CASPOFUNGIN AND CICLOSPORIN (CYCLOSPORINE)

Ciclosporin increases the AUC of caspofungin by 35% and causes increases in AST and ALT of up to 3-fold. Retrospective studies found no serious hepatic adverse events with the combination, but 2 of 40 patients had discontinued therapy because of abnormalities in hepatic enzymes. However, other studies suggest adverse hepatic events are increased by the combination.
The manufacturer advises that ciclosporin and caspofungin should only be used if the benefits outweigh the risks of treatment, and if they are used, close monitoring of liver enzymes is recommended.