Nurses Compass
Drug Guide
Rezafungin Acetate
Classification
Therapeutic: Antifungal
Pharmacological: Echinocandin
FDA Approved Indications
- Treatment of candidemia, invasive candidiasis, and inpatient candidiasis in adults
Mechanism of Action
Rezafungin inhibits β-(1,3)-D-glucan synthase, an enzyme essential for fungal cell wall synthesis, leading to cell wall weakening and fungal cell death.
Dosage and Administration
Adult: Loading dose of 400 mg IV on day 1, followed by 200 mg IV once weekly.
Pediatric: Not approved or studied for pediatric use as of now.
Geriatric: No specific dosage adjustment unless compromised renal or hepatic function noted.
Renal Impairment: No dose adjustment required for mild to moderate impairment; data limited for severe impairment.
Hepatic Impairment: No specific dose adjustments recommended; data limited.
Pharmacokinetics
Absorption: Administered intravenously; no oral absorption.
Distribution: Wide distribution, high plasma protein binding.
Metabolism: Primarily metabolized via non-CYP pathways; specific pathways under study.
Excretion: Primarily excreted via feces; minimal renal excretion.
Half Life: Approximately 70 hours, allowing once-weekly dosing.
Contraindications
- Known hypersensitivity to Rezafungin or other echinocandins.
Precautions
- Use cautiously in patients with hepatic impairment; monitor liver function.
- Limited data in pregnant or breastfeeding women; use only if clearly indicated.
Adverse Reactions - Common
- Infusion site reactions (Common)
- Nausea and vomiting (Common)
- Headache (Less common)
Adverse Reactions - Serious
- Hepatotoxicity (Less common)
- Hypersensitivity reactions including anaphylaxis (Rare)
Drug-Drug Interactions
- Potential interactions with drugs that affect hepatic enzymes or compete for protein binding, though minimal for rezafungin.
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor for signs of infusion reactions, hepatotoxicity, and fungal response.
Diagnoses:
- Risk for infection related to invasive fungal infection.
- Potential for allergic reaction.
Implementation: Administer as per prescribed schedule; monitor hepatic function; observe for infusion reactions.
Evaluation: Assess for resolution of infection, monitor liver enzymes, and observe adverse reactions.
Patient/Family Teaching
- Report any symptoms of allergic reaction (rash, difficulty breathing).
- Complete the full course of therapy.
- Report any unusual symptoms such as severe nausea or liver problems.
Special Considerations
Black Box Warnings:
- None currently issued.
Genetic Factors: Limited data; no specific genetic considerations identified.
Lab Test Interference: No significant interference with routine laboratory tests reported.
Overdose Management
Signs/Symptoms: Potential for increased infusion reactions or hepatotoxicity.
Treatment: Supportive care; monitor liver function and symptoms; no specific antidote.
Storage and Handling
Storage: Store at room temperature, away from direct light and moisture.
Stability: Stable under recommended conditions for the duration of the product's shelf life.