Cancidas

Cancidas is the brand name for caspofungin acetate, an intravenous antifungal agent in the echinocandin class. It works by inhibiting 1,3-beta-D-glucan synthase, an enzyme essential for fungal cell-wall synthesis, which leads to osmotic instability and fungal cell death. The drug has activity against most Candida species, including Candida albicans and Candida glabrata, with variable activity against other fungi. It is not active against Cryptococcus neoformans and has limited activity against certain molds; its use for invasive aspergillosis is generally as salvage therapy in patients not responding to, or intolerant of, other treatments.

Indications approved for Cancidas include treatment of candidemia and other invasive Candida infections, such as intra-abdominal infections, and esophageal candidiasis in adults and certain pediatric patients per labeling. It may be used as salvage therapy for invasive aspergillosis in patients intolerant of or refractory to other antifungal therapy. Dosing and approvals vary by age and weight, and pediatric regimens are adjusted accordingly.

Administration and pharmacokinetics: Cancidas is given by intravenous infusion. In adults, the typical regimen is a loading dose of 70 mg on day 1, followed by 50 mg once daily, with dose adjustments based on labeling and patient factors. It is primarily eliminated by hepatic metabolism, with minimal renal excretion; no major renal dosing adjustments are generally required, though severe hepatic impairment may necessitate changes.

Safety and adverse effects: Common adverse events include infusion-related reactions (such as flushing or fever), rash, nausea, vomiting, and mild to moderate elevations in liver enzymes. Hypersensitivity and rare anaphylactic reactions can occur. Cautions include potential liver injury and drug interactions; use during pregnancy or lactation should be guided by clinical risk and labeling.

See also: echinocandins, other antifungal agents such as micafungin and anidulafungin.