Capsofungin (Cancidas) is a semisynthetic lipopeptide known as an echinocandin, the first representative of a new class of antifungal agents that inhibit the synthesis of (3-(1,3)-D-glucan, a cell wall component of filamentous fungi. Capsofungin has in vitro activity against Asper-gillus fumigatus, Aspergillus flavus, and Aspergillus ter-reus; it is approved for the treatment of invasive as-pergillosis in patients not responding to other antifungal agents, such as amphotericin B, lipid formulations of am-photericin B, and itraconazole. Additional indications for the use of this drug await further clinical study.

Capsofungin is not absorbed from the gastrointestinal tract. It is highly protein bound and has a serum half-life of 9 to 11 hours. Capsofungin appears to undergo liver metabolism and is not excreted in the urine. Adverse effects are mediated through histamine release; they include facial flushing, rash, fever, and pruri-tis. Nausea and vomiting have also been reported. Dose reductions are required in the presence of moderate hepatic insufficiency.

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