Classifications: antibiotic; echinocandin, antifungal; Therapeutic: antifungal, echinocandin
Pregnancy Category: C
50 mg vial
Micafungin is an antifungal agent that inhibits the synthesis of glucan, an essential component of fungal cell walls. Micafungin
does not allow Candida fungi to replicate.
Has antifungal effects against various species of Candida.
Treatment of patients with esophageal candidiasis, and for prophylaxis of Candida infections in patients undergoing hematopoietic stem cell transplantation. Susceptible organisms include C. albicans, C. glabrata, C. krusei, C. parapsilosis, and C. tropicalis.
Treatment of pulmonary Aspergillus infection.
Hypersensitivity to any component in micafungin; pregnancy (category C). Safety and efficacy in children <18 y are unknown.
Hepatic and renal dysfunction; lactation; older adult.
Route & Dosage
Adult: IV 150 mg/d over 1 h x 14 d
Candidiasis Prophylaxis in Hematopoietic Stem Cell Transplantation Patients
Adult: IV 50 mg/d over 1 h x 18 d
PREPARE: IV Infusion: ??Reconstitute the 50 or 100 mg vial with 5 mL NS (without a bacteriostatic agent) to yield 10 mg/mL or 20 mg/mL, respectively.
Gently swirl, but do not shake, to dissolve. Solution should be clear.??Add required dose to 100 mL NS.
ADMINISTER: IV Infusion: Give slowly over 1 h. Flush existing IV line with NS before/after infusion. Protect IV solution from light.
INCOMPATIBILITIES Do not mix or infuse with any other medications.
- Store reconstituted vial and IV solution for up to 24 h at 25° C (77° F). Protect from light.
Adverse Effects (≥1%)CNS: Headache,
dizziness, somnolence. CV:
Flushing, hypertension, phlebitis. GI: Nausea, vomiting, diarrhea,
abdominal pain. Hematologic/Lymphatic:
Anemia, hemolytic anemia, leukemia, neutropenia, thrombocytopenia. Hepatic:
Elevated liver enzymes, jaundice
Hypocalcemia, hypokalemia, hypomagnesemia. Skin:
Pruritus, rash. Body as a Whole:
Injection site pain, pyrexia, rigors.
Micafungin increases levels of sirolimus
99% protein bound. Metabolism:
Biotransformation primarily in the liver. Elimination:
Fecal (major) and renal. Half-Life:
Assessment & Drug Effects
- Monitor for S&S of hypersensitivity during IV infusion; frequently monitor IV site for thrombophlebitis.
- Monitor for S&S of hemolytic anemia (i.e., jaundice).
- Lab tests: Periodic LFTs, kidney function tests, serum electrolytes, and CBC.
- Monitor blood levels of sirolimus or nifedipine with concurrent therapy. If sirolimus or nifedipine toxicity occurs, dosages
of these drugs should be reduced.
Patient & Family Education
- Report immediately any of the following: facial swelling, wheezing, difficulty breathing or swallowing, tightness in chest,
rash, hives, itching, or sensation of warmth.