Plasma concentrations of caspofungin at two different dosage regimens in a patient with hepatic dysfunction

K. C. M. van der Elst*, R. J. M. Bruggemann, M. G. G. Rodgers, J. W. C. Alffenaar

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

13 Citations (Scopus)

Abstract

The currently recommended dosage regimen of caspofungin (50 mg/day) was developed for patients with invasive candidiasis. With invasive aspergillosis, successful outcomes occur in less than half the patients. We evaluate the pharmacokinetics in a patient with elevated liver enzyme levels after liver transplantation, who received caspofungin for the treatment of aspergillosis. Plasma concentrations of caspofungin were monitored at 2 different dosage regimens. The area under the concentration-time curve (AUC) at a dosage of 70 mg was 191 mg h/L and was associated with an increase in liver enzymes. After dose reduction to 50 mg with an AUC of 100 mg h/L, liver enzymes normalized. In conclusion, caspofungin plasma concentrations may be helpful to evaluate exposure and reduce the need for off-label dosing.

Original languageEnglish
Pages (from-to)440-443
Number of pages4
JournalTransplant Infectious Disease
Volume14
Issue number4
DOIs
Publication statusPublished - Aug-2012

Keywords

  • invasive aspergillosis
  • caspofungin
  • plasma concentration
  • hepatic dysfunction
  • liver transplantation
  • INVASIVE ASPERGILLOSIS
  • ANTIFUNGAL THERAPY
  • 1ST-LINE THERAPY
  • CANDIDIASIS
  • PHARMACOKINETICS
  • COMBINATION
  • MULTICENTER
  • SAFETY

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