• Invasive aspergillosis refractory to, or intolerant of, other therapies.
• Candidemia and associated serious infections (intra-abdominal abscesses, peritonitis, pleural space infections).
• Esophageal candidiasis.
• Suspected fungal infections in febrile neutropenic patients.

Contraindicated in:

• Hypersensitivity
• OB: Pregnancy.

Use Cautiously in:

• Moderate hepatic impairment (↓ maintenance dose recommended)
• Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant.

Derm: flushing, pruritus, rash, STEVENS-JOHNSON SYNDROME (SJS), TOXIC EPIDERMAL NECROLYSIS.

GI: ↑liver enzymes, diarrhea, nausea, vomiting.

GU: ↑serum creatinine.

Local: venous irritation at injection site.

Neuro: headache.

Resp: bronchospasm.

Misc: chills, fever, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS AND ANGIOEDEMA).

Drug-Drug:

• ↑risk of hepatotoxicity with Cyclosporine; closely monitor liver enzymes during concurrent therapy.
• May ↓ levels and effectiveness of tacrolimus.
• Rifampin may ↓ levels and effectiveness; maintenance dose should be ↑ to 70 mg/day (in patients with normal hepatic function).
• Efavirenz, nelfinavir, nevirapine, phenytoin, dexamethasone, or carbamazepine may ↓ levels and effectiveness; an ↑ in the maintenance dose to 70 mg/day should be considered in patients who are not clinically responding.

(Generic available)

• Powder for injection: 50 mg/vial; 70 mg/vial;

• IV (Adults): 70 mg initially followed by 50 mg once daily; duration determined by clinical situation and response; Esophageal candidiasis: 50 mg once daily; duration determined by clinical situation and response.
• IV (Children 3 mo): 70 mg/m² (max = 70 mg) initially followed by 50 mg/m² once daily (max = 70 mg/day); duration determined by clinical situation and response.
• IV (Infants 1 to <3 mo and Neonates): 25 mg/m² once daily.

Cancidas

• Inhibits the synthesis of (1, 3)-D-glucan, a necessary component of the fungal cell wall.

• Death of susceptible fungi.

Therapeutic Classification: antifungals

Pharmacologic Classification: echinocandins

Absorption: IV administration results in complete bioavailability.

Distribution: Widely distributed to tissues.

Protein Binding: 97%.

Metabolism/Excretion: Slowly and extensively metabolized; <1.5% excreted unchanged in urine.

Half-life: Polyphasic: phase: 9–11 hr; phase: 40–50 hr.

• Explain the purpose of caspofungin to patient and family.
• Advise patient to notify health care professional immediately if symptoms of allergic reactions (rash, facial swelling, pruritus, sensation of warmth, difficulty breathing) occur.
• Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

kas-po-FUN-gin

NDC Code^*

• 0006- Merck Sharp and Dohme Corp.
  • 0006-3822- CANCIDAS
    • 0006-3822-10- 1 VIAL, SINGLE-USE in 1 CARTON (0006-3822-10) > 10.8 mL in 1 VIAL, SINGLE-USE

• 0006- Merck Sharp and Dohme Corp.
  • 0006-3823- CANCIDAS
    • 0006-3823-10- 1 VIAL, SINGLE-USE in 1 CARTON (0006-3823-10) > 10.8 mL in 1 VIAL, SINGLE-USE

• 0781- Sandoz Inc
  • 0781-3421- CASPOFUNGIN ACETATE
    • 0781-3421-94- 1 VIAL, SINGLE-DOSE in 1 CARTON (0781-3421-94) > 10.8 mL in 1 VIAL, SINGLE-DOSE (0781-3421-01)

• 0781- Sandoz Inc
  • 0781-3423- CASPOFUNGIN ACETATE
    • 0781-3423-94- 1 VIAL, SINGLE-DOSE in 1 CARTON (0781-3423-94) > 10.8 mL in 1 VIAL, SINGLE-DOSE (0781-3423-01)

• 47781- Alvogen Inc.
  • 47781-613- Caspofungin Acetate
    • 47781-613-07- 1 VIAL, SINGLE-DOSE in 1 CARTON (47781-613-07) > 10.8 mL in 1 VIAL, SINGLE-DOSE

• 47781- Alvogen Inc.
  • 47781-614- Caspofungin Acetate
    • 47781-614-07- 1 VIAL, SINGLE-DOSE in 1 CARTON (47781-614-07) > 10.8 mL in 1 VIAL, SINGLE-DOSE

• 63323- Fresenius Kabi USA, LLC
  • 63323-356- Caspofungin Acetate
    • 63323-356-10- 10 VIAL, SINGLE-DOSE in 1 CARTON (63323-356-10) > 10.8 mL in 1 VIAL, SINGLE-DOSE (63323-356-01)

• 63323- Fresenius Kabi USA, LLC
  • 63323-358- Caspofungin Acetate
    • 63323-358-10- 10 VIAL, SINGLE-DOSE in 1 CARTON (63323-358-10) > 10.8 mL in 1 VIAL, SINGLE-DOSE (63323-358-01)

• 67457- Mylan Institutional LLC
  • 67457-831- Caspofungin acetate
    • 67457-831-50- 1 VIAL, SINGLE-DOSE in 1 CARTON (67457-831-50) > 10.8 mL in 1 VIAL, SINGLE-DOSE

• 67457- Mylan Institutional LLC
  • 67457-832- Caspofungin acetate
    • 67457-832-70- 1 VIAL, SINGLE-DOSE in 1 CARTON (67457-832-70) > 10.8 mL in 1 VIAL, SINGLE-DOSE

• 68083- Gland Pharma Limited
  • 68083-158- Caspofungin Acetate
    • 68083-158-01- 1 VIAL in 1 CARTON (68083-158-01) > 10 mL in 1 VIAL

• 68083- Gland Pharma Limited
  • 68083-159- Caspofungin Acetate
    • 68083-159-01- 1 VIAL in 1 CARTON (68083-159-01) > 10 mL in 1 VIAL

• 69097- Cipla USA Inc.
  • 69097-365- caspofungin acetate
    • 69097-365-37- 10 mL in 1 VIAL, SINGLE-DOSE (69097-365-37)

• 69097- Cipla USA Inc.
  • 69097-366- caspofungin acetate
    • 69097-366-37- 10 mL in 1 VIAL, SINGLE-DOSE (69097-366-37)

• 70860- Athenex Pharmaceutical Division, LLC.
  • 70860-106- Caspofungin Acetate
    • 70860-106-10- 1 VIAL in 1 CARTON (70860-106-10) > 10.8 mL in 1 VIAL

• 70860- Athenex Pharmaceutical Division, LLC.
  • 70860-107- Caspofungin Acetate
    • 70860-107-10- 1 VIAL in 1 CARTON (70860-107-10) > 10.8 mL in 1 VIAL

• 72266- Fosun Pharma USA Inc.
  • 72266-106- Caspofungin Acetate
    • 72266-106-01- 1 VIAL in 1 CARTON (72266-106-01) > 1 mL in 1 VIAL

• 72266- Fosun Pharma USA Inc.
  • 72266-107- Caspofungin Acetate
    • 72266-107-01- 1 VIAL in 1 CARTON (72266-107-01) > 10 mL in 1 VIAL