Micafungin
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DRUG-MICAFUNGIN |
|---|---|
| Type | Drug |
| Aliases | FunguardMycamineМікафунгін |
| Status | reviewed 2026-04-27 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | SRC-NCCN-BCELL-2025 SRC-NCCN-MM-2025 |
Drug Facts
| Class | Echinocandin antifungal (β-1,3-D-glucan synthase inhibitor) |
|---|---|
| Mechanism | Semisynthetic lipopeptide echinocandin that non-competitively inhibits β-(1,3)-D-glucan synthase (Fks1/Fks2 complex), preventing synthesis of the essential fungal cell-wall polymer β-(1,3)-D-glucan and producing fungicidal activity against most Candida species (including many fluconazole-resistant strains) and fungistatic activity against Aspergillus species. NO activity against Cryptococcus, Mucorales, Fusarium, or Trichosporon. Pharmacologically similar to caspofungin but with a flat-dosing structure (no body-weight or hepatic adjustment in most patients), no loading dose, and the simplest DDI profile of the echinocandin class (no significant interactions with cyclosporine, tacrolimus, sirolimus). FDA-approved 2005. Notably approved for prevention of invasive candidiasis in HSCT recipients — pivotal indication in onco-hematology supportive care. |
| Typical dosing | HSCT prophylaxis (adult): 50 mg IV once daily, started day of conditioning through engraftment / ANC recovery. Esophageal candidiasis: 150 mg IV daily. Candidemia / invasive candidiasis (adult): 100 mg IV once daily over 60-min infusion. Empirical antifungal in persistent neutropenic fever (off-label primary): 100 mg IV daily. Pediatric: HSCT prophylaxis 1 mg/kg IV daily; candidemia 2 mg/kg IV daily (3 mg/kg if <40 kg consider). No loading dose required (steady-state achieved by day 4-5; clinical response unaffected by absence of loading vs caspofungin pattern). Renal: NO adjustment for any degree of renal impairment, including dialysis. Hepatic: no formal adjustment for mild-moderate; caut... |
| Ukraine registered | True |
| NSZU reimbursed | True |
| Ukraine last verified | 2026-04-27 |
Warnings
- Hepatobiliary tumors observed in 3-month rat carcinogenicity studies (clinical relevance unclear; long-term human data reassuring) — minimize unnecessary prolonged exposure
Notes
Standard antifungal prophylaxis in HSCT — pivotal trial (van Burik CID 2004) demonstrated superiority over fluconazole for invasive fungal infection prevention in HSCT recipients. Also first-line treatment for candidemia and invasive candidiasis (IDSA 2016 echinocandin recommendation). Differentiator from caspofungin: no loading dose, no body-weight adjustment, no hepatic adjustment in moderate impairment, even simpler DDI profile (no clinically meaningful interactions with cyclosporine or tacrolimus — key advantage in HSCT and solid-organ transplant where calcineurin inhibitors are concurrent). Boxed warning regarding hepatic tumors in rat carcinogenicity studies has not translated to human signal in two decades of post-marketing surveillance, but prescribing information warns against unnecessary prolonged use. Same spectrum limitations as caspofungin (no Mucor, no Cryptococcus, fungistatic for Aspergillus). Ukraine: registered, NSZU-covered; preferred echinocandin in HSCT contexts.
Used By
No reverse references found in the YAML corpus.