Classifications: antibiotic; echinocandin antifungal; Therapeutic:antifungal antibiotic
Pregnancy Category: C
50 mg powder for injection
Anidulafungin is a semisynthetic echinocandin with antifungal activity. It inhibits glucan synthase, an enzyme present in
fungal cells. Glucan is an essential component of the fungal cell wall; therefore, anidulafungin causes fungal cell death.
Anidulafungin interferes with reproduction and growth of susceptible fungi.
Treatment of candidemia and other Candida infections caused by C. albicans, C. glabrata, C. parapsilosis, and C. tropicalis. Treatment of esophageal candidiasis.
Fungal prophylaxis in immunocompromised children who are hospitalized with neutropenia.
Hypersensitivity to anidulafungin or another echinocandin antifungal agent; pregnancy (category C), lactation.
Hepatic impairment. Safety and efficacy in children have not been established.
Route & Dosage
|Candidemia and Other Candida Infections
Adult: IV 200 mg loading dose on day 1, then 100 mg IV daily for at least 14 d after last positive culture
For the Treatment of Esophageal Candidiasis
Adult: IV 100 mg loading dose on day 1, then 50 mg IV daily for at least 14 d (and for at least 7 d after resolution of symptoms)
PREPARE: IV Infusion: Reconstitute each vial with the supplied single-use 15 mL vial of diluent [20% (w/w) dehydrated alcohol in water] to
yield 3.33 mg/mL. Each 50 mg reconstituted vial must be further diluted with NS for D5W to a total infusion volume of 100
mL with a concentration of 0.5 mg/mL. ??For a 50 mg dose, dilute 15 mL reconstituted solution in 100 mL of IV fluid to yield 0.43 mg/mL.??For a 100 mg dose, dilute 30 mL reconstituted solution in 250 mL of IV fluid to yield 0.36 mg/mL.??For a 200 mg dose, dilute 60 mL reconstituted solution in 500 mL of IV fluid to yield 0.36 mg/mL.
ADMINISTER: IV Infusion: Give at a rate no greater than 1.1 mg/min. DO NOT give a bolus dose.
INCOMPATIBILITIES Y-site: Amphotericin B, ertapenem, sodium bicarbonate.
- Store unreconstituted vials, reconstituted vials, and companion diluent vials at 15° to 30° C (59°86°
F). Reconstituted vials must be further diluted and administered within 24 h.
Adverse Effects (≥1%)Body as a Whole:
Headache. GI: Diarrhea
, nausea. Hematologic: Neutropenia
Increased alkaline phosphatase
, increased ALT, increased gamma-glutamyl transferase, hypokalemia. Skin:
increases overall systemic exposure (i.e., area under the curve, or AUC).
84% protein bound. Metabolism:
Non-hepatic degradation to inactive metabolites. Elimination:
Assessment & Drug Effects
- Prior to initiating therapy with anidulafungin, obtain specimen for fungal culture.
- Monitor for and report S&S of hypersensitivity (e.g., dyspnea, flushing, hypotension, swelling about the face, pruritus,
rash, and urticaria) or liver dysfunction (e.g., jaundice, clay-colored stools).
- Discontinue infusion if signs of hypersensitivity appear.
- Monitor cardiac status especially with a preexisting history of dysrhythmias.
- Lab tests: Baseline and periodic liver function tests; periodic CBC with differential and platelet count; periodic serum
electrolytes, amylase, and lipase.
- Monitor for S&S hypokalemia and hepatic toxicity (see Appendix F).
- Monitor diabetics for loss of glycemic control.
Patient & Family Education
- Report any of the following immediately if experienced during or shortly after infusion: difficulty breathing, swelling
about the face, itching, rash.
- Report S&S of jaundice to the physician: clay-colored stool, dark urine, yellow skin or sclera, unexplained abdominal pain,