person that [50:50 mg. 1 Rate of Administration Administer by IV infusion over approximately 1 hour. 1 Dosage Available as caspofungin acetate; 1 dosage expressed in terms of the salt. 1 Pediatric Patients Dosage for pediatric patients 3 months to 17 years of age is based on body surface area (BSA) calculated using the Mosteller formula. 1 Calculate the loading dose (in mg) as BSA (m 2 ) x 70 mg/m 2 and calculate the maintenance dose (in mg) as BSA (m 2 ) x 50 mg/m 2 . 1 Regardless of the patient s calculated dose, the maximum loading dose and maximum daily maintenance dosage in pediatric patients should not exceed 70 mg. 1 Aspergillosis IV Pediatric patients 3 months to 17 years of age: A single loading dose of 70 mg/m 2 on day 1, followed by 50 mg/m 2 once daily. 1 If 50 mg/m 2 once daily is well tolerated but does not provide an adequate clinical response, dosage may be increased to 70 mg/m 2 (up to 70 mg) once daily. 1 Duration of treatment is based on severity of patient's underlying disease, recovery from immunosuppression, and clinical response. 1 423 IDSA recommends that treatment of invasive pulmonary aspergillosis be continued for at least 6 12 weeks. 423 Candidemia and Other Invasive Candida Infections (Intra-abdominal abscess, Peritonitis, Pleural Space Infections) IV Pediatric patients 3 months to 17 years of age: A single loading dose of 70 mg/m 2 on day 1, followed by 50 mg/m 2 once daily. 1 If 50 mg/m 2 once daily is well tolerated but does not provide adequate clinical response, dosage may be increased to 70 mg/m 2 (up to 70 mg) once daily. 1 Duration of treatment is based on clinical and microbiological response. 1 Manufacturer recommends treatment be continued for at least 14 days after the last positive culture and states that those who remain persistently neutropenic may require a longer course of therapy pending resolution of neutropenia. 1 IDSA recommends that antifungal treatment for candidemia (without persistent fungemia or metastatic complications) be continued for 2 weeks after documented clearance of Candida from the bloodstream, resolution of candidemia symptoms, and resolution of neutropenia. 425 Esophageal Candidiasis IV Pediatric patients 3 months to 17 years of age: A single loading dose of 70 mg/m 2 on day 1, followed by 50 mg/m 2 once daily. 1 441 If 50 mg/m 2 once daily is well tolerated but does not provide adequate clinical response, dosage may be increased to 70 mg/m 2 (up to 70 mg) once daily. 1 HIV-infected adolescents: 50 mg once daily. 440 Manufacturer recommends treatment be continued for 7 14 days after resolution of symptoms. 1 IDSA and others recommend that antifungal treatment for esophageal candidiasis be continued for 14 21 days. 425 440 Empiric Therapy in Febrile Neutropenic Patients IV Pediatric patients 3 months to 17 years of age: A single loading dose of 70 mg/m 2 on day 1, followed by 50 mg/m 2 once daily. 1 If 50 mg/m 2 once daily is well tolerated but does not provide adequate clinical response, dosage may be increased to 70 mg/m 2 (up to 70 mg) once daily. 1 Duration of empiric therapy is based on clinical response; 1 continue until neutropenia resolves. 1 If fungal infection is identified, continue for at least 14 days total and for at least 7 days after neutropenia and clinical symptoms resolve. 1 Adults Aspergillosis IV A single 70-mg loading dose on day 1, followed by 50 mg once daily. 1 423 436 440 Efficacy of dosages >50 mg once daily not evaluated. 1 Duration of treatment is based on severity of patient's underlying disease, recovery from immunosuppression, and clinical response. 1 423 IDSA recommends that treatment of invasive pulmonary aspergillosis be continued for at least 6 12 weeks. 423 Candidemia and Other Invasive Candida Infections (Intra-abdominal abscess, Peritonitis, Pleural Space Infections) IV A single 70-mg loading dose on day 1, followed by 50 mg once daily. 1 425 436 IDSA states consider a transition from the echinocandin to fluconazole (usually within 5 7 days) in patients who are clinically stable, have isolates susceptible to fluconazole (e.g., C. albicans ), and have negative repeat blood cultures after initial antifungal treatment. 425 Duration of treatment is based on clinical and microbiological response. 1 Manufacturer recommends treatment be continued for at least 14 days after the last positive culture and states that those who remain persistently neutropenic may require a longer course of therapy pending resolution of neutropenia. 1 IDSA recommends that antifungal treatment for candidemia (without persistent fungemia or metastatic complications) be continued for 2 weeks after documented clearance of Candida from the bloodstream and resolution of candidemia symptoms and neutropenia. 425 Osteoarticular infections : IDSA recommends 50 70 mg once daily. 425 After 2 weeks, can switch to fluconazole. 425 Endocarditis (native or prosthetic valve) or implantable cardiac device infections : IDSA recommends 150 mg once daily. 425 If infection caused by fluconazole-susceptible Candida , can switch to fluconazole after patient stabilized and Candida has been cleared from bloodstream. 