• Treatment of esophageal candidiasis.
• Treatment of candidemia/acute disseminated candidiasis/Candida peritonitis and abscesses (in adults and pediatric patients ≥4 mo).
• Treatment of candidemia/acute disseminated candidiasis/Candida peritonitis and abscesses without meningoencephalitis and/or ocular dissemination (in pediatric patients <4 mo).
• Prophylaxis of Candida infections during hematopoetic stem cell transplantation.

Contraindicated in:

• Hypersensitivity.

Use Cautiously in:

• Severe hepatic impairment
• OB: Use during pregnancy only if potential maternal benefit justifies potential fetal risk
• Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant
• Pedi: Children <4 mo with meningoencephalitis and/or ocular dissemination (safety and effectiveness not established).

GI: worsening hepatic function/hepatitis.

GU: renal impairment.

Hemat: hemolysis/hemolytic anemia.

Local: injection site reactions.
Misc: infusion reactions, (INCLUDING ANAPHYLAXIS)HYPERSENSITIVITY REACTIONS .

Drug-Drug:

• ↑ levels and risk of toxicity with sirolimus and nifedipine (dose adjustments may be necessary).

(Generic available)

• Lyophilized powder for injection: 50 mg/vial; 100 mg/vial;

Treatment of Esophageal Candidiasis

• IV (Adults): 150 mg once daily for 15 days (range 10–30 days).
• IV (Children ≥4 mo and >30 kg): 2.5 mg/kg once daily (max daily dose = 150 mg).
• IV (Children ≥4 mo and ≤30 kg): 3 mg/kg once daily.

Treatment of Candidemia/Acute Disseminated Candidiasis/Candida Peritonitis and Abscesses

• IV (Adults): 100 mg once daily for 15 days (range 10–47 days).
• IV (Children ≥4 mo and >30 kg): 2 mg/kg once daily (max daily dose = 100 mg).
• IV (Children ≥4 mo and ≤30 kg): 2 mg/kg once daily.

Treatment of Candidemia/Acute Disseminated Candidiasis/Candida Peritonitis and Abscesses Without Meningoencephalitis and/or Ocular Dissemination

• IV (Children <4 mo): 4 mg/kg once daily.

Prophylaxis of Candida Infections During Hematopoetic Stem Cell Transplantation.

• IV (Adults): 50 mg once daily (duration range 6–51 days).
• IV (Children ≥4 mo and >30 kg): 1 mg/kg once daily (max daily dose = 50 mg).
• IV (Children ≥4 mo and ≤30 kg): 1 mg/kg once daily.

Mycamine

• Inhibits synthesis of glucan required for the formation of fungal cell wall.

• Death of susceptible fungi.

Spectrum:

• Active against the following Candida spp.: C. albicans, C. glabrata, C. krusei, C. parapsilosis, C. tropicalis.

Therapeutic Classification: antifungals

Pharmacologic Classification: echinocandins

Absorption: IV administration results in complete bioavailability.

Distribution: Primarily distributed into lung, liver, and spleen; minimal distribution to CNS and eyes.

Protein Binding: >99%.

Metabolism/Excretion: Mostly metabolized in the liver; 71% fecal elimination.

Half-life: 15 hr.

(plasma concentrations)

• Inform patient of the purpose of micafungin.
• Advise patient to notify health care professional immediately if signs of anaphylaxis occur. Infusion should be discontinued if symptoms occur.
• Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking any other Rx, OTC, or herbal products.
• May cause fetal harm. Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

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