Eraxis

Indications

Anidulafungin is an antifungal medicine used in hospital to treat invasive candidiasis, including candidaemia (Candida yeast infection in the bloodstream), in adults and children aged one month and older. It is also used for oesophageal candidiasis (thrush of the food pipe) in some settings.

How It Works

Anidulafungin belongs to the echinocandin group. It blocks an enzyme called 1,3-beta-D-glucan synthase, which the fungus needs to build its cell wall. Without a strong wall, the fungal cells break down and die. Human cells do not have this wall, so the effect is selective.

Dosage and Administration

Anidulafungin is given in hospital by a doctor or nurse as a slow infusion (drip) into a vein, usually once a day after a higher first (loading) dose, as prescribed. Treatment usually continues for at least 14 days after the last positive blood culture and until symptoms improve. Children's doses are based on body weight. No dose change is needed for kidney or liver problems.

Interactions

It has few drug interactions because it is not processed by liver enzymes. Ciclosporin may slightly increase its levels, which is usually not significant. The medical team will check all medicines being given.

Contraindications

Do not use if allergic to Anidulafungin or other echinocandins (such as Caspofungin or Micafungin), or to any ingredient. Some products contain fructose and are not used in people with hereditary fructose intolerance.

Side Effects

Common effects include diarrhoea, nausea, vomiting, headache, low potassium, raised liver enzymes, flushing, rash and itching. Infusion-related reactions such as flushing, hot feeling, low blood pressure and wheeze can occur if the drip runs too fast.

Tell the nurse or doctor at once about difficulty breathing, swelling of the face or throat, severe rash, yellowing of the skin or eyes, or severe stomach pain. These are monitored in hospital.

Pregnancy and Lactation

It is not recommended in pregnancy unless the benefit clearly outweighs the risk. It passes into breast milk in animals; the doctor will decide whether to stop breastfeeding or treatment.

Precautions and Warnings

Liver tests are checked during treatment because liver problems can occur. The infusion is given slowly to reduce infusion reactions. Tell the doctor about liver disease or any allergies.

Overdose

Overdose is unlikely as it is given in hospital; higher doses have been tolerated in studies. It is not removed by dialysis. Treatment is supportive.

Therapeutic Class

Antifungal, echinocandin

Storage

Hospital medicine: store as directed on the pack, usually in a refrigerator at 2 to 8°C (short periods at room temperature may be allowed). Keep out of the reach of children.