Single- and multiple-dose administration of caspofungin in patients with hepatic insufficiency: implications for safety and dosing recommendations
| Autor: | Paul J. Deutsch, Gregory A. Winchell, Sheng Bi, Michael Hesney, Julie A. Stone, Kenneth C. Lasseter, Goutam C. Mistry, Elizabeth Migoya, Susan X. Li, Stacy C. Dilzer |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Antifungal Agents Population Loading dose Gastroenterology Peptides Cyclic chemistry.chemical_compound Echinocandins Lipopeptides Pharmacokinetics Caspofungin Internal medicine medicine Hepatic Insufficiency Humans Pharmacology (medical) Dosing education Aged Pharmacology education.field_of_study business.industry Case-control study Middle Aged Confidence interval Surgery Clinical research chemistry Area Under Curve Injections Intravenous Female business |
| Zdroj: | Journal of clinical pharmacology. 47(8) |
| ISSN: | 0091-2700 |
| Popis: | This report investigated safety and dosing recommendations of intravenous caspofungin in hepatic insufficiency. In the single-dose study, 8 patients each with mild and moderate hepatic insufficiency received 70 mg of caspofungin. In the multiple-dose study, 8 patients with mild hepatic insufficiency and 13 healthy matched controls received 70 mg on day 1 and 50 mg daily on days 2 through 14. Eight patients with moderate hepatic insufficiency received 70 mg on day 1 and 35 mg daily on days 2 through 14. Caspofungin was generally well tolerated with no discontinuations due to serious or nonserious adverse experiences. The area under the concentration-time profile over the interval of last quantifiable point to infinity (AUC(0-infinity)) geometric mean ratio (GMR) (90% confidence interval [CI]) for mild hepatic insufficiency/historical controls was 1.55 (1.32-1.86) in the single-dose study and for mild hepatic insufficiency/concurrent controls was 1.21 (1.04-1.39) for day 14 area under the concentration-time profile calculated over the interval 0 to 24 hours (AUC(0-24h)) following multidose. The AUC(0-infinity) GMR (90% CI) for moderate hepatic insufficiency/historical controls was 1.76 (1.51-2.06) following 70 mg; AUC(0-24h) GMR (90% CI) for moderate hepatic insufficiency/concurrent controls was 1.07 (0.90-1.28) on day 14 after 35 mg daily. No dosage adjustment is recommended for patients with mild hepatic insufficiency. A dosage reduction to 35 mg daily following the 70-mg loading dose is recommended for patients with moderate hepatic insufficiency. |
| Databáze: | OpenAIRE |
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