Caspofungin Intravenous Infusion for Adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Important information

• Reserve antimicrobial: Restricted for indications in the antimicrobial prescribing guidelines, or following approval by microbiology/infectious diseases
• There are numerous important interactions e.g. transplant medicines - check current BNF

Available preparations

Cancidas 50mg vial

Cancidas 70mg vial

Caspofungin 50mg vial (Clonmel)

Caspofungin 70mg vial (Clonmel)

Reconstitution

Water for injections

• 10.5ml per 50mg vial (produces a 5.2mg per ml solution)
• 10.5ml per 70mg vial (produces a 7.2mg per ml solution)
• (if a 35mg dose is required, draw up required volume from the reconstituted 50mg vial)
• Dilute further prior to administration

Infusion fluids

Sodium chloride 0.9%

Methods of intravenous administration

Intermittent intravenous infusion

• Add required dose to 250ml infusion fluid and administer over 60 minutes
• If necessary, doses of 50mg or 35mg may be added to 100ml of infusion fluid

Dose in adults

Patient weight	Day of treatment	Dose	Frequency
Less than 80kg	Day 1	70mg	once only
	Day 2 onwards (patient not on enzyme inducer drugs*)	50mg	every twenty-four hours
	Day 2 onwards (patient on enzyme inducer drugs*)	consider, 70mg	every twenty-four hours
Greater than 80kg	Day 1	70mg	once only
	Day 2 onwards	70mg	every twenty-four hours

* Enzyme inducer drugs include; for example,phenytoin, carbamazepine, rifampicin,dexamethasone, efavirenz, nevirapine

Hepatic impairment: Child-Pugh classification applies to patients with cirrhosis. If the patient has hepatic impairment but does not have cirrhosis, dosage adjustment should be discussed with Micro/ID

Hepatic impairment - SEE NOTE ABOVE	Day 1	Day 2 onwards
Moderate hepatic insufficiency(Child-Pugh score 7 to 9)	70mg once	35mg daily
Severe hepatic impairment (Child-Pugh score>9).	No dosage recommendations available based on lack of evidence-base, discuss with Micro/ID

Renal impairment

• No dosage adjustment required

Storage

• Store between 2 to 8⁰C

References

Caspofungin (Clonmel) SPC April 2021

Therapeutic classification

Antifungal agent