Small molecule
PubChem CID 16119814
Caspofungin
Cancidas
- Mechanism of action
- Inhibits fungal beta-(1,3)-D-glucan synthase, disrupting cell wall synthesis
- In plain language
- Blocks fungi from building their protective cell wall, a structure human cells don't have, so the fungal cell falls apart.
- How it works
- Caspofungin is an echinocandin antifungal that inhibits the synthesis of beta-(1,3)-D-glucan, a polysaccharide that forms an essential structural component of the cell wall in susceptible Aspergillus and Candida species. Because beta-(1,3)-D-glucan is not present in mammalian cells, this mechanism gives caspofungin a target-based selectivity distinct from sterol-targeting antifungals. Caspofungin is active against Candida species broadly and against regions of active cell growth in the hyphae of Aspergillus fumigatus. The manufacturer's label notes reports of clinical failure with caspofungin therapy tied to drug-resistant Candida or Aspergillus, including specific mutations in the Fks subunits of the glucan synthase enzyme that are associated with higher MICs and breakthrough infection.
- Therapeutic applications
- CANCIDAS is indicated in adults and pediatric patients 3 months of age and older for empirical therapy of presumed fungal infections in febrile, neutropenic patients; for treatment of candidemia and Candida infections including intra-abdominal abscesses, peritonitis, and pleural space infections (the label notes it has not been studied in Candida endocarditis, osteomyelitis, or meningitis); for treatment of esophageal candidiasis; and for treatment of invasive aspergillosis in patients who are refractory to or intolerant of other therapies. It is administered by slow intravenous infusion over approximately one hour, with a 70 mg loading dose on day 1 followed by 50 mg once daily for most indications (no loading dose for esophageal candidiasis), and the label specifies dosage reductions for hepatic impairment and dosage increases for patients on concomitant hepatic CYP-inducing drugs such as rifampin.
- Class
- Small molecule
- Therapeutic area
- Antifungal
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