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Anidulafungin

    Brands

    DEA Class; Rx

    Common Brand Names; Eraxis

    • Antifungals, Systemic; 
    • Antifungals, Echinocandin

    IV echinocandin antifungal drug
    Used for candidemia and other invasive candidiasis infections and esophageal and oropharyngeal candidiasis
    Efficacy for treatment of infections caused by fungi other than Candida has not been established

    Indicated for treatment of candidemia and intra-abdominal abscess and peritonitis caused by Candida infections
    Indicated for treatment of esophageal candidiasis
    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

    Hypersensitivity to any component or other echinocandins

    Known or suspected hereditary fructose intolerance

    Adults (candidemia)

    • Hypokalemia (25%)
    • Nausea (24%)
    • Diarrhea (18%)
    • Pyrexia (18%)
    • Hypotension (15%)
    • Insomnia (15%)
    • Hypertension (12%)
    • Dyspnea (12%)
    • Increased alkaline phosphatase (12%)
    • Hypomagnesemia (12%)
    • Peripheral edema (11%)

    Pediatric (candidemia)

    • Pyrexia (18%)
    • Diarrhea (16%)
    • Vomiting (16%)

    Abnormal LFTs observed; if elevated liver tests develop, monitor for evidence of worsening hepatic tests and evaluate risk benefit of continuing anidulafungin monitor for potential hepatic problems

    Anaphylactic reactions, including shock, reported; discontinue and initiate appropriate treatment if this occurs

    Infusion-related adverse reactions (possibly histamine-mediated) reported, including rash, urticaria, flushing, pruritus, bronchospasm, dyspnea, and hypotension; reduce risk by not exceeding recommended infusion rate

    Contains polysorbate 80, an inactive ingredient; thrombocytopenia, renal dysfunction, hepatomegaly, cholestasis, ascites, hypotension, and metabolic acidosis reported in low-birth weight infants receiving high doses of polysorbate; toxicity has not been reported with anidulafungin

    Contains fructose; may precipitate a metabolic crisis (eg, life-threatening hypoglycemia, hypophosphatemia, lactic acidosis, hepatic failure) in patients with hereditary fructose intolerance

    Based on findings from animal studies, therapy can cause fetal harm when administered to pregnant females; there are no available human data on use in pregnant females to inform a drug-associated risk of adverse developmental outcomes

    There are no data on presence of drug in human milk, effects on breastfed infant or on milk production

    Adults

    200 mg/day IV for loading dose; 100 mg/day IV for maintenance.

    Geriatric

    200 mg/day IV for loading dose; 100 mg/day IV for maintenance.

    Adolescents

    3 mg/kg IV (Max: 200 mg/dose) for loading dose; 1.5 mg/kg/day IV (Max: 100 mg/day) for maintenance dose.

    Children

    3 mg/kg IV (Max: 200 mg/dose) for loading dose; 1.5 mg/kg/day IV (Max: 100 mg/day) for maintenance dose.

    Infants

    3 mg/kg IV for loading dose; 1.5 mg/kg/day IV for maintenance dose.

    Neonates

    Safety and efficacy have not been established; however, 3 mg/kg IV as a loading dose and 1.5 mg/kg/day IV as a maintenance dose have been used off-label.

    Anidulafungin

    injection, lyophilized powder for reconstitution

    • 50mg/vial
    • 100mg/vial