Caspofungin

Antimycotic from the class of Echinocandine.

• Initial 70 mg i.v. on the 1st day of treatment, from day 2 on 50 mg/day i.v.
• For patients > 80 kg: No dose reduction after initial dose, continue treatment with 70 mg/day i.v.

• Notice! Dose reduction may be necessary in patients with liver failure.

Cancidas®

Red Hand Letter from 09.10.2025!

Summary
- The use of polyacrylonitrile-based membranes should be avoided in patients on continuous renal replacement therapy with caspofungin.
- Cases have been reported in which caspofungin was ineffective in patients on continuous renal replacement therapy with polyacrylonitrile filter membranes.
- The risk of antifungal treatment failure may lead to worsening systemic infection and ultimately death.
- It is recommended to use an alternative extracorporeal membrane or antifungal agent.

A dose increase is not applicable, as the problem of sequestration remains and the therapy will therefore still be ineffective!

further information: BfArM

1. Brown AL, Greig JR (2003) Caspofungin versus amphotericin B for invasive candidiasis. N Engl J Med 348:1287-1288
2. Letscher-Bru V, Herbrecht R (2003) Caspofungin: the first representative of a new antifungal class. J Antimicrob Chemother 51: 513-521
3. Smith K et al (2003) Resolution of azole-resistant oesophageal candidiasis in an AIDS patient after treatment with caspofungin. AIDS 17: 448-449
4. Walsh TJ (2002) Echinocandins--an advance in the primary treatment of invasive candidiasis. N Engl J Med 347: 2070-2072