Caspofungin
The first echinocandin, a cyclic lipopeptide that attacks the fungal cell wall
Caspofungin is a semi-synthetic cyclic lipopeptide that blocks the enzyme fungi use to build their cell walls, a target human cells lack. Approved as Cancidas in 2001, it is given by daily intravenous infusion for serious Candida infections and some cases of invasive aspergillosis.
What is it?
Echinocandins are cyclic lipopeptides, rings of six amino acids carrying a fatty tail, made by modifying natural products of fungi. They block beta-(1,3)-D-glucan synthase, which builds a polysaccharide in the fungal cell wall. Because human cells have no cell wall, the drug targets the fungus selectively. Caspofungin, approved as Cancidas in 2001, was the first of the class.
In a 2002 trial in 224 patients with invasive candidiasis, caspofungin was as effective as amphotericin B (73.4% against 61.7% success) with fewer side effects. In 1,095 patients with persistent fever and neutropenia, it was noninferior to liposomal amphotericin B as empirical therapy, with better outcomes in those with baseline fungal infections.
It is given by daily infusion after a loading dose; it cannot be taken by mouth. The label warns of hypersensitivity, liver effects, and raised liver enzymes when given with cyclosporine. Its plasma half-life has a 9-to-11-hour phase and a longer phase of 40 to 50 hours.
At a Glance
Every value in this table is printed from the Grey Peptides dataset, the same record the compound explorer and comparison tool read, so the three can never disagree.
Educational information, not medical advice. The doses on this page come from approved labels, published studies and, where no study exists, amounts reported by users. None is a recommendation for you. An unapproved compound has no established safe or effective human dose, and products sold for “research use only” are not made or tested for people. Talk to a doctor before acting on anything on this site, including before you start, stop or change any medicine or dose. Full medical disclaimer.
Half-Life: How Much Remains
The dataset records a half-life of beta-phase half-life 9 to 11 hours, with a longer gamma phase of 40 to 50 hours for Caspofungin. After each half-life, half of what was in the circulation is gone, so about 3% remains after five. Real clearance varies with the person, the dose, the route and kidney or liver function; this is arithmetic on a published figure, not a dosing tool.
Published Research
The studies behind caspofungin, from their PubMed abstracts.
Against amphotericin B in invasive candidiasis
In 224 patients in the modified intention-to-treat analysis, success was 73.4% on caspofungin and 61.7% on amphotericin B, similar efficacy; among patients meeting prespecified evaluation criteria, caspofungin was superior.
Empirical therapy in fever and neutropenia
In 1,095 patients, overall success was 33.9% on caspofungin and 33.7% on liposomal amphotericin B, meeting noninferiority; with baseline fungal infections, success was 51.9% against 25.9%, and survival at seven days after therapy 92.6% against 89.2%.
Refractory invasive aspergillosis
Among 83 patients refractory to or intolerant of other therapy, 45% had a favourable response, including 50% with pulmonary aspergillosis; two stopped for drug-related adverse events, and kidney and liver toxicity were infrequent.
The first echinocandin
A review of caspofungin as the first licensed echinocandin, its mechanism against the fungal cell wall and its early clinical development.
Side Effects & Contraindications
Reported Side Effects
From the studies above.
Contraindications & Cautions
Warnings from the Cancidas label (DailyMed, effective October 11, 2024).
Legal Status
Caspofungin is an approved prescription drug in the US.
Frequently Asked Questions
?Is caspofungin a peptide?
Yes. It is a cyclic lipopeptide, a ring of six amino acids with a fatty side chain, made by chemically modifying a natural fungal product.
?What is caspofungin used for?
Serious Candida infections including candidaemia, esophageal candidiasis, suspected fungal infection in febrile neutropenic patients, and invasive aspergillosis that has not responded to other drugs.
?How is it given?
By slow intravenous infusion once a day, usually after a loading dose on the first day. It cannot be taken by mouth.
References
- [fda] US FDA, Drugs@FDA (openFDA): CANCIDAS, NDA 021227 (January 26, 2001). Read October 3, 2026.
- [fda-pi] FDA. Cancidas (caspofungin acetate) US prescribing information (DailyMed set 3bad23a6-09a6-4194-9182-093ed61bc71c, effective October 11, 2024). Read October 3, 2026.
- [clinical-trial] Mora-Duarte J, et al. "Comparison of caspofungin and amphotericin B for invasive candidiasis." N Engl J Med, 2002;347(25):2020-9. PMID: 12490683.
- [clinical-trial] Walsh TJ, et al. "Caspofungin versus liposomal amphotericin B for empirical antifungal therapy in patients with persistent fever and neutropenia." N Engl J Med, 2004;351(14):1391-402. PMID: 15459300.
- [clinical-trial] Maertens J, et al. "Efficacy and safety of caspofungin for treatment of invasive aspergillosis in patients refractory to or intolerant of conventional antifungal therapy." Clin Infect Dis, 2004;39(11):1563-71. PMID: 15578352.
- [pubmed] Cornely OA, et al. "The first echinocandin: caspofungin." Mycoses, 2002;45 Suppl 3:56-60. PMID: 12690973.
Sources & Citations
Studies were read from their PubMed records; regulatory sources are listed below, read October 3, 2026.
Medical Disclaimer: This content is for educational and informational purposes only. It is not medical advice, and nothing here is an instruction to obtain or use any compound. Consult a licensed healthcare provider before making health decisions.