Parenteral Manual


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Alternate Name(s): 
Original Date: 
August 2005
Revised Date: 
May 2012
  • 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

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

- Incompatible: dextrose containing solutions


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

IV Direct


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



(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
  • Decreases blood concentration of tacrolimus (monitor tacrolimus blood concentration)
  • Rifampin may decrease caspofungin trough concentrations by 30% (adjust caspofungin daily dose)

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