Parenteral Manual

Caspofungin

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
CANCIDAS®
Classification: 
Antifungal
Original Date: 
August 2005
Revised Date: 
May 2012
Indications: 
  • Inhibitor of fungal cell wall synthesis
  • Activity against aspergillosis, candida species and pneumocystis carinii
  • Limited experience in pediatrics; Infectious Diseases should be consulted
Reconstitution and Stability: 
  • Prior to reconstitution, vial should be allowed to reach room temperature
  • 50 mg/vial - reconstitute with 10.5 mL Sterile Water for Injection to get 5 mg/mL
  • Vial stable 1 hour at room temperature  
  • Diluted solutions stable 48 hours refrigerated or 24 hours at room temperature
Compatibility: 

- Solutions Compatible: lactated ringers, 0.9%, 0.45% or 0.225% NaCl solutions

- Incompatible: dextrose containing solutions

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct

NO
IV Intermittent Infusion YES.  
Usual dilution: 0.2-0.5 mg/mL
Infusion time: 1 hour
IV Continuous Infusion NO

 

Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

  • Infants 1 month to less than 3 months:  25 mg/m2/dose  IV once daily
  • 3 months - 17 years
    Loading dose:  70 mg/m2 IV on day 1
    followed by :  50 mg/m2/day IV  once daily  
    Maximum dose: 70 mg/day

Click here to go to Lexicomp online to calculate the Body Surface Area.  From this page, type in "body surface area " in the lookup box, click on lookup tab and choose Body Surface Area:  Pediatric. 

  • > 17 years:
    Loading dose:  70 mg IV on day 1
    followed by:  50 mg IV once daily
    May increase to 70 mg daily in patient not clinically responding to 50 mg daily
  • No adjustment needed for renal impairment
  • Adjust for moderate to severe hepatic impairment - reduce daily dose to 0.75 mg/kg/day
  • May need to increase maintenance dose by 25-50% with concomitant use of hepatic metabolic inducers
Potential hazards of parenteral administration: 
  • Histamine release may be rate related (infuse over 1 hour)
  • Histamine release --> anaphylaxis
  • Vein irritation
  • Fever, nausea, vomiting, flushing, headache
  • Proteinuria, hypokalemia, eosinophilia, elevation of liver function tests, elevation of serum creatinine
Notes: 
  • Decreases blood concentration of tacrolimus (monitor tacrolimus blood concentration)
  • Rifampin may decrease caspofungin trough concentrations by 30% (adjust caspofungin daily dose)
References: 

The information contained on this website is provided for informational purposes only, as a guide to assist physicians, nurses and other healthcare providers in deciding on the appropriate care required for a particular patient. At all times, physicians, nurses and other healthcare providers must exercise their independent clinical judgment, based on their knowledge, training and experience, taking into account the specific facts and circumstances of each patient, when deciding on the appropriate course of investigation and/or treatment to recommend in a particular clinical situation.

CHEO has made every effort to ensure that the information contained on this website is as current and accurate as possible. However, changes can occur due to ongoing research and the constant influx of new information. Where possible, hospitals and healthcare practitioners should verify the information before acting on it.

Reliance on any information in this website is at the user's own risk. CHEO is not responsible or liable for any harm, loss or other consequences from the use or misuse of the information on this website.