Products
Caspofungin must be administered as an infusion solution because of its low oral bioavailability (Cancidas, generics). It has been approved in many countries since 2002 and was the first member of the echinocandins.
Structure and properties
Caspofungin is present in drugs as caspofungin diacetate (C52H88N10O15 – 2C2H4O2, Mr = 1213.42 g/mol), a hygroscopic white powder that is soluble in water. It is a semisynthetic lipopeptide obtained from a fermentation product from fungus.
Effects
Caspofungin (ATC J02AX04) has antifungal and antifungal properties against Candida and Aspergillus. It interferes with the formation of the polysaccharide 1,3-β-D-glucan, an important component of the fungal cell wall. The cell walls become defective and brittle and the fungus can no longer continue to grow. The effects are due to inhibition of the enzyme 1,3-β-D-glucan synthase, which is found only in fungi and not in humans.
Indications
Caspofungin is used to treat invasive infection with Candida fungi, candidemia, esophageal candidiasis, oropharyngeal candidiasis, and invasive aspergillosis. It is usually used only when 1st-line agents fail.
Dosage
According to the SmPC. Caspofungin is administered as an infusion because of poor oral availability.
Contraindications
- Hypersensitivity
For complete precautions, see the drug label.
Interactions
Caspofungin does not interact with CYP450. Interactions are possible with ciclosporin, rifampicin, dexamethasone, other enzyme inducers, and tacrolimus.
Adverse effects
Possible adverse effects include fever, headache, inflammation of veins, skin reactions, elevation of liver enzymes, nausea, diarrhea, vomiting, elevation of serum creatinine, anemia, palpitations, dyspnea, and hypokalemia.
