Micafungin

Micafungin Brand Name– Mycamine

What is Micafungin

Micafungin is an intravenous echinocandin antifungal agent, with antifungal activity against Candida albicans, C. glabrataC. guilliermondiiC. kruseiC. parapsilosis, and C. tropicalis. Micafungin, a semisynthetic lipopeptide, is derived from a fermentation product of Coleophoma empetri.

It is approved for use in adults and pediatric patients 4 months and older to treat esophageal candidiasis, candidemia, acute disseminated candidiasis, 

Candida peritonitis and abscesses, and for the prophylaxis of Candida infections in patients undergoing hematopoietic stem cell transplantation.

The drug is also approved for use in pediatric patients younger than 4 months of age to treat candidemia, acute disseminated candidiasis, Candida peritonitis and abscesses without meningoencephalitis or ocular dissemination; however, micafungin has been used off-label to treat CNS infections in these patients.

Indications

  1. aspergillosis
  2. aspergillosis prophylaxis
  3. bone and joint infections
  4. Candida albicans
  5. Candida glabrata
  6. Candida guilliermondii
  7. Candida krusei
  8. Candida parapsilosis
  9. Candida tropicalis
  10. candidemia
  11. candidiasis
  12. candidiasis prophylaxis
  13. endocarditis
  14. esophageal candidiasis
  15. febrile neutropenia
  16. infectious arthritis
  17. intraabdominal abscess
  18. intraabdominal infections
  19. oropharyngeal candidiasis (thrush)
  20. osteomyelitis
  21. peritonitis
  22. pneumonia

Side Effects

  1. abdominal pain
  2. anaphylactic shock
  3. anaphylactoid reactions
  4. anemia
  5. anxiety
  6. ascites
  7. atrial fibrillation
  8. azotemia
  9. cardiac arrest
  10. coagulopathy
  11. dehydration
  12. delirium
  13. diarrhea
  14. disseminated intravascular coagulation (DIC)
  15. dyspnea
  16. edema
  17. elevated hepatic enzymes
  18. encephalopathy
  19. epistaxis
  20. fever
  21. GI perforation
  22. headache
  23. hematuria
  24. hemolysis
  25. hemolytic anemia
  26. hepatic failure
  27. hepatitis
  28. hepatomegaly
  29. hyperbilirubinemia
  30. hyperglycemia
  31. hyperkalemia
  32. hypermagnesemia
  33. hypernatremia
  34. hypertension
  35. hypertonia
  36. hypocalcemia
  37. hypoglycemia
  38. hypokalemia
  39. hypotension
  40. ileus
  41. infusion-related reactions
  42. injection site reaction
  43. insomnia
  44. intracranial bleeding
  45. jaundice
  46. leukocytosis
  47. myocardial infarction
  48. nausea
  49. neutropenia
  50. oliguria
  51. pancytopenia
  52. pericardial effusion
  53. peripheral edema
  54. peripheral vasodilation
  55. phlebitis
  56. pleural effusion
  57. pruritus
  58. rash
  59. renal failure (unspecified)
  60. seizures
  61. sinus tachycardia
  62. Stevens-Johnson syndrome
  63. thrombocytopenia
  64. thrombocytosis
  65. thrombosis
  66. thrombotic thrombocytopenic purpura (TTP)
  67. toxic epidermal necrolysis
  68. urticaria
  69. vomiting

Monitoring Parameters

  • CBC
  • LFTs
  • serum creatinine/BUN

Contraindications

  • breast-feeding
  • cholestasis
  • hepatic disease
  • hepatitis
  • infants
  • infusion-related reactions
  • jaundice
  • neonates
  • pregnancy
  • renal disease
  • renal failure
  • renal impairment

Interactions

  • Corticosteroids
  • Cyclosporine
  • Dichlorphenamide
  • Itraconazole
  • Mycophenolate
  • Nifedipine
  • Saccharomyces boulardii
  • Sirolimus
  • Tacrolimus
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