Caspofungin Acetate Injection and Neoral

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Ask your doctor before using cycloSPORINE together with caspofungin. This can cause serious side effects that may affect your liver. Call your doctor immediately if you experience a fever, chills, joint pain or swelling, excessive tiredness or weakness, unusual bleeding or bruising, skin rash or itching, loss of appetite, nausea, vomiting, or yellowing of the skin or the whites of your eyes. If your doctor does prescribe these medications together, you may need a dose adjustment or special tests to safely take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

GENERALLY AVOID: Concomitant use of caspofungin and cyclosporine may be associated with transient elevations in serum transaminase levels. The mechanism has not been described. In one study, addition of cyclosporine (3 mg/kg twice a day) during the tenth day of caspofungin therapy (70 mg/day) resulted in ALT elevations on day 11 that were 2 to 3 times the upper limit of normal (ULN) in 3 of 4 healthy subjects. In another group from the same study, 2 of 8 subjects treated with caspofungin (35 mg/day) for 3 days and cyclosporine (3 mg/kg twice a day) on the first day had increases in ALT on day 2 that were slightly above ULN. In another study, 2 of 8 healthy men developed transient ALT elevations of less than 2 times ULN when cyclosporine (4 mg/kg) was administered on days 1 and 12 and caspofungin (70 mg/day) was administered on days 3 to 13. In all groups, AST levels were also elevated but of lesser magnitude. In a retrospective study of 40 immunocompromised patients treated with caspofungin and cyclosporine for 1 to 290 (median 17.5) days, 14 patients (35%) developed transaminase elevations greater than 5 times ULN or 3 times the baseline during concomitant therapy or the 14-day followup period. Five were considered possibly related to therapy. One patient had elevated bilirubin, but none developed clinical evidence of hepatotoxicity or serious hepatic events. In other studies, zero of four patients who were treated with caspofungin (50 mg/day) and cyclosporine for 2 to 56 days experienced increases in liver enzymes. In two clinical studies, cyclosporine increased exposure (AUC) of caspofungin by approximately 35%, but caspofungin did not increase plasma levels of cyclosporine.

MANAGEMENT: Until more data are available, the concomitant use of caspofungin and cyclosporine is not recommended unless the benefit is anticipated to outweigh the risk. Patients who develop abnormal liver function tests during concomitant therapy should be monitored, and the need for continued therapy should be evaluated.

Caspofungin Acetate Injection

Generic Name: caspofungin

Brand name: Cancidas

Synonyms: Caspofungin

What is Caspofungin Acetate Injection?

Neoral

Generic Name: cyclosporine

Brand name: Gengraf, Neoral, Sandimmune, Sandimmune

Synonyms: Neoral (Capsules, Modified)

What is Neoral?