Caspofungin - Non-formulary

Caspofungin - Non-formulary


Spectrum of Activity


General Information

Primary Indication(s)

  • Empiric antifungal for severely ill patients with invasive Candida infection or patients at risk of fluconazole resistance (e.g. receiving fluconazole prophylaxis)
  • Empiric yeast therapy for febrile neutropenia
  • Fungal endocarditis


  • An option for invasive Aspergillosis infections, but amphotericin or voriconazole is usually preferred
  • Periodic Liver enzymes, renal function, CBC with differential
  • Elevations in hepatic enzymes
  • Infusion-related reactions (rash, pruritis)
  • Phlebitis
  • Headache
  • GI upset, diarrhea
  • Pruritis, fever (most common in pediatrics)
  • Cyclosporin and tacrolimus
  • In patients on concomitant use of prolonged dexamethasone or other enzyme inducers (phenytoin, rifampin), consider increase dose to 70mg daily (especially if not responding).

Caspofungin has poor vitreous, CNS and urinary penetration. It should not be used for treatment of Candida urinary tract infections

Antimicrobial class: Echinocandin

Biliary penetration: Therapeutic

CSF penetration: Poor

Lung penetration: Therapeutic

Urine penetration: Poor