Caspofungin
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DRUG-CASPOFUNGIN |
|---|---|
| Type | Drug |
| Aliases | CancidasКаспофунгін |
| Status | reviewed 2026-04-27 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | SRC-NCCN-BCELL-2025 SRC-NCCN-MM-2025 |
Drug Facts
| Class | Echinocandin antifungal (β-1,3-D-glucan synthase inhibitor) |
|---|---|
| Mechanism | Semisynthetic lipopeptide echinocandin that non-competitively inhibits β-(1,3)-D-glucan synthase, the enzyme complex (Fks1/Fks2) that synthesizes β-(1,3)-D-glucan, an essential structural polymer of the fungal cell wall absent from mammalian cells. Cell-wall instability produces fungicidal activity against most Candida species (including C. glabrata, C. krusei, and many fluconazole-resistant strains) and fungistatic activity against Aspergillus species. NO activity against Cryptococcus, Mucorales (Mucor, Rhizopus), Fusarium, or Trichosporon (these lack significant β-glucan or have alternative cell-wall structures). Excellent safety profile vs amphotericin B; narrow drug interaction profile vs azoles. FDA-approved 2001 — first echinocandin approved. Standard agents in febrile neutropenia with persistent fever ≥4-7 days despite broad-spectrum antibacterials (empirical antifungal add-on pe... |
| Typical dosing | Adult: loading dose 70 mg IV on day 1 over 60-min infusion, then maintenance 50 mg IV once daily over 60-min infusion. For patients >80 kg, increase maintenance to 70 mg daily. Hepatic adjustment: moderate (Child-Pugh 7-9) → maintenance 35 mg daily after 70 mg load; severe (Child-Pugh >9) → no formal recommendation, use with caution. Renal: NO adjustment for any degree of renal impairment including dialysis (non-renal clearance — major advantage in critical care). Pediatric (≥3 months): 70 mg/m² IV day 1 (max 70 mg) then 50 mg/m² IV daily (max 50 mg). Coadministration with enzyme inducers (rifampin, efavirenz, phenytoin, carbamazepine, dexamethasone): increase maintenance to 70 mg daily to... |
| Ukraine registered | True |
| NSZU reimbursed | True |
| Ukraine last verified | 2026-04-27 |
Notes
First-line empirical antifungal in persistent FN despite broad- spectrum antibacterials (typically day 4-7 of unresolved fever), per IDSA / ECIL / NCCN. Echinocandin class also first-line for candidemia and invasive candidiasis (IDSA 2016 — replaced fluconazole as default). Major advantages over amphotericin B: comparable / superior efficacy in candidiasis, vastly better tolerability (no nephrotoxicity, no infusion reaction beyond mild histamine-related, no significant electrolyte wasting). Major advantage over azoles: minimal CYP-mediated DDIs (critical when patient is on cyclosporine, tacrolimus, vincristine, ibrutinib, venetoclax, or other CYP3A4 substrates). Disadvantages: limited Aspergillus activity (fungistatic; voriconazole or isavuconazole preferred for documented invasive aspergillosis), no Mucor or Cryptococcus coverage, IV-only (no oral switch). De-escalate to oral fluconazole when species and susceptibility known and patient tolerating PO. Loading dose 70 mg essential — single 50 mg dose produces sub-therapeutic exposure for first 48 h. Ukraine: NSZU- covered for onco-hematology indications; widely available.
Used By
No reverse references found in the YAML corpus.