUC) on Days 7 and 14 relative to healthy control subjects. Print 2018 Aug.Int J Clin Pharm. The efficacy of a 70-mg dose regimen in patients who are not clinically responding to the 50-mg daily dose is not known. In the remaining cases, the 24-h AUC/MIC was above 20, and patients received successful treatment in most cases (79%). 2005 Aug;27(8):1228-37. doi: 10.1016/j.clinthera.2005.08.007.Antoniadou A, Torres HA, Lewis RE, Thornby J, Bodey GP, Tarrand JP, Han XY, Rolston KV, Safdar A, Raad II, Kontoyiannis DP.Medicine (Baltimore). 2. It is freely soluble in water and methanol, and slightly soluble in ethanol. dosage Source: http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/dosage Epub 2005 Dec 2.Joseph M, Brady R, Attridge R, Cota J, Horlen C, Lusk K, Attridge RL.Hosp Pharm. Possible histamine-mediated symptoms have been reported including isolated reports of rash, facial swelling, pruritus, sensation of warmth or bronchospasm. Eighteen patients received tacrolimus and CANCIDAS concomitantly, of whom 8 also received mycophenolate mofetil. 2016 Dec;38(6):1398-1406. doi: 10.1007/s11096-016-0382-6.
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