Kansidas - instructions for use, reviews, analogues and forms of release (injections in ampoules for injection of lyophilizate 50 mg and 70 mg) of the drug for the treatment of skin and nail fungus, candidal stomatitis in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Cancidas. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Cancidas in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Kansidas in the presence of existing structural analogues.Use to treat fungus skin and nails, candidal stomatitis in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Cancidas - an antifungal agent for systemic use. It is a semisynthetic lipopeptide compound (echinocandin) synthesized from the fermentation product Glarea lozoyensis. Caspofungin (the active ingredient of the drug Kansidas) inhibits the synthesis of beta (1,3) -D-glucan, the most important component of the cell wall of many rifomycetes and yeast. Cancidas active against various pathogenic fungi of the genus Aspergillus (including Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger, Aspergillus nidulans, Aspergillus terreus and Aspergillus candidus) and Candida (Candida) (including Candida albicans, Candida dubliniensis, Candida glabrata, Candida guilliermondii, Candida kefyr , Candida krusei, Candida lipolytica, Candida lusitaniae, Candida parapsilosis, Candida rugosa and Candida tropicalis). Caspofungin is active against strains of Candida fungi resistant to fluconazole, amphotericin B or flucytosine, which have a different mechanism of action.

Composition

Caspofungina acetate + excipients.

Pharmacokinetics

Caspofungin binds intensely to proteins (approximately 97%) with minimal penetration into erythrocytes. About 92% is found in the tissues 36-48 hours after the administration of a single dose of 70 mg of labeled caspofungin acetate.During the first 30 hours after administration, the excretion and biotransformation of caspofungin are insignificant.

About 75% of the dose is excreted from the body: 41% - with urine and 34% - with feces. Concentrations in the plasma of the radioactive label and caspofungin during the first 24-48 hours after the administration of the dose are not different, after that the concentration of caspofungin decreases more rapidly, the decrease in its concentration below the level of quantitative determination is observed 6-8 days after the dose, and the radioactive label - through 22.3 weeks. A small amount of caspofungin is excreted unchanged in the urine (approximately 1.4% of the dose). The renal clearance of the unchanged substance is low and is approximately 0.15 ml per minute.

Concentration of caspofungin in plasma in healthy men and women on the 1st day after the administration of a single dose of 70 mg is the same. After 13 daily administrations of 50 mg, the concentration of caspofungin in plasma in some women is approximately 20% higher than in men.

The content of caspofungin in plasma in healthy men and women of advanced age (65 years and older), compared with healthy young men, slightly increased by 28%. In elderly patients with invasive candidiasis or during empirical therapy, the same moderate changes in plasma drug concentration were observed,as in the group of healthy elderly patients in relation to healthy patients of young age. Correction of the dosing regimen for the elderly (65 years and older) patients is not required.

The concentration of caspofungin in the plasma of patients with mild hepatic insufficiency after the administration of a single dose of 70 mg increases by approximately 55%, compared to healthy volunteers. Introduction to these patients for 14 days (70 mg on the first day followed by a daily administration of 50 mg) is accompanied by a moderate increase in its plasma concentration and is 19-25% on the 7th and 14th day, compared with healthy volunteers.

Indications

• empirical therapy in patients with febrile neutropenia in case of suspected fungal infection;
• invasive candidiasis (including candidemia) in patients with neutropenia and without it;
• invasive aspergillosis (in patients refractory to other therapy or not tolerating it);
• esophageal candidiasis;
• oropharyngeal candidiasis.

Forms of release

Injections in ampoules for injection lyophilizate 50 mg and 70 mg.

Instructions for use and dosing regimen

The dose is set individually, depending on the indications and the therapy scheme used.Single dose is 50-70 mg. Introduce intravenously by slow infusion (more than 1 hour) 1 time per day.

With moderate hepatic insufficiency (from 7 to 9 points on the Child-Pugh scale) correction of the dosing regimen is required.

Side effect

• nausea, vomiting;
• diarrhea;
• increased activity of hepatic enzymes (AST, ALT, APF);
• increase in the concentration of direct and total bilirubin;
• impaired liver function;
• increased serum creatinine levels;
• anemia (decrease in hemoglobin level);
• leukopenia (decrease in the number of leukocytes);
• neutropenia (a decrease in the level of neutrophils);
• thrombocytopenia (decrease in the number of platelets);
• eosinophilia (increase in the number of eosinophils);
• tachycardia (increased heart rate);
• phlebitis (inflammation of the venous wall);
• thrombophlebitis (inflammation of the internal venous wall with the formation of a thrombus);
• redness of the face;
• edema;
• increased partial thromboplastin and prothrombin time;
• microhematuria (blood in the urine is not detectable by the eye, but detectable in a laboratory study for the presence of erythrocytes);
• leucocyturia (increased number of leukocytes in urine);
• proteinuria (urinary excretion of protein in excess of normal values);
• rash;
• itching;
• increased sweating;
• feeling of heat;
• bronchospasm (state of acute respiratory failure);
• anaphylaxis (an allergic reaction of an immediate type);
• hypercalcemia (increased concentration of calcium in the blood plasma);
• hypoalbuminemia (decrease in the level of albumin in the blood);
• hypoproteinemia (abnormally low level of protein in the blood plasma);
• hypokalemia (low concentration of potassium ions in the blood);
• hyponatremia (low concentration of sodium);
• hypomagnesemia (decrease in magnesium concentration);
• hypocalcemia (low calcium in the blood plasma);
• hyperthermia (fever);
• headache;
• abdominal pain;
• feeling chills.

