侵袭性真菌感染的挑战[精品文档].ppt

* * * * * * * * Studies in vitro show that caspofungin is not an inhibitor of any enzyme in the cytochrome P-450 (CYP) system. In clinical studies, caspofungin did not induce the CYP3A4 metabolism of other drugs. Caspofungin is not a substrate for P-glycoprotein and is a poor substrate for CYP-450 enzymes.18 Concomitant use with cyclosporine is not recommended unless the potential benefit outweighs the potential risk to the patient.18 In one clinical study, three of four subjects who received caspofungin 70 mg on days 1 through 10 and cyclosporine (two 3 mg/kg doses administered 12 hours apart on day 10) developed transient elevations of alanine transaminase (ALT) on day 11 that were two to three times the upper limit of normal (ULN).18 In a separate panel of subjects within the same study, two of eight patients who received caspofungin 35 mg daily for 3 days and cyclosporine (two 3 mg/kg doses administered 12 hours apart on day 1) had smaller increases in ALT (slightly above the ULN) on day 2.18 In both groups, elevations in aspartate transaminase (AST) paralleled ALT elevations, but were of lesser magnitude.18 * Use Av conc SS * QC K Dejonghe (17 Sep 2001) - No QC issues. * QC’d by Scott Vincent on 19/06/2001 QC Issues: 10000001057162\5.0\Approved\18-Oct-2000 10:13 10000001065376\10.17\Approved\26-Oct-2000 12:45 10000001041465\4.0\Approved\04-Oct-2000 12:22 10000000830606\3.9\Approved\06-Mar-2000 08:12 10000000848784\1.3\Approved\07-Sep-2000 11:36 10000001044066\4.3\Approved\06-Oct-2000 09:46 10000001178822\4.3\Approved\27-Mar-2001 04:17 * QC’d by Scott Vincent on 19/06/2001 QC Issues: 10000001057162\5.0\Approved\18-Oct-2000 10:13 10000001065376\10.17\Approved\26-Oct-2000 12:45 10000001041465\4.0\Approved\04-Oct-2000 12:22 10000000830606\3.9\Approved\06-Mar-2000 08:12 10000000848784\1.3\Approved\07-Sep-2000 11:36 10000001044066\4.3\Approved\06-Oct-2000 09:46 10000001178822\4.3\Approved\27-Mar-2001 04:17 * * QC K Dejonghe (17 Sep 2001) - No QC issu