caspofungin
Caspofungin (Cancidas) is effective at treating fungal infections when you can't take other medications, but it has many side effects and can be expensive.
What is Caspofungin (Cancidas)?
What is Caspofungin (Cancidas) used for?
Fungal infections in people with a fever and a low number of white blood cells
Candidemia (a fungal infection in your blood) and other infections caused by Candida
Candidiasis of the esophagus (thrush in the esophagus)
Invasive aspergillosis (a serious fungal infection affecting multiple areas of the body)
How Caspofungin (Cancidas) works
Caspofungin (Cancidas) is an antifungal medication. It works by slowing the growth of the fungus causing your infection.
Drug Facts
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What are the side effects of Caspofungin (Cancidas)?
Common Side Effects
- Fever (20%)
- Diarrhea (14%)
- Changes to liver blood tests (12-13%)
- Low potassium (11%)
- Chills (10%)
- Headache (10%)
- Nausea (9%)
- Vomiting (8%)
- Rash (8%)
Other Side Effects
- Swelling of the arms or legs
- Cough
- Pneumonia
- Redness
- Low blood pressure
Serious Side Effects
- Allergic reactions
- Life-threatening skin reactions
- Liver failure
Source:Â DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
More common
Bloating or swelling of the face, arms, hands, lower legs, or feet
blue lips, fingernails, or skin
blurred vision
changes in skin color
confusion
cracked lips
decreased urine
difficult or troubled breathing
difficulty with swallowing
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
headache
increased thirst
irregular heartbeat
irregular, fast, slow, or shallow breathing
loss of appetite
mood changes
muscle pain or cramps
nervousness
numbness or tingling in your hands, feet, or lips
pain or redness at the injection site
pain, tenderness, or swelling of the foot or leg
pale skin
pounding in the ears
rapid weight gain
seizures
slow or fast heartbeat
sores, ulcers, or white spots on the lips, tongue, or inside the mouth
sweating
tightness in the chest
troubled breathing with exertion
unusual bleeding or bruising
unusual tiredness or weakness
unusual weight gain or loss
vomiting
Less common
Bloody urine
decreased frequency or amount of urine
increased blood pressure
lower back or side pain
yellow eyes or skin
Incidence not known
Black, tarry stools
bladder pain
bleeding gums
blood in the urine or stools
bloody nose
chest pain or discomfort
clay-colored stools
cloudy urine
dark urine
decreased appetite
drowsiness
fever with or without chills
flushed, dry skin
frequent urge to urinate
fruit-like breath odor
general feeling of tiredness or weakness
incoherent speech
increased hunger
increased urination
indigestion
light-colored stools
metallic taste
muscle spasms (tetany) or twitching seizures
muscle weakness
no blood pressure or pulse
noisy, rattling breathing
pain or discomfort in the arms, jaw, back, or neck
pains in the stomach, side, or abdomen, possibly radiating to the back
pinpoint red spots on the skin
rapid weight gain
rash
right upper abdominal or stomach pain and fullness
shakiness in the legs, arms, hands, or feet
stomach pain, continuous
stomach pain or tenderness
stopping of heart
trembling or shaking of the hands or feet
troubled breathing at rest
ulcers, sores, or white spots in the mouth
unconsciousness
unexplained weight loss
unpleasant breath odor
vomiting of blood
weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Flushing, redness of the skin
unusually warm skin
Incidence not known
Back pain
belching
blistering, peeling, or loosening of the skin
bloated or feeling of fullness
bumps on the skin
difficulty in moving
dry, red, hot, or irritated skin
fear
flaking and falling off of the skin
hives or welts
indigestion
joint or muscle pain
lack or loss of strength
muscle pain or stiffness
pressure in the stomach
red skin lesions, often with a purple center
red, irritated eyes
redness of the skin
sleepiness or unusual drowsiness
small red or purple spots on the skin
stomach discomfort, upset, or pain
swelling of the abdominal or stomach area
trouble sleeping
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Caspofungin (Cancidas)
Pros
Treats life-threatening infections
Works when other antifungals fail
Can be used if you have kidney problems
Has been used safely in children as young as 3 months old
Cons
Must be given through an IV line over 1 hour
Usually only given in a hospital or by a trained home healthcare professional
Expensive without insurance
Many side effects
Hard on the liver
Pharmacist tips for Caspofungin (Cancidas)
Store your vials of caspofungin (Cancidas) in the fridge. Do not freeze the medication. The vials of caspofungin (Cancidas) are made of glass, so be careful handling them.
It takes 1 hour for your dose of caspofungin (Cancidas) to be given through an IV line. This helps lower the amount of discomfort you might feel where caspofungin (Cancidas) is being infused.
Don't drink alcohol while you're on caspofungin (Cancidas). Caspofungin (Cancidas) can cause liver damage and drinking alcohol raises your risk of this.
