Vol.65 No.4 July 2017
Safety of caspofungin in patients with moderate hepatic dysfunction
1)Department of Pharmacy, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho, Ogaki, Gifu, Japan
2)Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University
Abstract
Caspofungin (CPFG) is one of the echinocandin antifungal agents. It is reported to have less side effects than other antifungals. However, its main side effect is liver dysfunction. In the drug package insert, for patients with moderate hepatic insufficiency who have scored 7 to 9 under the Child-Pugh classification (class B), the dose reduction to 35 mg per day following the first 70 mg loading dose is recommended. However, few studies have reported on the safety and tolerability of CPFG for liver dysfunction patients. In this report, we examined CPFG for patients classified as Child-Pugh class B.
We stratified 98 evaluable patients according to the Child-Pugh classification: class A accounted for 65.3% and class B for 34.7%. Except for one case, the applied dose of CPFG was 50 mg per day in all cases followed. The incidence of side effects between the class A and B groups was as follows: The expression rate for class B group was higher than class A group in regards to the increase in AST (asparate aminotransferase), ALT (alanine aminotransferase) and ALP (alkaline phosphatase), with a significant difference seen in all (p< 0.05).
Therefore, based on our results, we believe that necessary to carefully before starting consider the dose following evaluation of patients with the Child-Pugh score before starting administration of CPFG.
Key word
caspofungin acetate, side effect, liver dysfunction
Received
June 6, 2016
Accepted
February 8, 2017
Jpn. J. Chemother. 65 (4): 597-601, 2017
