An antifungal drip (echinocandin)
Caspofungin
A hospital antifungal drip for serious invasive fungal infections such as candida and aspergillus.
What is Caspofungin?
Caspofungin is an antifungal given by a drip into a vein in hospital to treat serious invasive fungal infections, particularly those caused by candida and aspergillus. It belongs to a group called echinocandins, which damage the wall around fungal cells while leaving human cells largely alone, so it is generally well tolerated. The main effects to watch for are some changes in liver tests and reactions during the infusion, such as flushing or rash. It is always given and monitored by specialists.
Education and reference only. This is a plain-language guide to Caspofungin — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Caspofungin is an echinocandin antifungal used in hospital to treat serious, deep-seated fungal infections, especially invasive candida and aspergillus infections in people who are very unwell or whose immune system is weakened. It is given only as a drip into a vein, because it is not absorbed when taken by mouth. It is used when infections are in the bloodstream or organs rather than for everyday thrush or skin fungal problems.
How it works
Caspofungin blocks an enzyme the fungus needs to build its cell wall, the protective layer surrounding each fungal cell. Without an intact wall, the fungal cells cannot survive, so the infection is brought under control. Because human cells do not have this kind of cell wall, the medicine targets the fungus while having relatively little effect on the body's own cells, which helps explain why echinocandins are usually well tolerated.
Company & origin
Originated / developed by: Generic (originally MSD).
An echinocandin antifungal given as a drip in hospital for serious invasive fungal infections.
Practical use
How to take Caspofungin
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given only as a slow drip into a vein by nurses and doctors in hospital; it cannot be taken as a tablet.
- The dose and how long it runs are decided and adjusted by the specialist team caring for you.
- Tell the staff straight away if you feel flushing, itching, a rash or feverish while the drip is running.
- Blood tests, including liver tests, are taken during treatment so the team can keep an eye on how you are doing.
- It is used together with treatment of your underlying illness, so keep taking your other prescribed medicines as advised.
Weighing it up
Advantages & disadvantages of Caspofungin
Advantages
- An effective treatment for serious invasive candida and aspergillus infections.
- Generally well tolerated, with fewer kidney effects than some older antifungals such as amphotericin.
- Has relatively few drug interactions compared with the azole antifungals.
Disadvantages
- Can only be given as a drip in hospital, not as a tablet at home.
- May raise liver blood tests, which need monitoring.
- Can cause infusion-related reactions such as flushing, rash or fever.
Practical use
Good to know
Caspofungin is a specialist hospital medicine, so the care team handles the dose and timing and watches closely for effects. It is generally one of the better tolerated antifungals, but it can raise liver blood tests, so these are checked during treatment. Some people get reactions while the drip is running, such as flushing, rash, itching or fever, which can often be managed by slowing the infusion. The dose may be adjusted in people with liver problems. It is given alongside treatment of the underlying illness, and the team decides how long it is needed based on how the infection responds.
Who should not take it / use with caution
- People who have had an allergic reaction to caspofungin or other echinocandins should not be given it.
- It is used with caution and may need dose changes in people with moderate liver problems.
- In pregnancy and breastfeeding it is used only if the specialist judges the benefit outweighs the risk.
Monitoring
- Liver blood tests during treatment.
- Watching for infusion reactions while the drip is running.
- Reviewing how the infection is responding to decide how long treatment is needed.
Side effects
- Fever, flushing, rash or itching, sometimes during the infusion.
- Changes in liver blood tests, nausea, headache or low potassium.
- Rarely, more serious allergic reactions, which staff watch for during treatment.
Key interactions
- Ciclosporin can raise caspofungin levels and affect liver tests, so the combination is monitored closely.
- Some medicines, such as rifampicin and certain anti-epileptics, can lower caspofungin levels and may need a dose adjustment.
- It has fewer interactions than azole antifungals, but the team still reviews all your medicines.
Available as: A drip (infusion) into a vein, given in hospital.
Answers
Caspofungin: frequently asked questions
Why is caspofungin given as a drip and not a tablet?
It is not absorbed properly from the gut, so it has to be given directly into a vein to reach the infection, which is why it is only used in hospital.
What kind of infections does it treat?
It is used for serious, deep-seated fungal infections, particularly invasive candida and aspergillus infections, not for everyday thrush or skin problems.
Is it hard on the kidneys?
Echinocandins such as caspofungin are usually gentler on the kidneys than older antifungals like amphotericin, though the team still monitors you carefully.
Why are my liver tests being checked?
Caspofungin can sometimes raise liver blood tests, so these are monitored during treatment so any change can be picked up early.
What happens if I react during the infusion?
Tell the staff if you feel flushing, itching, a rash or feverish; they can often help by slowing the drip and will keep a close watch.
The wider class
About Antifungal (echinocandin)
Caspofungin belongs to the antifungal (echinocandin) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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