CAPSOFUNGIN
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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