1 vial 50mg

$577.27

1 vial 70mg

$862.50

  • invasive of oesophageal candidiasis: treatment of candidaemia and the following Candida infections: intra-abdominal abscesses, peritonitis and pleural space infections. Caspofungin acetate has not been studied in endocarditis, osteomyelitis, and meningitis due to Candida.

  • Aspergillus infection: Caspofungin is indicated for treatment of invasive aspergillosis in patients who are refractory to or intolerant of other therapies (i.e., amphotericin B, lipid formulations of amphotericin B, and/or itraconazole); however, it has not been studied as initial therapy for invasive aspergillosis.

  • Empirical therapy for presumed fungal infections in febrile, neutropaenic patients.

IV:
50mg and 70mg vials of white powder
Refrigerate at 2-8°C. Do not freeze.
Bring vial to room temperature and reconstitute by adding 10.5ml of water for injection. Mix gently until completely dissolved producing a clear solution. Concentrations of reconstituted vials are 7mg/ml (70mg vial) or 5mg/ml (50mg vial).
Add required volume of reconstituted solution to 250ml of compatible IV fluid and administer slowly over approximately 1 hour. A reduced volume of 100ml may be used for 50mg or 35mg doses only.
Reconstituted solution and diluted infusion solution are stable for 24 hours at or below 25°C
Compatible with:
Normal saline Hartmanns


ADULT DOSE
IV:
Loading dose of 70mg followed by 50mg daily
See also IMPORTANT DRUG INTERACTIONS FOR THE INTENSIVE CARE UNIT as dosage adjustment is required when coadministered with particular medicines.
Note: dosage adjustment is required in liver failure:
Patients with mild hepatic insufficiency (Child-Pugh score 5-6) do not need a dosage adjustment. For patients moderate hepatic insufficiency (Child-Pugh score 7-9), caspofungin acetate 35 mg daily is recommended. However, where recommended, a 70-mg loading dose should still be administered on Day 1. There is no clinical experience in patients with severe hepatic insufficiency (Child-Pugh score >9).

PAEDIATRIC DOSE
70mg/m
2 day 1, then 50mg/m2 daily IV
Note: The safety and efficacy of Caspofungin in the paediatric population is not established.

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY
Dose as in normal renal function

Caspogunfin is the first of a new class of antifungal drugs (echinocandins) that inhibit the synthesis of an integral component of the fungal cell wall.

Caspofungin exhibits in vitro activity against Aspergillus species (Aspergillus fumigatus, Aspergillus flavus, and Aspergillus terreus) and Candida species (Candida albicans, Candida glabrata, Candida guilliermondii, Candida krusei, Candida parapsilosis, and Candida tropicalis).

Based on available evidence from clinical studies, it appears that caspofungin is as effective as amphotericin B in empirical therapy of persistent febrile neutropaenia and in patients with invasive Candidiasis.

CONTRAINDICATIONS:

  • Hypersensitivity to caspofungin.

WARNINGS
Concomitant use of caspofungin acetate with cyclosporin is not recommended unless the potential benefit outweighs the potential risk to the patient due to an increased risk of liver toxicity.

PRECAUTIONS
General
The efficacy of a 70-mg dose regimen in patients with invasive aspergillosis who are not clinically responding to the 50-mg daily dose is not known. Limited safety data suggest that an increase in dose to 70 mg daily is well tolerated.
Laboratory abnormalities in liver function tests have been seen in healthy volunteers and patients treated with caspofungin acetate. In some patients with serious underlying conditions who were receiving multiple concomitant medications along with caspofungin acetate, clinical hepatic abnormalities have also occurred. Isolated cases of significant hepatic dysfunction, hepatitis, or worsening hepatic failure have been reported in patients; a causal relationship to caspofungin acetate has not been established.

Laboratory Tests:
No tests in addition to standard tests are indicated.

Drug/Laboratory Test Interactions:
None known.

Caspofungin with:
Tacrolimus: Caspofungin acetate reduces the blood levels of tacrolimus. For patients receiving both therapies, standard monitoring of tacrolimus blood concentrations and appropriate tacrolimus dosage adjustments are recommended.
Cyclosporin: See WARNINGS.
Rifampicin: A drug-drug interaction study with rifampin in healthy volunteers has shown a 30% decrease in caspofungin trough concentrations. Patients on rifampin should receive 70 mg of caspofungin acetate daily.
Dexamethasone: Increases clearance of caspofungin; use 70mg daily of caspofungin
Phenytoin: Increases clearance of caspofungin; use 70mg daily of caspofungin
Carbamazepine: Increases clearance of caspofungin; use 70mg daily of caspofungin

Body as a whole:
Chills, Fever, Flushing, Perspiration/diaphoresis
Cardiovascular System:
Hypertension, Tachycardia
Gastrointestinal System:
Abdominal pain, Diarrhoea, Nausea, Vomiting
Musculoskeletal System:
Back pain
Respiratory System:
Dyspnoea, Tachypnoea
Nervous System:
Headache
Metabolic:
Hypokalaemia
Skin:
Rash

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