Generic Name: Cancidas Brand Name(s): Generics only. No brands available.

Uses

What is Cancidas (caspofungin) used for?

Cancidas (caspofungin) is used to treat a variety of fungal infections. Caspofungin belongs to a class of drugs known as echinocandins. It works by stopping the growth of fungi.

How should I take Cancidas (caspofungin)?

This medication is given by injection into a vein as directed by your doctor, usually once a day over 1 hour. The dosage and length of treatment are based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). In children, the dosage is also based on their body size.

If you are using this medication at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid.

Learn how to store and discard medical supplies safely.

Infusion reactions may happen while you are receiving the drug. Tell your doctor right away if you have symptoms such as fever, chills, shortness of breath, flushing, or dizziness.

Continue to use this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.

Tell your doctor if your condition does not get better or if it gets worse.

How do I store Cancidas (caspofungin)?

Store Cancidas powder in a refrigerator. Do not freeze. You may take the powder out of the refrigerator and allow it to reach room temperature before mixing your medicine.

After mixing Cancidas with a diluent in an IV bag or bottle, you may store the mixture for up to 24 hours at room temperature, or up to 48 hours in a refrigerator.  There may be different brands of Cancidas (caspofungin) that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Cancidas (caspofungin) down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Cancidas (caspofungin)?

Before using caspofungin, tell your doctor or pharmacist if you are allergic to it; or to other echinocandin antifungal drugs (such as anidulafungin, micafungin); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Cancidas (caspofungin) during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Cancidas (caspofungin). Cancidas (caspofungin) is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Cancidas (caspofungin)?

Swelling/redness/irritation at the injection site, nausea/vomiting, diarrhea, or headache may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: signs of liver disease (such as nausea/vomiting that doesn’t stop, loss of appetite, dark urine, stomach/abdominal pain, yellowing eyes/skin), swelling ankles/feet/hands, fast/irregular heartbeat, muscle cramps.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Cancidas (caspofungin)?

Cancidas (caspofungin) may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Cancidas (caspofungin)?

Cancidas (caspofungin) may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Cancidas (caspofungin)?

Cancidas (caspofungin) may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Cancidas (caspofungin).

What is the dose of Cancidas (caspofungin) for an adult?

Usual Adult Dose for Aspergillosis – Invasive

In patients refractory to or intolerant of other therapies:

Loading dose: 70 mg IV on day 1

Maintenance dose: 50 mg IV once a day

Duration of therapy should be based on the severity of the patient’s underlying disease, recovery from immunosuppression, and clinical response.

Usual Adult Dose for Candidemia

Candidemia and the following Candida infections – intraabdominal abscesses, peritonitis, and pleural space infections:

Loading dose: 70 mg IV on day 1

Maintenance dose: 50 mg IV once a day

Duration of therapy should be dictated by the patient’s clinical and microbiological response. In general, antifungal therapy should continue for at least 14 days after the last positive culture. Patients who remain persistently neutropenic may warrant a longer course of therapy pending resolution of the neutropenia.

Usual Adult Dose for Esophageal Candidiasis

50 mg IV once a day for 7 to 14 days after symptom resolution

A 70 mg loading dose has not been studied with this indication. Because of the risk of relapse of oropharyngeal candidiasis in patients with HIV infections, suppressive oral therapy could be considered.

Usual Adult Dose for Febrile Neutropenia

Empirical therapy for presumed fungal infections:

Loading dose: 70 mg IV on day 1

Maintenance dose: 50 mg IV once a day

Duration of treatment should be based on the patient’s clinical response. Empirical therapy should continue until resolution of neutropenia. Patients found to have a fungal infection should be treated for a minimum of 14 days; treatment should continue for at least 7 days after both neutropenia and clinical symptoms are resolved. If the 50 mg dose is well tolerated but does not provide an adequate clinical response, the daily dose can be increased to 70 mg.

Renal Dose Adjustments

No adjustment recommended.

Liver Dose Adjustments

Adults:

Mild hepatic dysfunction (Child-Pugh score 5 to 6): No adjustment recommended.

