rezafungin

Inhibits the synthesis of 1, 3-β-D-glucan, a necessary component of the fungal cell wall.

Therapeutic effects:

Death of susceptible fungi.

Spectrum:

Active against the following:
- Candida albicans,
- Candida glabrata,
- Candida parapsilosis,
- Candida tropicalis.

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Well distributed to tissues.

Metabolism/Excretion: Metabolic pathway unknown. 74% excreted in feces (primarily as unchanged drug), with 25.7% excreted in urine (primarily as inactive metabolites).

Half-Life: 152 hr.

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
IV	rapid	end of infusion	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity to rezafungin or other echinocandins.

Use Cautiously in:

OB: Safety during pregnancy not established;
Lactation: Safety during breastfeeding not established;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

CV: edema

Derm: erythema, photosensitivity

F and E: hypokalemia, hypomagnesemia, hypophosphatemia

GI: diarrhea, ↑liver enzymes, abdominal pain, constipation, dysphagia, GI BLEEDING, nausea, vomiting

GU: acute kidney injury

Hemat: anemia, disseminated intravascular coagulation

Neuro: dizziness, headache, insomnia, peripheral neuropathy, tremor

Misc: fever, infusion-related reactions

Interactions ⬆ ⬇

Drug-drug:

None reported.

Route/Dosage ⬆ ⬇

IV (Adults ): 400 mg initially on Day 1; then 200 mg once weekly beginning on Day 8 for up to four doses (including the dose on Day 1).

Availability ⬆ ⬇

Lyophilized powder for injection: 200 mg/vial

Assessment ⬆ ⬇

Monitor for signs and symptoms of infusion-related reactions (fever, chills, sweating, myalgia, headache, dizziness, nausea, vomiting, urticaria, pruritus, dyspnea, wheezing) during and within 24 hr of infusion. If infusion-related reaction occurs, slow or pause infusion; restart at a lower rate.
Monitor for signs and symptoms of GI bleeding (hematemesis, coffee ground emesis, hematochezia, melena, abdominal pain or cramping, anemia, fatigue, dyspnea, pallor of skin or sclera).

Lab Test Considerations:

Monitor liver function tests during therapy; may ↑ liver enzymes.
May ↓ potassium, magnesium, and phosphate levels.

Implementation ⬆ ⬇

IV Administration:

Y-Site Incompatibility: Do not administer other drugs through same IV line.

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of rezafungin to patient. Advise patient to read Patient Information before starting therapy.
Advise patient to notify health care professional if signs and symptoms of infusion-related reactions (fever, chills or shivering, nausea, vomiting, diarrhea, tiredness, dizziness, sweating, hives, itching, shortness of breath, wheezing) occur.
Advise patient to report signs or symptoms of GI bleeding (nausea, blood in vomit or stool, abdominal pain or cramping, fatigue, trouble breathing, pale skin).
Photosensitivity may occur. Instruct patient to use protection from sun exposure and other sources of UV radiation during treatment.
Advise 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 other medications.
Rep: Advise women of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes ⬆ ⬇

Death of susceptible fungi.
Improvement in candidemia and invasive candidiasis infection.

US Brand Names ⬆ ⬇

Code ⬆

NDC Code

68225- Patheon Italia S.p.A.
- 68225-236-
  - 68225-236-00- 56 VIAL in 1 BOX (68225-236-00) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL

70842- Melinta Therapeutics, LLC
- 70842-240- REZZAYO
  - 70842-240-01- 1 VIAL in 1 CARTON (70842-240-01) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