Micafungin
- Atc Codes:J02AX05
- CAS Codes:208538-73-2#235114-32-6
- PHARMGKB ID:208538-73-2#235114-32-6
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Substrate of
- Inhibits
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Mycamine; Bulgaria: Mycamine; Cyprus: Mycamine; Czech Republic: Mycamine; Denmark: Mycamine; Estonia: Mycamine; Finland: Mycamine; France: Mycamine; Germany: Mycamine; Greece: Mycamine; Hungary: Mycamine; Ireland: Mycamine; Italy: Mycamine; Latvia: Mycamine; Lithuania: Mycamine; Luxembourg: Mycamine; Malta: Mycamine; Netherlands: Mycamine; Poland: Mycamine; Portugal: Mycamine; Romania: Mycamine; Slovakia: Mycamine; Slovenia: Mycamine; Spain: Mycamine; Sweden: Mycamine; UK: Mycamine.
North America
Canada: Mycamine; USA: Mycamine.
Asia
Japan: Funguard.
Drug combinations
Chemistry
Micafungin Sodium: C~56~H~70~N~9~NaO~23~S. Mw: 1292.26. (1) Pneumocandin A0, 1-[(4R,5R)-4,5-dihydroxy-N^2^-[4-[5-[4-(pentyloxy)phenyl]-3-isoxazolyl]benzoyl]-L-ornithine]-4-[(4S)-4-hydroxy-4-[4-hydroxy-3-(sulfooxy)phenyl]-L-threonine]-, monosodium salt; (2) 5-[(1S,2S)-2-[(2R,6S,9S,11R,12R,14aS,15S,16S,20S,23S,25aS)-20-[(1R)-3-Amino-1-hydroxy-3-oxopropyl]-2,11,12,15-tetrahydroxy-6-[(1R)-1-hydroxyethyl]-16-methyl-5,8,14,19,22,25-hexaoxo-9-[[4-[5-[4-(pentyloxy)phenyl]isoxazol-3-yl]benzoyl]amino]tetracosahydro-1H-dipyrrolo[2,1-c:2′,1′-l][1,4,7,10,13,16]hexaazacyclohenicosin-23-yl]-1,2-dihydroxyethyl]-2-hydroxyphenyl sodium sulfate. CAS-208538-73-2; CAS-235114-32-6 (micafungin)(2004).
Pharmacologic Category
Antifungals; Echinocandins. Parenteral Antifungal Agent. (ATC-Code: J02AX05).
Mechanism of action
Concentration-dependent inhibition of 1,3-β-D-glucan synthase resulting in reduced formation of 1,3-β-D-glucan, essential polysaccharide comprising 30% to 60% of Candida cell walls (absent in mammalian cells). Decreased glucan content leads to osmotic instability and cellular lysis.
Therapeutic use
Treatment of esophageal candidiasis. Candida prophylaxis in patients undergoing hematopoietic stem cell transplant. Treatment of candidemia, acute disseminated candidiasis, and other Candida infections (peritonitis and abscesses).
Pregnancy and lactiation implications
Visceral teratogenic and abortifacient effects noted in animal studies. There are no adequate, well-controlled studies in pregnant women. Use only if benefit outweighs risk. Excretion in breast milk unknown (use caution).
Unlabeled use
Treatment of infections due to Aspergillus spp. Prophylaxis of HIV-related esophageal candidiasis.
Contraindications
Hypersensitivity to micafungin, other echinocandins, or any component of the formulation.
Warnings and precautions
Anaphylactic reactions, including shock reported. Hemolytic anemia and hemoglobinuria reported. Hepatic failure reported (use caution in pre-existing mild-moderate hepatic impairment). Increased BUN, serum creatinine, renal dysfunction, and/or acute renal failure reported (use with caution in pre-existing renal impairment).