Caspfungin: new warning against use of polyacrylonitrile-based membranes during continuous renal replacement therapy

PRAC has endorsed a direct healthcare professional communication (DHPC) warning about the use of polyacrylonitrile (PAN)-based membranes during continuous renal replacement therapy (CRRT) in critically ill patients receiving caspofungin. CRRT involves non-stop dialysis in patients with acute kidney injury and fluid overload.

Caspofungin is an antifungal medicine, given by intravenous infusion for the treatment of fungal infections in adults and children.

Laboratory data suggest that the PAN-based membranes used to filter the blood in CRRT can bind caspofungin and decrease its effectiveness. In addition, lack of caspofungin effectiveness has been reported in patients undergoing CRRT with these membranes.

Antifungal treatment failure may lead to worsening of the systemic fungal infection, which may be fatal in these critically ill patients.

Healthcare professionals should verify the type of haemofiltration membrane used before initiating and during treatment with caspofungin. If PAN-derived membranes are being used, healthcare professionals should either switch to an alternative membrane or consider an alternative antifungal medicine.