Micafungin

Micafungin is a prescription medication used to treat fungal infections caused by Candida. 

• Micafungin is available under the following different brand names: Mycamine.

Adult and pediatric dosage

Powder for injection

• 50mg/vial
• 100mg/vial

Treatment of candidemia, acute disseminated candidiasis, candida peritonitis and abscesses

Adult dosage

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

Pediatric dosage

• Children aged 4 months or older: 
• 2 mg/kg IV once daily; not to exceed 100 mg/day

Treatment of Esophageal Candidiasis

Adult dosage

• 150 mg/day IV infusion x10-30 days (mean 15 days)

Pediatric dosage

• Children weighing 30 kg or less: 3 mg/kg IV once daily
• Children weighing over 30 kg: 2.5 mg/kg IV once daily; not to exceed 150 mg/day

Prophylaxis of Candida Infections in HSCT Recipients

Adult dosage

• 50 mg/day IV infusion x6-51 days (mean 19 days)

Pediatric dosage

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

Dosage Considerations – Should be Given as Follows: 

• See "Dosages."

Common side effects of Micafungin include:

• nausea, 
• vomiting, 
• diarrhea, 
• flushing (warmth, redness, or tingly feeling), 
• mild itching, and
• rash
• headache
• constipation
• indigestion

Serious side effects of Micafungin include:

• hives, 
• difficulty breathing, 
• swelling in the face, lips, tongue, or throat, 
• pale or yellowed skin, 
• dark colored urine, 
• fever, 
• confusion, 
• weakness, 
• swelling, 
• rapid weight gain, 
• little or no urination, 
• upper stomach pain, 
• itching, 
• loss of appetite, 
• clay-colored stools, and
• yellowing of the skin or eyes (jaundice)

Rare side effects of Micafungin include:

• none 

This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

• Micafungin has severe interactions with no other drugs.
• Micafungin has serious interactions with the following drugs:
  • lonafarnib
  • Saccharomyces boulardii
• Micafungin has moderate interactions with at least 16 other drugs.
• Micafungin has minor interactions with the following drug:
  • ruxolitinib

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this drug, tell your doctor or pharmacist of all the drugs you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Contraindications

• Hypersensitivity 

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Micafungin?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Micafungin?”

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; patients who develop clinical or laboratory evidence of hemolysis or hemolytic anemia during therapy should be monitored closely for evidence of worsening of these conditions and evaluated for risk/benefit of continuing therapy
• Abnormalities in liver function tests; isolated cases of hepatic impairment, hepatitis, and hepatic failure reported; in some patients with serious underlying conditions receiving therapy along with multiple concomitant medications, clinical hepatic abnormalities have occurred, and isolated cases of significant hepatic impairment, hepatitis, and hepatic failure reported; patients who develop abnormal liver function tests during therapy should be monitored for evidence of worsening hepatic function and evaluated for risk/benefit of continuing therapy
• Elevations in BUN and creatinine; isolated cases of renal impairment or acute renal failure reported; patients who develop abnormal renal function tests during therapy should be monitored for evidence of worsening renal function
• Infusion and injection site reactions
  • Possible histamine-mediated symptoms reported. including rash, pruritus, facial swelling, and vasodilation; slow infusion rate if reactions occur
  • Injection site reactions, including phlebitis and thrombophlebitis reported; these reactions occur more often when administered via peripheral IV

Pregnancy and Lactation

• Based on findings from animal studies, may cause fetal harm when administered to pregnant women
• Human data are insufficient on use in pregnant women to inform a drug-associated risk of adverse developmental outcomes
• Data are not available regarding the presence of micafungin in human milk, effects on breastfed infants, or effects on milk production
• Micafungin was present in the milk of lactating rats following IV administration; when a drug is present in animal milk, it is likely that the drug will be present in human milk