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Capsofungin (Cancidas) is a semisynthetic lipopeptide known as an echinocandin, the first representative of a new class of antifungal agents that inhibit the synthesis of -(1,3)-D-glucan, a cell wall component of filamentous fungi. Capsofungin has in vitro activity against Asper-gillus fumigatus, Aspergillus flavus, and Aspergillus ter-reus; it is approved for the treatment of invasive as-pergillosis in patients not responding to other antifungal agents, such as amphotericin B, lipid formulations of am-photericin B, and itraconazole. Additional indications for the use of this drug await further clinical study.
Capsofungin is not absorbed from the gastrointesti-nal tract. It is highly protein bound and has a serum half-life of 9 to 11 hours. Capsofungin appears to un-dergo liver metabolism and is not excreted in the urine. Adverse effects are mediated through histamine re-lease; they include facial flushing, rash, fever, and pruri-tis. Nausea and vomiting have also been reported. Dose reductions are required in the presence of moderate hepatic insufficiency.
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