Micagin

Indications

Micafungin is an antifungal medicine given by drip into a vein. It is used in hospital to treat serious Candida (yeast) infections, including Candida in the bloodstream (candidaemia), deep organ infections and Candida infection of the food pipe (oesophageal candidiasis). It is also used to prevent fungal infections in people with a very weak immune system, such as those having a stem cell transplant.

How It Works

Micafungin belongs to the echinocandin group. It blocks an enzyme the fungus needs to build its cell wall. Without a strong wall the fungal cell breaks down and dies. Human cells do not have this kind of cell wall, so the medicine targets the fungus.

Dosage and Administration

Micafungin is given by a doctor or nurse as a slow infusion into a vein, usually over about one hour, once a day. The dose and length of treatment are set by the doctor according to the type of infection, body weight (especially in children) and response. Treatment usually continues for some time after symptoms and blood tests improve.

Interactions

• It can raise blood levels of Sirolimus, Nifedipine and Itraconazole; doses may need adjusting and monitoring.
• Tell the doctor about all other medicines, especially those that can affect the liver or blood cells.

Contraindications

• Allergy to Micafungin or other echinocandins (such as Caspofungin or Anidulafungin).

Side Effects

Possible effects include nausea, vomiting, diarrhoea, headache, fever, rash, raised liver enzymes, low potassium or magnesium, low white blood cell counts and pain or swelling at the drip site. Flushing, itching or a fall in blood pressure can occur during the infusion.

Get urgent medical help (tell the nurse at once) if you have difficulty breathing, swelling of the face or throat, a severe rash or blistering, yellow skin or eyes, dark urine, or sudden tiredness with pale skin, which may be signs of a serious allergy, liver injury or breakdown of red blood cells.

Pregnancy and Lactation

There is limited information on use during pregnancy. It is used only if the doctor decides the benefit outweighs the possible risk. It is not known whether it passes into breast milk; the doctor will advise whether to continue breastfeeding.

Precautions and Warnings

Liver tests and blood counts are checked during treatment. Animal studies with long-term use have shown liver tumours, so the doctor weighs this, especially in people with liver disease. Tell the doctor about any kidney problems, liver disease or a rare inherited sugar intolerance.

Overdose

As it is given in hospital, overdose is unlikely. If too much is given, the patient is monitored and treated for symptoms. It is not removed by dialysis.

Therapeutic Class

Antifungal agent; echinocandin.

Storage

Hospital product: store as directed on the pack, usually below 25°C, away from light. Prepared solutions are used as instructed by the pharmacy. Keep out of the reach of children.