Plasma concentrations of caspofungin at two different dosage regimens in a patient with hepatic dysfunction |
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| Authors: | K.C.M. van der Elst R.J.M. Brüggemann M.G.G. Rodgers J.W.C. Alffenaar |
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| Affiliation: | 1. Department of Hospital and Clinical Pharmacy, University of Groningen, University Medical Center Groningen, , Groningen, The Netherlands;2. Department of Clinical Pharmacy, Radboud University Nijmegen Medical Centre, and Nijmegen Centre for Infection, Inflammation and Immunity, , Nijmegen, The Netherlands;3. Department of Critical Care, University of Groningen, University Medical Center Groningen, , Groningen, The Netherlands |
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| Abstract: | 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. |
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| Keywords: | invasive aspergillosis caspofungin plasma concentration hepatic dysfunction liver transplantation |
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