Caspofungin
Caspofungin acetate
Also known as: Cancidas · caspofungina · caspofungine · caspofungini · kaspofungiinia · kaspofungina · L-743873 · MK-0991
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Invasive aspergillosis or disseminated candidal infections (Investigational) | 0.8-1.6 mg/kg in patients weighing less than 50 kg and 50-75 mg (total dose) in those weighing more than 50 kg | IV | Not specified | — | 🌎 NA |
- Invasive aspergillosis or disseminated candidal infections (Investigational): Extrapolated from human pediatric studies. Highly investigational in veterinary patients.
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Invasive aspergillosis or disseminated candidal infections (Investigational) | 0.8-1.6 mg/kg | IV | Not specified | — | 🌎 NA |
- Invasive aspergillosis or disseminated candidal infections (Investigational): Extrapolated from human pediatric studies. Highly investigational in veterinary patients.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Caspofungin is a parenteral antifungal belonging to the echinocandin class. It has potential for treating invasive aspergillosis or disseminated candidal infections in companion animals, though clinical experience in veterinary medicine is currently very limited.
Clinical Pearl: Echinocandins are often referred to as the "penicillins of antifungals" because they target the fungal cell wall rather than the cell membrane (like azoles or amphotericin B), making them highly specific to fungi with generally lower mammalian toxicity.
- Spectrum of Activity: Effective against Aspergillus spp., Candida spp., and Pneumocystis carinii pneumonia.
- Resistance/Inefficacy: Not effective against Cryptococcus neoformans due to the lack of target enzymes in this organism.
- Cost: Treatment is very expensive, often reserving it as a salvage therapy for refractory infections.
Mechanism of action
Caspofungin acts as a beta-glucan synthase inhibitor.
It blocks the synthesis of beta-(1,3)-D-glucan, an essential structural component found in the cell walls of many filamentous fungi and yeast.
Inhibition of beta-glucan synthase → Depletion of beta-(1,3)-D-glucan → Loss of cell wall structural integrity → Osmotic instability and fungal cell death (fungicidal activity).
Safety & warnings
Contraindications
- Hypersensitivity to caspofungin
- Significant hepatic impairment
Adverse effects
- Histamine-mediated signs (rash, facial swelling, pruritus)
- Anaphylaxis
- Intravenous site reactions (pain, redness, phlebitis)
- Hepatic dysfunction
Precautions
Hepatic Impairment: Dosage adjustment is recommended in humans with moderate hepatic impairment. Avoid use in patients with significant hepatic impairment.
Pregnancy: FDA Category C. Animal studies have shown adverse effects on fetal ossification. Avoid during the first trimester unless the benefits of treatment outweigh the risks.
Lactation: Likely safe to administer during lactation because the drug is not appreciably absorbed from the gastrointestinal tract.
Drug interactions
Reduced caspofungin plasma levels
Increased caspofungin plasma levels and increased risk of hepatic enzyme increases
Reduced caspofungin plasma levels
Reduced caspofungin plasma levels
Reduced caspofungin plasma levels
Monitoring
- Clinical efficacy
- Periodic liver function tests
- CBC
- Serum electrolytes
Pharmacokinetics
Absorption
Not appreciably absorbed from the gut; must be administered IV.
Distribution
High protein binding (97%, primarily to albumin). Distributed to tissues over a 36-48 hour period.
Metabolism
Slowly metabolized via hydrolysis and N-acetylation. Also spontaneously degrades chemically.
Elimination
Polyphasic elimination. Excreted mostly as metabolites via feces and urine. Only small amounts (1-2%) are excreted unchanged into the urine.
Overdose
Limited information is available for veterinary patients.
- Humans: Dosages of 210 mg (about 3X normal) were well tolerated.
- Primates: Monkeys receiving 5-8 mg/kg (approx. 4-6X normal) over 5 weeks developed sites of microscopic subcapsular necrosis on their livers.
Available products
Formulations
- Lyophilized powder for injection
Human-labeled
- Caspofungin Acetate Lyophilized Powder for Injection: 50 mg & 70 mg in single-use vials
Regulatory status
No regulatory data for: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Store refrigerated (2-8°C). Do not use if the solution is cloudy or has precipitated. Do not mix or infuse with any other medications and do not use with intravenous solutions containing dextrose.
Client information
- Inpatient Use Only: This medication must be administered via intravenous infusion and is appropriate for inpatient hospital use only.
- Investigational Nature: Pet owners should understand that the use of this drug in veterinary patients is highly investigational.
- Cost: Treatment with caspofungin is associated with significant expense.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.