title: Safety of the concomitant use of caspofungin and cyclosporin A in patients with invasive fungal infections.
abstract: Caspofungin, an echinocandin antifungal agent, is active against invasive Aspergillus and Candida infections. In a phase I study in healthy volunteers, mild transient increases in serum aminotransferases were observed with the concomitant administration of caspofungin and cyclosporin A (CsA). As a result, it is recommended that the concomitant use of the two drugs be limited to those settings with appropriate risk-benefit balance. We retrospectively assessed safety data in 14 patients with refractory invasive mycoses who were treated concomitantly with CsA and caspofungin before the drug was licensed in Spain. In all, 13 patients were adults (median age, 31.5 years; range, 14-67 years). The average duration of concomitant therapy was 15 days (range, 2-43 days). No clinically significant elevations of serum aminotransferases were observed, and no patient had concomitant therapy discontinued or interrupted due to a drug-related adverse event. In this study of a limited number of patients, the coadministration of caspofungin and CsA was generally well tolerated.
authors.affiliation: Department of Clinical Research, Merck Sharp and Dohme of Spain, Madrid, Spain. cesar_sanzrodriguez@merck.com
authors.forename: C
authors.initials: C
authors.lastname: Sanz-Rodriguez
authors.forename: M
authors.initials: M
authors.lastname: Lopez-Duarte
authors.forename: M
authors.initials: M
authors.lastname: Jurado
authors.forename: J
authors.initials: J
authors.lastname: Lopez
authors.forename: R
authors.initials: R
authors.lastname: Arranz
authors.forename: J-M
authors.initials: JM
authors.lastname: Cisneros
authors.forename: M L
authors.initials: ML
authors.lastname: Martino
authors.forename: P J
authors.initials: PJ
authors.lastname: Garcia-Sanchez
authors.forename: P
authors.initials: P
authors.lastname: Morales
authors.forename: T
authors.initials: T
authors.lastname: Olivé
authors.forename: M
authors.initials: M
authors.lastname: Rovira
authors.forename: C
authors.initials: C
authors.lastname: Solano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use / Q000633:toxicity; D000077336:Caspofungin; D004796:Clinical Enzyme Tests; D016572:Cyclosporine / Q000627:therapeutic use* / Q000633:toxicity; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D054714:Echinocandins; D005260:Female; D006801:Humans; D055666:Lipopeptides; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000150:complications / Q000188:drug therapy*; D010456:Peptides, Cyclic / Q000627:therapeutic use* / Q000633:toxicity; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D010456:Peptides, Cyclic; D016572:Cyclosporine; D000077336:Caspofungin