Chills, nausea, vomiting, and diarrhea are common side effects from caspofungin (Cancidas). They tend to happen most right after you finish receiving your infusion but some people continue to experience these side effects several hours later. If these side effects stop you from being able to perform normal activities (grocery shopping, cleaning around the house, going to work), please speak with your healthcare provider on how to best manage them. There are medications you can take shortly before your dose of caspofungin (Cancidas) to help lessen these side effects.
Caspofungin (Cancidas) interacts with transplant medications like cyclosporine. This combination can lead to liver damage. Because continuing transplant medications is necessary to prevent problems, you will most likely need blood tests done to check your liver health while using caspofungin (Cancidas). It is possible you may need to stop caspofungin (Cancidas) and use something different if your liver blood tests start to show damage.
Frequently asked questions about Caspofungin (Cancidas)
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What are the risks and warnings for Caspofungin (Cancidas)?
Caspofungin (Cancidas) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
ALLERGIC REACTIONS
Severe allergic reactions to caspofungin (Cancidas) are possible, including life-threatening problems like anaphylaxis (closing of the throat). Call 911 if this happens and you are at home. A healthcare professional giving caspofungin (Cancidas) at home will have epinephrine with them in case of a sudden allergic reaction. If you notice hives, rash, swelling of the lips or tongue, or difficulty breathing after using caspofungin (Cancidas), call your healthcare provider right away.
SEVERE SKIN REACTIONS
Very rarely, people have developed severe, potentially life-threatening skin reactions, including Stevens-Johnson syndrome (SJS), after starting caspofungin (Cancidas). These types of allergic rashes are painful and create blisters all over the body. Seek immediate medical attention if you notice a new or severe rash, a rash accompanied by a fever, unexplained blisters, or new sores inside your mouth.
LIVER FAILURE
Risk factors: History of liver problems | Current liver problems | People taking cyclosporine | Alcohol use
Caspofungin (Cancidas) can cause severe liver damage or liver failure, which is life-threatening. Your risk of this is higher if you have or have had liver problems, if you take cyclosporine, or if you drink alcohol while using caspofungin (Cancidas). If you have any of these risk factors, you will have to have blood tests done while taking caspofungin (Cancidas) to make sure your liver stays healthy. If you experience unexplained stomach pain, nausea, vomiting, dark urine, pale stools, or yellowing of your skin or eyes, contact your healthcare provider immediately. Blood tests will need to be done to check your liver health.
Caspofungin (Cancidas) dosage forms
Typical dosing for Caspofungin (Cancidas)
Caspofungin (Cancidas) is usually given in a hospital or at home by a visiting nurse.
Fungal infections in people with a fever and a low number of white blood cells: Adults receive 70 mg of caspofungin (Cancidas) by IV infusion on the first day. After that, 50 mg of caspofungin (Cancidas) is given by IV infusion once a day. This dose can be raised back up to 70 mg if the 50 mg dose isn't working well enough. The dose for children between the age of 3 months and 17 years is based on their body surface area but should never be more than what the typical adult dose is. You will continue to receive caspofungin (Cancidas) by IV once a day until you have been symptom-free for at least 7 days or until your blood tests show no fungus for 14 days in a row.
Candidemia and other Candida infections: 70 mg of caspofungin (Cancidas) is given by IV infusion on the first day. After that, 50 mg of caspofungin (Cancidas) is given by IV infusion once a day. The dose for children between the age of 3 months and 17 years is based on their body surface area but should never be more than what the typical adult dose is. You will continue to receive caspofungin (Cancidas) by IV once a day until your blood tests show no fungus for at least 14 days in a row.
Thrush of the esophagus: 50 mg of caspofungin (Cancidas) is given by IV infusion once a day. The dose for children between the age of 3 months and 17 years is based on their body surface area but should never be more than what the typical adult dose is. You will continue to receive caspofungin (Cancidas) by IV once a day until you have been symptom-free for at least 7 to 14 days.
Invasive aspergillosis: 70 mg of caspofungin (Cancidas) is given by IV infusion on the first day. After that, 50 mg of caspofungin (Cancidas) is given by IV infusion once a day. The dose for children between the age of 3 months and 17 years is based on their body surface area but should never be more than what the typical adult dose is. The length of time you receive caspofungin (Cancidas) is different for everyone and depends on how fast your infection gets better.
Interactions between Caspofungin (Cancidas) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
How much does Caspofungin (Cancidas) cost?
What are alternatives to Caspofungin (Cancidas)?
Fungal infections in people with a fever and a low number of white blood cells
Candidemia (a fungal infection in your blood) and other infections caused by Candida
Candidiasis of the esophagus (thrush in the esophagus)
Invasive aspergillosis (a serious fungal infection affecting multiple areas of the body)
Candidemia (candidiasis infection of the bloodstream)
Candidiasis infections that have spread to deep tissue areas, including stomach and wounds
Scedosporiosis and fusariosis fungal infections in people who can't take, or didn't respond well, to other treatment
Fungal infections in people with a fever and a low number of white blood cells
Cryptococcal meningitis in people with HIV
People with severe fungal infections caused by Aspergillus, Candida, or Cryptococcus who have already tried other antifungals or cannot take other antifungals
Black fever (visceral leishmaniasis)
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