micafungin (Rx)

Brand and Other Names:Mycamine
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

powder for injection

  • 50mg/vial
  • 100mg/vial
more...

Candidiasis

Treatment (esophageal): 150 mg/day IV infusion x10-30 days (mean 15 days)

Prophylaxis in hematopoietic stem cell transfer (HSCT) patients: 50 mg/day IV infusion x6-51 days (mean 19 days)

Candidemia, Disseminated Candidiasis, Candida Peritonitis & Abscesses

100 mg/day IV infusion x10-47 days (mean 15 days)

Candida auris (Off-label)

Based on the limited data, an echinocandin drug (eg, anidulafungin, caspofungin, micafungin) is recommended by the CDC as initial therapy for treatment of C auris infections

100 mg IV qDay

Dosage Forms & Strengths

powder for injection

  • 50mg/vial
  • 100mg/vial
more...

Candida Infections

Indicated for candidemia, acute disseminated candidiasis, Candida peritonitis and abscesses, esophageal candidiasis, and prophylaxis of Candida infections in hematopoietic stem cell transplants (HSCT) recipients

<4 months: Safety and efficacy not established

≥4 months: See specific Candida infection below

Treatment of Candidemia, acute disseminated candidiasis, Candida peritonitis and abscesses

  • 2 mg/kg IV qDay; not to exceed 100 mg/day

Treatment of esophageal candidiasis

  • ≤30 kg: 3 mg/kg IV qDay
  • >30 kg: 2.5 mg/kg IV qDay; not to exceed 150 mg/day

Prophylaxis of Candida infections in HSCT recipients

  • 1 mg/kg IV qDay; not to exceed 50 mg/day

Candida auris (Off-label)

Neonates and infants <2 months

  • In exceptional circumstances, where CNS involvement has been definitively ruled out, may consider use of caspofungin or micafungin with caution; the CDC recommends amphotericin B deoxycholate as initial treatment of choice
  • 10 mg/kg/day IV

≥2 months

  • Based on the limited data, an echinocandin drug (eg, anidulafungin, caspofungin, micafungin) is recommended by the CDC as initial therapy for treatment of C auris infections in adults and children aged ≥2 months
  • 2 mg/kg/day IV; option to increase to 4 mg/kg/day IV if body weight at least 40 kg
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Interactions

Interaction Checker

and micafungin

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            1-10%

            Abd pain

            Anemia

            Headache

            Diarrhea

            Increased LFTs

            Leukopenia

            Nausea

            Neutropenia

            Phlebitis

            Pruritus

            Pyrexia

            Rash

            Rigors

            Thrombocytopenia

            Vomiting

            Facial swelling

            Vasodilation

            <1%

            Delirium

            Dizziness

            Somnolence

            Postmarketing Reports

            Blood and lymphatic system disorders: white blood cell count decreased, hemolytic anemia, disseminated intravascular coagulation

            Hepatobiliary disorders: hyperbilirubinemia, hepatic function abnormal, hepatic disorder, hepatocellular damage

            Renal and urinary disorders: acute renal failure and renal impairment

            Skin and subcutaneous tissue disorders: Stevens-Johnson syndrome, toxic epidermal necrolysis

            Vascular disorders: shock

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            Warnings

            Contraindications

            Hypersensitivity

            Cautions

            NOT for IV bolus

            No data on effectiveness against fungi other than Candida

            Anaphylaxis and anaphylactoid reactions (including shock) reported; discontinue therapy and administer appropriate treatment

            Isolated cases of acute intravascular hemolysis, hemolytic anemia and hemoglobinuria reported

            Abnormalities in liver function tests; isolated cases of hepatic impairment, hepatitis, and hepatic failure reported

            Elevations in BUN and creatinine; isolated cases of renal impairment or acute renal failure reported

            Monitor closely patients who develop clinical or laboratory evidence of above reactions and evaluate risk/benefit of continuing therapy

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: use caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Semisynthetic lipopeptide (echinocandin class), inhibits fungal cell wall synthesis

            Pharmacokinetics

            Protein Bound: >99%

            Metabolism: Hepatic to catechol & methoxy forms

            Half-life: 5.6-11hr (preterm infants); 12.5 +/- 4.6 hr (4 months to 16 years < 30 kg); 13.6 +/- 8.8 hr (4 months to 16 years > 30 kg); 11-21 hr (adults)

            Excretion: Feces (71%), urine (<1%)

            Dialyzable: No

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            Administration

            IV Preparation

            Aseptically add 5 mL 0.9% NaCl to vial to obtain 10 mg/mL (50 mg vial) or 20 mg/mL (100 mg vial)

            Gently swirl to mix, do not shake vigorously or vortex

            Dilute further by adding reconstituted solution to 100 mL of 0.9% NaCl or D5W

            IV Administration

            Flush existing infusion line with 0.9% NaCl before administration

            Infuse IV over 1 hr

            Storage

            Reconstituted vial or diluted solution: May be stored at controlled room temperature for up to 24 hr

            Protect from light

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            Images

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            Formulary

            FormularyPatient Discounts

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            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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