Drug reference

Micafungin

Echinocandin · Antifungal

EchinocandinAntifungal

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

—

none in our sources

PREGNANCY

—

not curated

Mechanism

Micafungin is a cyclic lipopeptide echinocandin that non-competitively inhibits 1,3-β-D-glucan synthase, the enzyme responsible for synthesizing the structural glucan polymer of the fungal cell wall. Glucan depletion causes osmotic instability and cell lysis, producing fungicidal activity against Candida species and fungistatic activity against Aspergillus. As 1,3-β-D-glucan is absent from mammalian cells, micafungin has an excellent safety profile with minimal human toxicity.

Indications

Invasive candidiasisOesophageal candidiasisProphylaxis of candidiasis in patients undergoing haematopoietic stem cell transplantation when fluconazole, itraconazole or posaconazole cannot be usedTreatment of candidal esophagitisTreatment of candidemiaAntifungal prophylaxis in hematopoietic stem cell transplantationTreatment of invasive aspergillosis (favorable results in open-label trials)Treatment of invasive candidiasis (favorable results in open-label trials)Prophylaxis for aspergillosisInvasive aspergillosis

Dosing

Adult: BY INTRAVENOUS INFUSION:Invasive candidiasis: Adult (body-weight up to 40 kg): Initially 2 mg/kg once daily for at least 14 days; increased if necessary to 4 mg/kg once daily if response inadequate.…

Pharmacokinetics

Bioavailability

—

Protein binding

99%

Excretion

<1%

Side effects

Common

AnaemiaAnxietyAppetite decreasedArrhythmiasConfusionConstipationDiarrhoeaDizzinessDrowsinessDyspnoeaElectrolyte imbalanceEosinophiliaFlushingGastrointestinal discomfortHeadacheHyperbilirubinaemiaHyperhidrosisMinimal toxicityMinimal drug interactions

Serious