Monograph Details
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Infections & Infestations
> Fungal infections
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CANCIDAS |
| Manufacturer |
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Merck & Co., Inc. |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Glucan synthesis inhibitor (echinocandin). |
| Generic Name |
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Caspofungin acetate 50mg, 70mg; per vial; pwd for IV infusion after reconstitution and dilution. |
| Indications |
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Presumed fungal infections in febrile neutropenia, as empiric therapy. Candida infections of the esophagus, blood, peritoneum, intraabdominal abscess, pleural space. Invasive aspergillosis in patients refractory to or intolerant of other therapies (not for initial therapy). |
| Children |
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<18yrs: not recommended. |
| Adults |
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Give by slow IV infusion over 1 hour. ≥18yrs: Esophageal candidiasis: 50mg daily. Other Candida infections, aspergillosis, or empiric: 70mg once on day 1 then 50mg daily. Give 70mg daily if on concomitant rifampin, consider 70mg daily for concomitant nevirapine, efavirenz, carbamazepine, dexamethasone, phenytoin. For all: continue at least 14 days after last positive culture. Empiric: treat for at least 14 days; continue for at least 7 more days after resolution of neutropenia and clinical symptoms; may increase to 70mg/day. Moderate hepatic insufficiency: 35mg daily (may give 70mg on day 1 when indicated). |
| Precautions |
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Severe hepatic insufficiency. Elderly. Pregnancy (Cat.C). Nursing mothers. |
| Interactions |
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See Adult dose. Cyclosporine: see literature. Monitor tacrolimus levels. |
| Adverse Reactions |
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Inj site reactions, flushing, GI upset, fever, headache, rash, blood dyscrasias, decreased hematocrit, increased alkaline phosphatase, ALT/AST. |
| How Supplied |
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Single-use vials—1 |
| Additional Resources |
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• Related Prescribing Note |
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