Adult Dosing

Fungal infections (Empirical therapy)

• Loading dose: 70 mg IV on day 1
• Maintenance dose: 50 mg IV q24 hrs x 14 days
• Max: 70 mg/day
• Note: Raise daily dose to 70 mg IV if 50 mg IV is tolerated but fails to provide an adequate response

Candidemia/candida infections

• Loading dose: 70 mg IV on day 1
• Maintenance dose: 50 mg IV q24 hrs x 14 days
• Max: 70 mg/day
• Note: Prolonged therapy may be provided in persistently neutropenic patients

Esophageal candidiasis

• 50 mg IV q24 hrs x 7-14 days after resolution of symptoms
• Max: 70 mg/day

Invasive aspergillosis, refractory

• Loading dose:70 mg IV on day 1
• Maintenance dose: 50 mg IV q24 hrs
• Max: 70 mg/day
• Note: Duration of therapy is based on severity of the patient’s underlying disease, recovery from immunosuppression, and clinical response

• Administer by slow intravenous (IV) infusion over 1 hr
• Do not administered by IV bolus administration

Pediatric Dosing

Fungal infections (Empirical therapy)

3 months-17 yrs

• Loading dose: 70 mg/m²IV on day 1
• Maintenance dose: 50 mg/m² IV q24 hrs
• Max: 70 mg/day
• Note: Continue for 14 days following the last positive culture

Candidemia/candida infections

3 months-17 yrs

• Loading dose: 70 mg/m²IV on day 1
• Maintenance dose: 50 mg/m² IV q24 hrs
• Max: 70 mg/day
• Note: Continue for 14 days following the last positive culture; not studied in meningitis, osteomyelitis, or endocarditis due to candida

Esophageal candidiasis

3 months-17 yrs

• Loading dose: 70 mg/m²IV on day 1
• Maintenance dose: 50 mg/m² IV q24 hrs
• Max: 70 mg/day
• Continue for 7-14 days after resolution of symptom

Invasive aspergillosis, refractory

3 months-17 yrs

• Loading dose: 70 mg/m²IV on day 1
• Maintenance dose: 50 mg/m² IV q24 hrs
• Max: 70 mg/day
• Note: Duration of therapy is based on severity of the patient’s underlying disease, recovery from immunosuppression, and clinical response

Febrile neutropenia

• Loading dose: 70 mg/m² IV on day 1
• Maintenance dose: 50 mg/m² IV q24 hrs
• Max: 70 mg/day

• Administer by slow intravenous (IV) infusion over 1 hr
• Do not administered by IV bolus administration
• Continue treatment until resolution of neutropenia, or for a minimum of 14 days in persistent fungal infection

[Outline]

• Adult Dosing
• Pediatric Dosing

• Fungal infections (Empirical therapy)
• Candidemia/candida infections
• Esophageal candidiasis
• Invasive aspergillosis, refractory or intolerant to other therapies

• Hypersensitivity to any of the ingredients of the product

• N/A

Renal Dose Adjustments

• Renal impairment: No dose adjustments

Hepatic Dose Adjustments

• Moderate hepatic impairment (Child-Pugh score 7 to 9): Loading dose of 70 mg IV for 1 day if indicated followed by 35 mg IV q24 hrs
• Severe hepatic impairment: Dose adjustments not defined

• Limit concurrent use with cyclosporine to patients for whom the potential benefit outweighs the potential hazards
• Transient elevations of alanine transaminase, aspartate transaminase may occur on concurrent use of drug with cyclosporine
• Abnormal LFTs may occur, monitor LFTs during therapy for evidence of worsening of hepatic function
• Hepatic dysfunction, hepatitis, and hepatic failure may occur in patients with serious underlying manifestations
• Anaphylactic reactions have been reported with therapy. Histamine-mediated adverse reactions including rash, facial swelling, angioedema, pruritus, sensation of warmth or bronchospasm may occur with therapy. Discontinue the treatment if anaphylaxis develops and administer appropriate treatment

Use cautiously in

• Hepatic impairment

Pregnancy Category:C

Breastfeeding: Safety unknown; it is not known whether drug is excreted in human milk. Manufacturer advises caution when administering to nursing woman

• RESP: Respiratory failure, pleural effusion, respiratory distress, cough, pneumonia, dyspnea, rales
• GU: Nephrotoxicity
• GI: Pancreatitis, nausea, vomiting, elevated bilirubin, abdominal pain, diarrhea
• DERM: Erythema multiforme, Stevens-Johnson syndrome, rash, decubitus ulcer
• HEMA: Anemia
• LOCAL: Infusion reaction
• METABOLIC: Hypokalemia
• CNS: Headache
• CV: Tachycardia, hypotension, peripheral edema, hypertension
• LAB TESTS: Increased alanine aminotransferase, blood alkaline phosphatase, aspartate aminotransferase, blood glucose, blood urea, blood creatinine, decreased blood potassium, magnesium, white blood cells
• EENT: Mucosal inflammation
• MUSC: Back pain
• HYPERSENSITIVITY: Anaphylaxis
• MISC: Septic shock, fever, chills, phlebitis, graft Versus host disease

• Antifungal; inhibits fungal cell wall synthesis
• Metabolism: Metabolized by liver, undergoes spontaneous chemical degradation, poor substrate for cytochrome P450
• Excretion: 41% (1.4% unchanged in urine), 35%(feces)
• Half life: 9-11 hrs (beta-phase), 40-50 hrs (gamma-phase)

US Trade Name(s)

• Cancidas

US Availability

Cancidas

• PWDR for INJ: 50 mg/vial
• PWDR for INJ: 70 mg/vial

Canadian Trade Name(s)

• Cancidas

Canadian Availability

Cancidas

• PWDR for INJ: 50 mg/vial
• PWDR for INJ: 70 mg/vial

UK Trade Name(s)

• Cancidas

UK Availability

Cancidas

• PWDR for INJ: 50 mg/vial
• PWDR for INJ: 70 mg/vial

Australian Trade Name(s)

• Cancidas

Australian Availability

Cancidas

• PWDR for INJ: 50 mg/vial
• PWDR for INJ: 70 mg/vial

[Outline]

Antimicrobials

Antifungals (Systemic)

Echinocandins

Infectious Disease

Antifungals (Systemic)

Echinocandins