Caspofungin

Used intravenously, the drugs distribute widely to the tissues and are eliminated largely via hepatic metabolism. Caspofungin has a half-life of 9–12 h. The echinocandins, inhibiting the synthesis of β(1-3)glucan, a critical component of fungal cell walls Caspofungin is used for disseminated and mucocutaneous Candida infections in patients who fail to respond to amphotericin B and in the treatment of mucormycosis. Anidulafungin is used for esophageal and invasive candidiasis. Infusion-related effects of caspofungin include headache, gastrointestinal distress, fever, rash,phlebitis and flushing (histamine release). Combined use of echinocandins with cyclosporine may elevate liver transaminasescaspofungin is the first approved member of the echinocandins class of antifungal drugs.Caspofungin has activity against Aspergillus and most Candida species, including those species resistant to azoles. Flushing occurs, which is probably due to the release of histamine from mast cells .Concomitant administration of caspofungin with CYP450 enzyme inducers may require an increase in the daily dose administered. Caspofungin should not be coadministered with cyclosporine. Caspofungin is a second-line antifungal for those who have failed or cannot tolerate amphotericin B or an azole.