Contraindications

• increased sensitivity to caspofungin.

Application in pregnancy and lactation

There is no clinical experience with the use of Candida during pregnancy and lactation (breastfeeding). Caspofungin should not be used during pregnancy, except in cases of vital necessity.

Since there is no data on the allocation of caspofungin with breast milk, if necessary, use during lactation should stop breastfeeding.

Use in children

It is not recommended to use Cancidas in children and adolescents under 18 years of age.

special instructions

Use with caution in patients receiving cyclosporine, as well as in patients with moderate hepatic insufficiency (from 7 to 9 on the Child-Pugh scale). Clinical experience of the drug in patients with severe hepatic insufficiency (more than 9 points on the Child-Pugh scale) is not available.

Drug Interactions

Caspofungin reduces the 12-hour tacrolimus concentration in the blood by 26% (with simultaneous use, it is recommended that the standard monitoring of tacrolimus concentration in the blood and, if necessary, correction of its dosage regimen) be recommended.

When used simultaneously with cyclosporin, a transient increase in the activity of AST and ALT (no more than 3 times as compared with IGN) is possible, as well as an increase in the AUC of caspofungin by approximately 35% without changing the concentration of cyclosporine (if simultaneous use is necessary, the potential benefits of therapy and possible risk).

Rifampin can both accelerate and slow the distribution of caspofungin.

The simultaneous use of caspofungin inductors clearance of drugs (efavirenz, nevirapine, phenytoin, Carbamazepine or dexamethasone) may lead to a clinically significant reduction in the concentration of caspofungin. Available data indicate that these drugs induced decrease in caspofungin concentrations occur sooner by accelerating the elimination rather than metabolism. Therefore, the combined use of caspofungin efavirenz, nelfinavir, nevirapine, rifampin, dexamethasone, phenytoin or carbamazepine should consider the possibility of increasing the daily dosage to 70 mg caspofungin after applying normal loading dose of 70 mg.

Analogues of the medicinal product Kansidas

Kansidas has no structural analogs for the active substance.

Analogues for the pharmacological group (antifungal agents):

• Amphotericin;
• Amfocil;
• Atitis;
• Batrafen;
• Binafin;
• Beefasam;
• Biflurin;
• Bifonazole;
• Bifosin;
• Vikand;
• Vfend;
• VORICOSE;
• Voriconazole;
• Gynofort;
• Griseofulvin;
• Dactanol;
• Dactarine;
• Dermazol;
• Diflason;
• Diflucan;
• Zalain;
• Irunin;
• Itrazole;
• Itraconazole;
• Itramikol;
• Kandibene;
• Candide;
• Candisol;
• Kanesten;
• Canison;
• Ketoconazole;
• Clotrimazole;
• Lamisyl;
• Levorin;
• Lomexin;
• Loceril;
• Mizol;
• Mikamin;
• Mikogal;
• Mikoderil;
• Mycosorrhal;
• Mycosyst;
• Mycospores;
• Mycoterbine;
• Mycoflucan;
• Natamycin;
• Nizoral;
• Nystatin;
• Nitrofungin;
• Oronazole;
• Orunite;
• Pimafucin;
• Primafungin;
• Procanazole;
• Rumikoz;
• Sertaconazole;
• Terbisyl;
• Terbiks;
• Terbinafine;
• Terbifin;
• Thermic;
• Fangifflu;
• Flucosan;
• Flukoside;
• Fluconazole;
• Flukonorm;
• Flukoral;
• Flucostat;
• Forkan;
• Fungizon;
• Fungolon;
• Fungoterbine;
• Exifin;
• Exoderyl;
• Ecofuqin;
• Eraksis.

A doctor's opinion of a dermatologist

Cancidas is an effective antifungal drug. Its active ingredient acts well on moldy mushrooms aspergillus and fungi of the genus Candida. Moreover, Cancidas is effective even in cases when amphotericin, fluconazole, flucytosine does not work. I assign it to patients with a fungus of skin, fungal lesions of nail plates, candida septicemia, candidal stomatitis. The drug has many serious side effects - treatment is carried out under the strictest medical supervision.

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