AFUNDAS-L 70mg Infusion/Powder for concentrate for solution for

What is AFUNDAS-L 70mg

AFUNDAS-L 70mg is an antifungal medication containing the active ingredient Caspofungin, presented as a powder for concentrate for solution for infusion. It belongs to a class of antifungals known as echinocandins. This medicine is used to treat serious fungal infections, particularly in hospitalized or immunocompromised patients.

• Active Ingredient: Caspofungin acetate
• Form: Powder for concentrate for solution for infusion
• Strength: 70 mg per glass vial
• Common Use: Treatment of invasive candidiasis, esophageal candidiasis, and invasive aspergillosis (especially in cases resistant or intolerant to other antifungals like amphotericin B or itraconazole)

This medication is often reserved for patients who are severely ill, such as those in intensive care, oncology, or hematology units, where systemic fungal infections pose a life-threatening risk.

How to use AFUNDAS-L 70mg

AFUNDAS-L should be administered in a hospital setting under the supervision of experienced healthcare professionals. The powder is reconstituted and diluted before intravenous infusion.

• Preparation: The contents of the vial are first reconstituted with sterile water for injection, then further diluted in a compatible intravenous fluid like 0.9% Sodium Chloride or 5% Dextrose.
• Administration: Administered by slow intravenous infusion over approximately 1 hour, once daily.
• Initial Dose: Usually a loading dose of 70 mg on Day 1.
• Maintenance Dose: 50 mg daily from Day 2 onward (adjusted depending on the clinical condition).

Important Considerations:

• Do not administer as a rapid IV injection or bolus.
• Inspect solution visually for particulate matter before use.
• Dosing must be adjusted in hepatic impairment or if drug interactions are likely.
• Ensure compatibility with other IV drugs; use a separate IV line if needed.

Mode of Action AFUNDAS-L 70mg

AFUNDAS-L works by targeting the fungal cell wall, which is essential for fungal survival and growth. Specifically, Caspofungin acts on the synthesis of a key polysaccharide called 1,3-β-D-glucan.

• Mechanism: Inhibits the enzyme β-(1,3)-D-glucan synthase, which is responsible for forming 1,3-β-D-glucan in fungal cell walls.
• Result: Weakens the cell wall, causing osmotic instability and leading to cell lysis and death.
• Target: Most Candida species and Aspergillus species.

Advantages of Echinocandins like Caspofungin:

• Fungicidal activity against Candida spp.
• Fungistatic activity against Aspergillus spp.
• Low toxicity to human cells, as human cells lack a cell wall
• Low potential for cross-resistance with other antifungal classes like azoles or polyenes

AFUNDAS-L 70mg Interactions AFUNDAS-L 70mg

Like many antifungals, AFUNDAS-L (Caspofungin) can interact with other medications that affect liver enzyme activity, especially cytochrome P450 inducers and inhibitors.

• Cyclosporine: May increase Caspofungin levels and liver enzyme elevations; monitor liver function tests.
• Rifampin, Phenytoin, Carbamazepine: These enzyme inducers may decrease Caspofungin levels, requiring dose adjustment to maintain efficacy.
• Dexamethasone: Can also lower Caspofungin levels via hepatic enzyme induction.
• Tacrolimus: Caspofungin may slightly increase tacrolimus levels; monitor drug levels if co-administered.

General Guidelines:

• Always review the patient’s full medication list before starting AFUNDAS-L.
• Monitor liver enzymes regularly during co-administration with hepatically metabolized drugs.
• Use caution in transplant patients or those on multiple immunosuppressants.

Dosage of AFUNDAS-L 70mg

Dosage of AFUNDAS-L depends on the type of fungal infection, patient weight, liver function, and presence of other medications.

• Loading Dose: 70 mg IV on Day 1 (infused over ~1 hour)
• Maintenance Dose: 50 mg IV once daily from Day 2 onwards
• For Invasive Candidiasis: Continue for at least 14 days after the last positive culture and resolution of symptoms

Adjustments:

• Hepatic impairment (moderate): Reduce maintenance dose to 35 mg daily
• Renal impairment: No dose adjustment needed
• Pediatric Use: Doses are calculated based on body surface area
• Elderly: No routine dosage adjustment needed unless hepatic function is impaired

Always follow physician or institutional guidelines and individualize therapy based on patient response and microbiological results.

Possible side effects of AFUNDAS-L 70mg

Most patients tolerate AFUNDAS-L well, but as with all medications, side effects may occur. These can range from mild infusion-related reactions to more serious systemic effects.

• Common Side Effects:
  • Fever
  • Headache
  • Infusion-related reactions (rash, itching, facial swelling)
  • Elevated liver enzymes (AST, ALT, ALP)
  • Gastrointestinal discomfort (nausea, vomiting, diarrhea)
• Less Common:
  • Phlebitis at injection site
  • Back pain
  • Hypokalemia
  • Anemia
• Serious (Rare):
  • Anaphylaxis or severe hypersensitivity
  • Hepatotoxicity
  • Cardiac arrhythmias

Patients should be closely monitored during treatment, particularly during the first infusion. Any unusual symptoms should be reported to the healthcare provider immediately.

AFUNDAS-L 70mg Contraindications AFUNDAS-L 70mg

Although AFUNDAS-L is considered safe in most hospitalized patients, certain contraindications and cautionary scenarios must be considered.

• Known Hypersensitivity: Contraindicated in patients with a history of allergy to Caspofungin or any echinocandin component.
• Severe Hepatic Impairment: Use with caution and under close monitoring; may require dose adjustment.
• Pregnancy and Lactation: Not well studied in pregnant or breastfeeding women. Use only if clearly necessary and prescribed by a specialist.
• Pediatric Use: Should be used with adjusted doses under specialist supervision.

Use with caution in:

• Patients with multiple co-administered drugs that are hepatically metabolized
• Immunosuppressed individuals, where infection masking may delay diagnosis of side effects
• Patients undergoing chemotherapy or with hematologic malignancies

Storage of AFUNDAS-L 70mg

Proper storage of AFUNDAS-L is crucial to maintaining its stability and therapeutic efficacy.

• Storage Conditions (Unreconstituted): Store the vials at 2°C to 8°C (refrigerated), protected from light.
• After Reconstitution: The concentrate can be stored at room temperature (up to 25°C) for a limited time—usually not more than 24 hours prior to dilution.
• After Dilution: The final infusion solution should be used within 24 hours if stored at room temperature or 48 hours if refrigerated.

Additional Notes:

• Do not freeze the reconstituted or diluted solution.
• Visually inspect for particles or discoloration before use.
• Use aseptic technique during preparation to avoid contamination.
• Keep out of reach of children and do not use past expiry date.