Micafungin

C difficile risk
Low
Oral Bioavailability
N/A
Cost
$100/day

Dosing

0 - 1000 g1000+ g10 mg/kg/DAY IV given q24h Doses of 10 - 15 mg/kg/DAY IV have been used7 - 10 mg/kg/DAY IV given q24h

8 -12 mg/kg/DAY given q24h

Disseminated Candidiasis: Usual dose IV: 2 mg/kg/DAY given as a single daily dose, doses of 4-10 mg/kg/DAY have been used; maximum dose: 200 mg.Aspergillosis, Esophageal Candidiasis: Usual dose IV: 1.5-3 mg/kg/DAY given as a single daily dose, doses of 4 - 8.6 mg/kg/DAY have been used; maximum/DOSE 325 mg.Prophylaxis in Hematopoietic Stem Cell Transplant Recipients: IV: 1.5-3 mg/kg/DAY given as a single daily dose.
Dose recommendation vary based on indication and immun status of patient; refer to alternative references if needed.

Use doses at the higher end of the dosing range for CNS infections due to poor CNS penetration.

No dosage adjustment needed in patients with mild-to-moderate hepatic impairment; the effect of severe hepatic impairment on micafungin pharmacokinetics has not been studied

No dosage adjustment required in patients with renal impairment.

General Information

Therapy of suspected and confirmed invasive fungal infections

Periodic liver function tests, renal function tests, CBC with differential

Increased liver enzymes, elevated bilirubin

GI upset

Anemia, pruritis, fever (most common in pediatrics)

Increases levels of sirolimus

Antimicrobial class: Echinocandin

Average serum half life:

  • Neonates: PNA <1week: 6.7 hours. PNA >3 weeks: 5.6-11 hours.

  • Pediatrics: ≤30 kg: 12.5 ± 4.6 hours. >30kg: 13.6 ± 8.8 hours

  • Healthy adults: 11-21 hours

Route of Elimination: <1% of dose is eliminated unchanged in the urine. 71% is eliminated in the feces