Caspofungin
Structural formula | |||||||||||||
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General | |||||||||||||
Non-proprietary name | Caspofungin | ||||||||||||
other names |
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Molecular formula |
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Drug information | |||||||||||||
ATC code | |||||||||||||
Drug class |
Antifungal , Echinocandin |
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Mechanism of action |
Inhibition of β (1,3) - D -glucan synthase |
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properties | |||||||||||||
Molar mass | |||||||||||||
solubility |
slightly soluble in water and in methanol, less soluble in ethanol (caspofungin diacetate) |
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safety instructions | |||||||||||||
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As far as possible and customary, SI units are used. Unless otherwise noted, the data given apply to standard conditions . |
Caspofungin is an antifungal from the echinocandins group and is used in the treatment of fungal infections. It is marketed by MSD under the name Cancidas .
chemistry
Caspofungin is a semi-synthetic lipopeptide compound ( Echinocandin ) whose starting substance is Pneumocandin B 0 . This is obtained from the fungus Glarea lozoyensis .
pharmacology
Mechanism of action
Mushrooms have from chitin and other polysaccharides existing cell wall . One building block of this cell wall is β (1,3) - D -glucan. Caspofungin inhibits the enzyme β (1,3) - D -glucan synthase, which is responsible for the structure of this cell wall component in fungi. Human cells do not have such a cell wall and therefore also no β (1,3) - D -glucan synthase.
- Germ spectrum
- Aspergillus spp., Candida spp., Histoplasma capsulatum , Coccidioides immitis
- Ineffective at
- Cryptococcus neoformans , Fusarium sp., Scedoporium , Trichosporon spp., Family of the Zygomycetes
Absorption and distribution in the body (pharmacokinetics)
Caspofungin is not absorbed in the intestine . It can therefore only be given intravenously . It is 96% bound to plasma proteins. The breakdown of the substance takes place mainly in the liver . 35% of it is excreted in the faeces and around 41% through the kidneys . The biological half-life is 9–11 hours.
Application areas (indications)
- Treatment of invasive candida infections in adult or pediatric patients.
- Treatment of invasive aspergillosis in adult or pediatric patients who are unresponsive or intolerant to therapy with amphotericin B , lipid formulations of amphotericin B and / or itraconazole . Failure to respond is defined as progression of the infection or if there is no improvement after at least 7 days of antifungal therapy at therapeutic doses.
- Empirical therapy for suspected fungal infections (such as Candida or Aspergillus) in adult or pediatric patients with fever and neutropenia .
Contraindications (contraindications)
Hypersensitivity to caspofungin or any other ingredient.
Adverse effects (side effects)
- Fever , chills
- inflammatory reactions at the infusion site ( phlebitis )
- Abdominal pain , nausea , vomiting
- Rash, itching , sweating
- Anemia ( anemia )
- a headache
Drug interactions
- Concurrent administration of cyclosporine increased the concentration of cyclosporine. Caspofungin remained unchanged.
- When tacrolimus was administered at the same time , its minimum plasma concentration decreased.
- In a few patients, the AUC of caspofungin decreased with simultaneous use of
- Efavirenz
- Nevirapine
- Rifampicin
- Dexamethasone
- Phenytoin
- Carbamazepine
literature
- Technical information: CANCIDAS ® (as of September 2011)
Web links
- New drugs: Caspofungin Cancidas. Pharmaceutical newspaper online (2002)
- Extract from the Journal of Chemotherapy - Caspofungin
- Journalmed: Caspofungin
- Infomed: Caspofungin
- Public Assessment Report (EPAR) of the European Medicines Agency (EMA) for: Caspofungin
Individual evidence
- ↑ Maryadele J. O'Neil et al. (Ed.): The Merck Index. An Encyclopedia of Chemicals, Drugs, and Biologicals. 14th edition. Merck & Co., Inc., Whitehouse Station NJ 2006, ISBN 0-911910-13-1 , pp. 308-309.
- ↑ This substance has either not yet been classified with regard to its hazardousness or a reliable and citable source has not yet been found.
- ↑ Red List, as of August 2009.
- ↑ AM comp. d. Switzerland, as of August 2009.
- ↑ AGES-PharmMed, as of August 2009.