Moderate hepatic dysfunction (Child-Pugh score 7 to 9):

Loading dose (where recommended): 70 mg IV on day 1

Maintenance dose: 35 mg IV once a day

Dose Adjustments

Adults:

On rifampin: Should receive 70 mg of caspofungin once a day

On nevirapine, efavirenz, carbamazepine, dexamethasone, or phenytoin: May require an increase in dose to 70 mg of caspofungin once a day

Dialysis

Caspofungin is not removed by hemodialysis, thus supplementary dosing is not required following hemodialysis.

Other Comments

Caspofungin should be administered by slow IV infusion over approximately 1 hour.

What is the dose of Cancidas (caspofungin) for a child?

Usual Pediatric Dose for Candidemia

Candidemia and the following Candida infections – intraabdominal abscesses, peritonitis, and pleural space infections:

3 months or older:

Loading dose: 70 mg/m2 IV on day 1

Maintenance dose: 50 mg/m2 IV once a day

The maximum loading dose and the daily maintenance dose should not exceed 70 mg, regardless of the patient’s calculated dose. If the 50 mg/m2 daily dose is well tolerated but does not provide adequate clinical response, the daily dose can be increased to 70 mg/m2 daily (not to exceed 70 mg).

Duration of therapy should be dictated by the patient’s clinical and microbiological response. In general, antifungal therapy should continue for at least 14 days after the last positive culture. Patients who remain persistently neutropenic may warrant a longer course of therapy pending resolution of the neutropenia.

Usual Pediatric Dose for Aspergillosis – Invasive

In patients refractory to or intolerant of other therapies:

3 months or older:

Loading dose: 70 mg/m2 IV on day 1

Maintenance dose: 50 mg/m2 IV once a day

The maximum loading dose and the daily maintenance dose should not exceed 70 mg, regardless of the patient’s calculated dose. If the 50 mg/m2 daily dose is well tolerated but does not provide adequate clinical response, the daily dose can be increased to 70 mg/m2 daily (not to exceed 70 mg).

Duration of therapy should be based on the severity of the patient’s underlying disease, recovery from immunosuppression, and clinical response.

Usual Pediatric Dose for Esophageal Candidiasis

3 months or older:

Loading dose: 70 mg/m2 IV on day 1

Maintenance dose: 50 mg/m2 IV once a day for 7 to 14 days after symptom resolution

The maximum loading dose and the daily maintenance dose should not exceed 70 mg, regardless of the patient’s calculated dose. If the 50 mg/m2 daily dose is well tolerated but does not provide adequate clinical response, the daily dose can be increased to 70 mg/m2 daily (not to exceed 70 mg).

Because of the risk of relapse of oropharyngeal candidiasis in patients with HIV infections, suppressive oral therapy could be considered.

Usual Pediatric Dose for Febrile Neutropenia

Empirical therapy for presumed fungal infections:

3 months or older:

Loading dose: 70 mg/m2 IV on day 1

Maintenance dose: 50 mg/m2 IV once a day

The maximum loading dose and the daily maintenance dose should not exceed 70 mg, regardless of the patient’s calculated dose. If the 50 mg/m2 daily dose is well tolerated but does not provide adequate clinical response, the daily dose can be increased to 70 mg/m2 daily (not to exceed 70 mg).

Duration of treatment should be based on the patient’s clinical response. Empirical therapy should continue until resolution of neutropenia. Patients found to have a fungal infection should be treated for a minimum of 14 days; treatment should continue for at least 7 days after both neutropenia and clinical symptoms are resolved.

Dose Adjustments

Pediatrics:

Coadministered with inducers of drug clearance, such as rifampin, efavirenz, nevirapine, phenytoin, dexamethasone, or carbamazepine: A caspofungin dose of 70 mg/m2 once a day (not to exceed 70 mg) should be considered

Precautions

Safety and effectiveness have not been established in pediatric patients less than 3 months of age.

How is Cancidas (caspofungin) available?

Cancidas (caspofungin) is available in the following dosage forms and strengths:

  • Intravenous powder for injection.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Cancidas (caspofungin), take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: June 4, 2018 | Last Modified: June 4, 2018

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