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.