Mycamine (micafungin sodium)
Last reviewed · Source: First Databank (FDB) drug data
Overview
Micafungin sodium is a semisynthetic, echinocandin antifungal agent.
Micafungin sodium, a semisynthetic lipopeptide synthesized from a fermentation product of Coleophoma empetri F-11899, is an echinocandin antifungal agent. Echinocandins (e.g., anidulafungin, caspofungin, micafungin) are glucan synthesis inhibitors and differ structurally and pharmacologically from other currently available antifungal agents.
Like other echinocandins, micafungin inhibits the synthesis of beta(1,3)-d-glucan, an essential component of the fungal cell wall that is not present in mammalian cells. The drug may be fungistatic or fungicidal in action. Depending on concentration, micafungin may be fungicidal against some Candida, but usually is fungistatic against Aspergillus.
Micafungin appears to be metabolized slowly in the liver, principally via arylsulfatase with further metabolism by catechol-O-methyltransferase. Hydroxylation of micafungin by the cytochrome P-450 (CYP) 3A isoenzyme appears to be only a minor metabolic pathway. The drug is about 99% protein bound (primarily albumin and to a lesser extent alpha1-acid glycoprotein).
The elimination half-life of micafungin at steady state is approximately 13.4-17.2 hours in adults. Typically, 85% of the steady-state concentration is achieved after 3 days of once-daily IV micafungin. Micafungin is eliminated principally in feces.
In healthy individuals, about 71% of a single IV dose of radiolabeled micafungin sodium was recovered in feces over 28 days.
USES: This medication is used to treat a variety of fungal infections. It is also used to prevent fungal infections in patients who are having a stem cell transplant. Micafungin belongs to a class of drugs known as echinocandins.
It works by stopping the growth of fungi.
Generic name: micafungin sodium
Pronunciation: (MYE-ka-FUN-jin)
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
Today’s intelligence on Mycamine
Indications
The following indications are listed for Mycamine:
- Acute Disseminated Candidiasis
- Candida Peritonitis
- Candidal Septicemia
- Candidemia
- Esophageal Candidiasis
- Prevention Of Disseminated Candidiasis
Also known as: Candida Species Peritonitis, Candida Spp. Peritonitis, Candidal Sepsis, Disseminated Candidiasis Prophylaxis, Disseminated Candidosis Prophylaxis, Disseminated Moniliasis Prophylaxis, Esophageal Candidosis, Esophageal Moniliasis, Prevention Of Invasive Candidiasis, Septic Candidiasis, Septic Moniliasis, Systemic Candidiasis Prophylaxis.
Dosing
Dosage of micafungin sodium is expressed in terms of micafungin.
A loading dose of micafungin is not required.
Micafungin sodium is administered by slow IV infusion. The drug should not be given by rapid IV injection.
No dosing information is available for this tab.
No dosing information is available for this tab.
Drug interactions
There is no enhanced messaging for this drug.
There are no contraindication interactions for this drug.
There are no severe interactions for this drug.
There are no moderate interactions for this drug.
Contraindications
Micafungin is contraindicated in patients with known hypersensitivity to the drug, other echinocandin antifungals (e.g., anidulafungin, caspofungin), or any ingredient in the formulation.
There are no contraindication contraindications for this drug.
There are no severe contraindications for this drug.
There are no moderate contraindications for this drug.
Adverse reactions
Adverse effects reported in 5% or more of patients receiving micafungin include GI effects (diarrhea, nausea, vomiting, abdominal pain, abdominal distention ), pyrexia, infusion-related reactions, hypoglycemia, hypomagnesemia, hypernatremia, hyperkalemia, epistaxis, hematologic effects (thrombocytopenia, neutropenia, anemia), febrile neutropenia, increased AST, increased ALT, increased alkaline phosphatase, rash, pruritus, urticaria, headache, insomnia, anxiety, decreased urine output, hematuria, atrial fibrillation, and tachycardia. Injection site reactions (inflammation, phlebitis, thrombophlebitis) have been reported.
There are no severe adverse reactions for this drug.
There are no less severe adverse reactions for this drug.
Precautions
No enhanced messaging available.
Safety and efficacy of micafungin have not been established in pediatric patients younger than 4 months of age.
Safety and efficacy of micafungin in pediatric patients 4 months of age and older have been demonstrated based on evidence from adequate and well-controlled studies in adults and pediatric patients and additional pediatric pharmacokinetic and safety data.
Although data are limited, some experts state that micafungin can be considered for first-line treatment of invasive candidiasis or for alternative treatment of esophageal candidiasis in children with human immunodeficiency virus (HIV) infection.
Category C. (See Users Guide.)
There are no adequate and well-controlled studies of micafungin in pregnant women, and the manufacturer states that the drug should be used during pregnancy only if potential benefits outweigh potential risks to the fetus.
In rabbits, administration of micafungin in a dosage about 4 times the recommended human dosage (based on body surface area comparisons) resulted in increased abortions and visceral abnormalities (abnormal lobation of the lung, levocardia, retrocaval ureter, anomalous right subclavian artery, dilatation of the ureter).
Micafungin is distributed into milk in rats; it is not known whether the drug is distributed into milk in humans.
Micafungin should be used with caution in nursing women.
Dosage adjustments are not necessary in patients 65 years of age or older.
Although no overall differences in safety and efficacy were observed between geriatric adults 65 years of age or older and younger adults in clinical trials and other clinical experience has not revealed any evidence of age-related differences, the possibility that some older patients may have increased sensitivity to the drug cannot be ruled out.
There are no clinically important differences in the pharmacokinetics of micafungin in healthy adults 66-78 years of age compared with those 20-24 years of age. Dosage adjustments are not necessary when micafungin is used in geriatric patients.
ICD codes
No ICD codes are available for this drug.
Formulary status
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Last reviewed · Source: First Databank (FDB) drug data
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