Caspofungin (Cancidas)

Caspofungin (Cancidas) is an anti-fungal drug approved for the treatment of invasive aspergillosis in immunosuppressed adults who do not tolerate or do not respond to amphotericin (Fungilin / Fungizone) or itraconazole (Sporanox). It has also been approved for the treatment of candidiasis (thrush).

Caspofungin belongs to a new group of anti-fungal agents known as glucan synthesis inhibitors. Specifically, it is an echinocandin, which is thought to inhibit beta-1,3-glucan synthase, a component of the fungal cell wall.

Caspofungin is manufactured by Merck Sharp and Dohme. It was formerly known as L-743,872 and MK-0991 and by the trade name Caspofungin MSD.

Caspofungin solution is administered by infusion over an hour. The first daily dosage is 70mg. Subsequent daily dosing depends on weight. People over 80kg continue to receive 70mg daily, while others receive 50mg daily. In people with moderate liver damage, a daily dose of 35mg is recommended but people with only mild hepatic impairment should take the standard 50mg dose.

Caspofungin is not approved for use in children due to a lack of research.

Levels of caspofungin may be lowered in people taking the non-nucleoside reverse transcriptase inhibitors efavirenz (Sustiva) or nevirapine (Viramune), as well as rifampicin (Rifadin / Rimactane), dexamethasone (Decadron), phenytoin (Epanutin) or carbamazepine (Tegretol). The 70mg dose of caspofungin may be considered in people taking these drugs.

Common side-effects include fever, headache, abdominal pain, nausea, diarrhoea, vomiting, rash and itching. Redness and pain around the injection site may occur. Altered liver enzyme levels and blood abnormalities may also occur. Caspofungin should be avoided during pregnancy and breastfeeding.