Home Drug Guide Micafungin Sodium

Drug Guide

Generic Name

Micafungin Sodium

Brand Names Mycamine, Micafungin, Micafungin In Sodium Chloride 0.9%

Classification

Therapeutic: Antifungal agent

Pharmacological: Echinocandin

FDA Approved Indications

  • Invasive candidiasis
  • Esophageal candidiasis
  • Candida bloodstream infections (candidaemia)

Mechanism of Action

Micafungin inhibits 1,3-β-D-glucan synthase, an enzyme essential for fungal cell wall synthesis, leading to cell wall weakening and fungal cell death.

Dosage and Administration

Adult: Typically 100 mg once daily, adjustable based on infection severity and site.

Pediatric: Dosage varies; generally 2 mg/kg/day for children, up to a maximum of 150 mg/day.

Geriatric: Dose adjustments generally not required but monitor for hepatic function.

Renal Impairment: Adjustments not typically necessary; monitor renal function.

Hepatic Impairment: Use with caution; hepatic function should be monitored.

Pharmacokinetics

Absorption: Not applicable; administered intravenously.

Distribution: Extensive tissue distribution with high protein binding (~99%).

Metabolism: Minimal hepatic metabolism; primarily excreted unchanged.

Excretion: Excreted mainly via feces; minimal renal clearance.

Half Life: Approximately 11-13 hours.

Contraindications

  • Hypersensitivity to micafungin or any echinocandins.

Precautions

  • Hepatic impairment; monitor liver function tests.
  • Elderly patients; monitor renal and hepatic function closely.

Adverse Reactions - Common

  • Headache (Common)
  • Nausea (Common)
  • Vomiting (Common)
  • Fever (Common)

Adverse Reactions - Serious

  • Liver enzyme elevations (Uncommon)
  • Anaphylaxis (Rare)
  • Severe skin reactions (Rare)

Drug-Drug Interactions

  • Cyclosporine may increase micafungin levels.
  • Other CYP450 substrates with hepatic metabolism may have interactions.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor hepatic function and for signs of allergic reactions.

Diagnoses:

  • Risk of infection due to invasive candidiasis.
  • Risk for adverse drug reactions.

Implementation: Administer IV infusion over at least 60 minutes.

Evaluation: Assess clinical response and adverse reactions.

Patient/Family Teaching

  • Report any signs of allergic reactions, liver problems, or unusual symptoms immediately.
  • Do not miss doses and complete the entire course of therapy.

Special Considerations

Black Box Warnings:

  • None reported.

Genetic Factors: None specified.

Lab Test Interference: May cause transient elevations in liver function tests.

Overdose Management

Signs/Symptoms: Possible hypersensitivity reactions or severe hepatic impairment.

Treatment: Supportive care; no specific antidote. Hemodialysis not effective in removing micafungin.

Storage and Handling

Storage: Store at room temperature, away from direct light and moisture.

Stability: Stable for the duration specified by manufacturer, typically 24 months.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.