Diluents containing dextrose should not be used. The duration of treatment should be based on the severity of the patient's underlying disease, recovery from immunosuppression, and clinical response. For patients with moderate hepatic insufficiency, a dose of 35 mg daily is recommended after the initial 70 mg loading dose. Plasma concentrations of caspofungin decline in a polyphasic manner following single one-hour intravenous infusions. Distribution, rather than excretion or biotransformation, is the dominant mechanism influencing plasma clearance.
Metabolism is by hydrolysis and N-acetylation.
The most common adverse reactions reported in clinical trials included rash, facial swelling, pruritus, sensation of warmth, fever, nausea and vomiting, and flushing. Anaphylaxis has also been reported. The drug has not been studied as initial therapy for invasive aspergillosis. Following single subcutaneous doses, the mean absorption half-life is approximately 4.6 hours. The mean elimination half-life is approximately 40 hours.