425 Esophageal Candidiasis IV 50 mg once daily recommended by manufacturer. 1 Although manufacturer states use of a 70-mg loading dose not evaluated for treatment of esophageal candidiasis, 1 IDSA recommends a single 70-mg loading dose on day 1, followed by 50 mg once daily. 425 HIV-infected adults: 50 mg once daily. 440 Manufacturer recommends treatment be continued for 7 14 days after resolution of symptoms. 1 IDSA and others recommend that antifungal treatment be continued for 14 21 days. 425 440 Oropharyngeal Candidiasis IV IDSA recommends a single 70-mg loading dose on day 1, followed by 50 mg once daily for 7 14 days. 425 Candida auris Infections IV CDC recommends a single 70-mg loading dose on day 1, followed by 50 mg once daily. 510 Empiric Therapy in Febrile Neutropenic Patients IV A single 70-mg loading dose on day 1, followed by 50 mg once daily. 1 425 If 50 mg once daily is well tolerated but does not provide an adequate clinical response, dosage may be increased to 70 mg once daily. 1 Duration of empiric therapy is based on clinical response; continue until neutropenia resolves. 1 If fungal infection is identified, continue for at least 14 days total and for at least 7 days after both neutropenia and clinical symptoms resolve. 1 Prescribing Limits Pediatric Patients Maximum loading dose: 70 mg daily. 1 Maximum maintenance dose: 70 mg daily. 1 Special Populations Hepatic Impairment Adults with mild hepatic impairment (Child-Pugh score 5 6): Dosage adjustments not necessary. 1 Adults with moderate hepatic impairment (Child-Pugh score 7 9): 35 mg once daily; use an initial 70-mg loading dose (if usually indicated). 1 Adults with severe hepatic impairment (Child-Pugh score >9): Data not available. 1 Pediatric patients with any degree of hepatic impairment: Data not available. 1 Renal Impairment Adults with renal impairment: Dosage adjustments not necessary. 1 Not dialyzable; 1 3 supplemental dose not required following hemodialysis. 1 3 Geriatric Patients Adults 65 years of age: Dosage adjustments not necessary. 1 Cautions for Caspofungin Acetate Contraindications Known hypersensitivity (e.g., anaphylaxis) to caspofungin or any ingredient in the formulation. 1 Warnings/Precautions Sensitivity Reactions Hypersensitivity Reactions Hypersensitivity reactions (e.g., anaphylaxis) reported. 1 If such reactions occur, discontinue the drug and administer appropriate treatment. 1 Possible histamine-mediated symptoms (e.g., rash, facial swelling, pruritus, sensation of warmth, bronchospasm) reported; 1 may require discontinuance of the drug and/or administration of appropriate treatment. 1 Postmarketing reports of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). 1 Use with caution in patients with a history of allergic skin reactions. 1 Hepatic Effects Abnormal liver function test results reported when used in healthy volunteers or in adult and pediatric patients. 1 Clinically important hepatic dysfunction, hepatitis, and hepatic failure reported in some adult and pediatric patients with serious underlying conditions receiving multiple drugs concomitantly; 1 causal relationship not established. 1 Transient elevations in liver enzymes reported in patients receiving caspofungin and cyclosporine concomitantly. 1 (See Specific Drugs under Interactions.) If abnormal liver function test results occur, monitor for evidence of worsening hepatic function and evaluate benefits versus risks of continuing caspofungin. 1 Specific Populations Pregnancy Category C. 1 No adequate and well-controlled studies in pregnant women; 1 use during pregnancy only if potential benefits justify potential risks to the fetus. 1 In animals, embryofetal toxicity (increased resorptions, increased peri-implantation loss, incomplete ossification at multiple fetal sites) reported with caspofungin dosage about 2 times the recommended human dosage (based on body surface area comparisons). 1 Lactation Distributed into milk in rats; 1 not known whether distributed into milk in humans. 1 Use with caution in nursing women. 1 Pediatric Use Safety and efficacy not established in neonates and infants]} FEATURED: CAR-T Cell Therapy Overview Mechanism of Action KTE-C19 Studies KTE-C19 Cancer Targets Adverse Events Manufacturing Drug Status Rx Availability Prescription only C Pregnancy Category Risk cannot be ruled out N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Drug Class Echinocandins Related Drugs Aspergillosis, Invasive itraconazole , voriconazole , amphotericin b , Sporanox , Cresemba , caspofungin , More... Candidemia fluconazole , Diflucan , itraconazole , voriconazole , amphotericin b , Sporanox , More... Esophageal Candidiasis fluconazole , Diflucan , itraconazole , voriconazole , amphotericin b , Sporanox , More... Febrile Neutropenia ciprofloxacin , Augmentin , vancomycin , gentamicin , amoxicillin / clavulanate , More... Caspofungin Rating No Reviews - Be the first! No Reviews - Be the first! Not Rated - Be the first!} } substantial
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