Micafungin
Also known as: FK-463, FK463, Micafungin sodium, Mycamine
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Summary
Micafungin is an intravenous echinocandin antifungal used to treat and prevent invasive Candida infections and esophageal candidiasis.
Mechanism of Action
Non-competitive inhibition of 1,3-β-D-glucan synthase, impairing fungal cell wall synthesis
Routes of Administration
Goals & Uses
- Disseminated candidiasisTherapeuticHigh
- Treatment of invasive aspergillosisAntifungalLow
- Pediatric candidal infectionsAntifungal TreatmentModerate
- Prophylaxis in hematopoietic stem cell transplantationPreventiveHigh
- Invasive candidiasis treatmentAntifungalHigh
- Treatment of candidemia and invasive candidiasisAntifungal TreatmentHigh
- Prophylaxis of Candida infections in HSCT recipientsAntifungal ProphylaxisHigh
- Treatment of esophageal candidiasisAntifungal TherapyHigh
- Esophageal candidiasisTherapeuticHigh
- Febrile neutropenia with suspected fungal infectionTherapeuticModerate
Contraindications
- Severe hepatic impairment (Child-Pugh C)HepaticModerate
- Hypersensitivity to micafungin or other echinocandinsAllergyHigh
- Neonates <4 monthsAgeModerate
- Known hypersensitivity to micafungin or other echinocandinsAllergyHigh
- Severe hepatic impairment (relative)Organ ImpairmentModerate
Adverse Effects
- Phlebitis/infusion site reactionsLocal/infusionUncommon
- Elevated liver enzymes (AST/ALT)HepatotoxicityCommon
- RashDermatologicUncommonSkin eruption or discoloration
- HeadacheNeurologicUncommonPain in the head or upper neck
- Anaphylaxis/hypersensitivityImmunologicRare
- Infusion-related reactions (e.g., flushing, pruritus)GeneralCommon
- NauseaGastrointestinalUncommonFeeling of sickness or urge to vomit
- Elevated liver transaminasesHepaticCommon
- Hemolytic anemiaHematologicRare
Drug Interactions
- RifampinModerate
- Oral contraceptivesLowDelayed gastric emptying may affect absorption timing
- ItraconazoleLow
- CyclosporineModerate
- NifedipineLow
- Amphotericin B deoxycholateModerate
- SirolimusModerate
Population Constraints
- Pregnancy (Category C)ReproductiveRelative
- Pediatric patients (≥4 months)AgeRelative
- Hepatic impairmentOrgan FunctionRelative
- Renal impairmentOrgan ImpairmentRelative
- Neonates/premature infantsPediatricRelative
- Patients with hepatic impairmentOrgan FunctionRelative
- BreastfeedingReproductiveRelative
Regulatory Status
- European UnionApprovedApproved: Invasive candidiasis, Esophageal candidiasis, Prophylaxis in hematopoietic stem cell transplantationEMA approval 2005
- United StatesApprovedApproved: Invasive candidiasis, Esophageal candidiasis, Prophylaxis in hematopoietic stem cell transplantationApproved 2005
- United KingdomApprovedApproved: Invasive candidiasis, Esophageal candidiasis, Prophylaxis in hematopoietic stem cell transplantationMHRA approved
FDA approved in 2005; EU EMA approved 2005; contraindicated in patients with hypersensitivity; pediatric use limited.
Evidence & Sources
No sources recorded yet.
Frequently Asked Questions
What is Micafungin?
Micafungin is an intravenous echinocandin antifungal used to treat and prevent invasive Candida infections and esophageal candidiasis.
What is Micafungin used for?
Micafungin is educationally associated with: Disseminated candidiasis, Treatment of invasive aspergillosis, Pediatric candidal infections, Prophylaxis in hematopoietic stem cell transplantation, Invasive candidiasis treatment, Treatment of candidemia and invasive candidiasis, Prophylaxis of Candida infections in HSCT recipients, Treatment of esophageal candidiasis, Esophageal candidiasis, Febrile neutropenia with suspected fungal infection. Educational only — not medical advice.
How is Micafungin administered?
Recorded routes of administration: Intravenous.
What are the potential side effects of Micafungin?
Reported adverse effects include: Phlebitis/infusion site reactions, Elevated liver enzymes (AST/ALT), Rash, Headache, Anaphylaxis/hypersensitivity, Infusion-related reactions (e.g., flushing, pruritus), Nausea, Elevated liver transaminases, Hemolytic anemia. This list is not exhaustive — consult a qualified clinician.
Who should avoid Micafungin?
Recorded contraindications: Severe hepatic impairment (Child-Pugh C), Hypersensitivity to micafungin or other echinocandins, Neonates <4 months, Known hypersensitivity to micafungin or other echinocandins, Severe hepatic impairment (relative). Consult a qualified clinician before use.