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
  • Fluid restriction (ref 1): Final concentration must not exceed 0.5mg/mL e.g.70mg in 140mL

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
Higher doses (unlicensed)May be recommended by Micro/ID for specific indications. Contact pharmacy for information on doses and administration(pharmacists- log in to medinfogalway to view document)

* 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 November 2022

1. Injectable medicines guide, downloaded from Medusa, 13/02/2025

Therapeutic classification

Antifungal agent