Drug Index

Micafungin

 
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Mechanism :

It is an echinocandin with concentration-dependent inhibition of 1,3-beta-D-glucan synthase resulting in reduced formation of 1,3-beta-D-glucan, an essential polysaccharide comprising 30% to 60% of Candida cell walls.


Indication :

• Esophageal candidiasis

• Treatment of candidemia, acute disseminated candidiasis, Candida peritonitis and abscesses

• Prophylaxis of Candida infections


Contraindications :

Hypersensitivity to micafungin, other echinocandins, or any component of the formulation.


Dosing :

Candidemia, acute disseminated candidiasis, and Candida peritonitis and abscesses:

Premature Neonates >1000 g and Term Neonates: Limited data are available. 7 to 10 mg/kg/dose IV once daily. Doses of 10 to 15 mg/kg/dose IV once daily have been used successfully in the setting of CNS infections.

Premature Neonates <1000 g: Limited data are available. 10 mg/kg/dose IV once daily

1-3 months: 2 mg/kg IV OD. If there is an inadequate clinical response after 5 days, may increase dose to 4 mg/kg/day.

≥4 months: 2 mg/kg IV OD; (Maximum: 100 mg once daily in children <40 kg and 200 mg/day in >40 kg). If there is an inadequate clinical response after 5 days, may increase dose to 4 mg/kg/day.

Duration: At least 14 days after resolution of symptoms or last positive culture, whichever is longer.

Esophageal candidiasis:

1-3 months: 5 to 7 mg/kg/dose IV once daily for 14 to 21 days.

>4 months, ≤30 kg: 3 mg/kg once daily for 14 to 21 days.

>4 months, >30 kg: 2.5 mg/kg once daily; maximum: 150 mg once daily for 14 to 21 days.

Prophylaxis of Candida infection in hematopoietic stem cell transplantation:

1 mg/kg once daily; maximum: 50 mg once daily for 6 weeks.


Adverse Effect :

Abdominal pain, Anemia, Headache, Diarrhea, Increased transaminases, Leukopenia, Nausea Neutropenia, Phlebitis, Pruritus, Pyrexia, Rash, Rigors, Thrombocytopenia, Vomiting, Facial swelling, Vasodilation, Stevens-Johnson syndrome, toxic epidermal necrolysis, shock.


Interaction :

Sirolimus: Micafungin may increase the serum concentration of Sirolimus.
Saccharomyces boulardii: Antifungal Agents may diminish the therapeutic effect of Saccharomyces boulardii.


07/15/2019 06:12:44 Micafungin
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