Behandling af svampeinfektion
PICU-børn
Doser: 70mg/m2 dag 1. Derefter: Alder < 3 mdr: 25 mg/m2/d, alder > 3 mdr 50mg/m2/dag.
Dosis kan evt. øges til 70mg/m2/dag.
En daglig dosis.
Infusion over 1 time.
Maximal døgndosis: 70 mg
Bivirkninger: Pyrexia, udslæt, hovedpine, takycardi, hypotension, eosinofili, forhøjede leverenzymer
In paediatric patients, results from regression analyses of pharmacokinetic data suggest that co-administration of dexamethasone with caspofungin may result in clinically meaningful reductions in caspofungin trough concentrations. This finding may indicate that paediatric patients will have similar reductions with inducers as seen in adults. When caspofungin is co-administered to paediatric patients (12 months to 17 years of age) with inducers of drug clearance, such as rifampicin, efavirenz, nevirapine, phenytoin, dexamethasone, or carbamazepine, a caspofungin dose of 70-mg/m2 daily (not to exceed an actual daily dose of 70 mg) should be considered.
Preparation of the 70 mg/m2 infusion for paediatric patients >3 months of age (using a 50-mg vial or a 70-mg vial)
1. Determine the actual loading dose to be used in the paediatric patient by using the patient's BSA (as calculated above) and the following equation:
BSA (m2) X 70 mg/m2 = Loading Dose
The maximum loading dose on Day 1 should not exceed 70 mg regardless of the patient's calculated dose.
2. Equilibrate the refrigerated vial of CANCIDAS to room temperature.
3. Aseptically add 10.5 ml of water for injection.a This reconstituted solution may be stored for up to 24 hours at or below 25°C.b This will give a final caspofungin concentration in the vial of 5.2 mg/ml (if using a 50-mg vial) or 7.2 mg/ml (if using a 70-mg vial).
4. Remove the volume of medicinal product equal to the calculated loading dose (Step 1) from the vial. Aseptically transfer this volume (ml)c of reconstituted CANCIDAS to an IV bag (or bottle) containing 250 ml of 0.9%, 0.45%, or 0.225% Sodium Chloride Injection, or Lactated Ringers Injection. Alternatively, the volume (ml)c of reconstituted CANCIDAS can be added to a reduced volume of 0.9%, 0.45%, or 0.225% Sodium Chloride Injection or Lactated Ringers Injection, not to exceed a final concentration of 0.5 mg/ml. This infusion solution must be used within 24 hours if stored at or below 25°C or within 48 hours if stored refrigerated at 2 to 8°C.
Preparation of the 50 mg/m2 infusion for paediatric patients >3 months of age (using a 50-mg vial or a 70-mg vial)
1. Determine the actual daily maintenance dose to be used in the paediatric patient by using the patient's BSA (as calculated above) and the following equation:
BSA (m2) X 50 mg/m2 = Daily Maintenance Dose
The daily maintenance dose should not exceed 70 mg regardless of the patient's calculated dose.
2. Equilibrate the refrigerated vial of CANCIDAS to room temperature.
3. Aseptically add 10.5 ml of water for injection.a This reconstituted solution may be stored for up to 24 hours at or below 25°C.b This will give a final caspofungin concentration in the vial of 5.2 mg/ml (if using a 50-mg vial) or 7.2 mg/ml (if using a 70-mg vial).
4. Remove the volume of medicinal product equal to the calculated daily maintenance dose (Step 1) from the vial. Aseptically transfer this volume (ml)c of reconstituted CANCIDAS to an IV bag (or bottle) containing 250 ml of 0.9%, 0.45%, or 0.225% Sodium Chloride Injection, or Lactated Ringers Injection. Alternatively, the volume (ml)c of reconstituted CANCIDAS can be added to a reduced volume of 0.9%, 0.45%, or 0.225% Sodium Chloride Injection or Lactated Ringers Injection, not to exceed a final concentration of 0.5 mg/ml. This infusion solution must be used within 24 hours if stored at or below 25°C or within 48 hours if stored refrigerated at 2 to 8°C.
Ordination: Læger
Administration og dispensering: Sygeplejersker
http://www.medicines.org.uk/emc/medicine/12843/SPC/CANCIDAS+(formerly+Caspofungin+MSD)/