Echinocandin Capsules (Cresemba) is an azole antifungal medication. For patients taking this drug, it is crucial to understand its potential side effects, severe adverse reactions that require vigilance, and medication precautions.
What Are the Side Effects of Echinocandin Capsules (Cresemba)?
Gastrointestinal Reactions
Nausea (incidence rate: 26%)
Vomiting (incidence rate: 25%)
Diarrhea (incidence rate: 22%)
Neurological and Systemic Reactions
Headache (incidence rate: 17%)
Back pain (incidence rate: 10%)
Abnormal Laboratory Test Results
Elevated liver function test indicators (incidence rate: 16%)
Hypokalemia (incidence rate: 14%)
Severe Side Effects of Echinocandin Capsules (Cresemba) That Require Vigilance
Hepatic Adverse Reactions
Reports have shown that Cresemba can cause elevations in liver enzymes (alanine transaminase [ALT], aspartate transaminase [AST], alkaline phosphatase, and total bilirubin).
More severe hepatic adverse reactions include hepatitis, cholestasis, or liver failure, especially in patients with severe underlying diseases such as hematological malignancies.
It is recommended to monitor liver function regularly at the start of and during Cresemba treatment.
If clinical signs and symptoms of liver disease potentially related to Cresemba occur, the drug should be discontinued immediately.
Infusion-Related Reactions
Infusion-related reactions may occur during intravenous administration, including hypotension, dyspnea, chills, dizziness, paresthesia, and hypoesthesia.
If these reactions occur, the infusion should be stopped immediately and appropriate measures taken.
Hypersensitivity Reactions and Severe Skin Reactions
Severe hypersensitivity reactions and severe skin reactions (such as anaphylaxis or Stevens-Johnson syndrome) have been reported during treatment with other azole antifungal drugs.
If a severe skin adverse reaction occurs, Cresemba should be discontinued.
Currently, there is no information on cross-allergy between Cresemba and other azole antifungal drugs, but patients allergic to other azoles should use Cresemba with caution.
Embryo-Fetal Toxicity
Animal studies have shown that Cresemba may cause harm to the fetus.
Pregnant women should use this drug only if the potential benefit outweighs the risk to the fetus.
Patients who become pregnant during treatment should inform their doctor.
Lactating women should not breastfeed.
Drug Particle Issue
Insoluble particles may form in the intravenous formulation after reconstitution.
Administration must be done using an in-line filter.
Precautions for Taking Echinocandin Capsules (Cresemba)
Medication for Special Populations
Pregnant women: Use only if the potential benefit outweighs the risk to the fetus; the potential risks should be informed to pregnant women.
Lactating women: Should not breastfeed.
Children: The efficacy in patients under 18 years of age has not been established.
Elderly patients: No dose adjustment is required.
Patients with renal impairment: No dose adjustment is required, including patients with end-stage renal disease.
Patients with hepatic impairment: No dose adjustment is required for patients with mild to moderate hepatic impairment; patients with severe hepatic impairment should use this drug only if the benefit outweighs the risk, and adverse reactions should be closely monitored.
Precautions for Capsule Administration
Can be taken with or without food.
Should be swallowed whole; do not chew, crush, dissolve, or open the capsule.
Precautions for Intravenous Administration
Must use an in-line filter with a pore size of 0.2 to 1.2 micrometers.
The intravenous infusion time should be at least 1 hour, and the compatible diluent is 250 mL.
Should not be administered as an intravenous bolus injection.
Before and after infusion, the intravenous line should be flushed with 0.9% sodium chloride injection or 5% dextrose injection.
After reconstitution, the solution can be stored at 25°C for a maximum of 1 hour; after dilution, the solution can be stored at room temperature for a maximum of 6 hours (if it cannot be used within 6 hours, it should be refrigerated immediately and used within 24 hours).
