Premium
Plasma concentrations of caspofungin at two different dosage regimens in a patient with hepatic dysfunction
Author(s) -
van der Elst K.C.M.,
Brüggemann R.J.M.,
Rodgers M.G.G.,
Alffenaar J.W.C.
Publication year - 2012
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/j.1399-3062.2011.00716.x
Subject(s) - caspofungin , medicine , liver transplantation , dosing , regimen , aspergillosis , pharmacokinetics , plasma concentration , liver enzyme , area under the curve , pharmacology , gastroenterology , transplantation , antifungal , voriconazole , immunology , dermatology
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.