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Micafungin

    Brands

    DEA Class; Rx

    Common Brand Names; Mycamine

    • Antifungals, Systemic; 
    • Antifungals, Echinocandin

    Echinocandin antifungal
    Used for Candida infection prophylaxis and treatment
    Efficacy for treatment of infections caused by fungi other than Candida has not been established

    Indicated for the treatment of

    • Treatment of candidemia, acute disseminated candidiasis, candida peritonitis and abscesses
    • Treatment of Esophageal Candidiasis
    • Prophylaxis of Candida Infections in HSCT Recipients
    • Candida auris (Off-label)

    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

    • Abd pain
    • Anemia
    • Headache
    • Diarrhea
    • Increased LFTs
    • Leukopenia
    • Nausea
    • Neutropenia
    • Phlebitis
    • Pruritus
    • Pyrexia
    • Rash
    • Rigors
    • Thrombocytopenia
    • Vomiting
    • Facial swelling
    • Vasodilation
    • Delirium
    • Dizziness
    • Somnolence

    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

    Based on findings from animal studies, may cause fetal harm when administered to pregnant women

    Data are not available regarding the presence of micafungin in human milk, effects on breastfed infants, or effects on milk production

    Adults

    150 mg/day IV.

    Geriatric

    150 mg/day IV.

    Adolescents

    weight more than 30 kg: 2.5 mg/kg/day IV (Max: 150 mg) is the FDA-approved maximum dosage; however, doses up to 4.5 mg/kg/day IV (Max: 225 mg/day) have been used off-label.
    weight 30 kg or less: 3 mg/kg/day IV is the FDA-approved maximum dosage; however, doses up to 4.5 mg/kg/day IV have been used off-label.

    Children

    weight more than 30 kg: 2.5 mg/kg/day IV (Max: 150 mg) is the FDA-approved maximum dosage; however, doses up to 4.5 mg/kg/day IV (Max: 225 mg/day) have been used off-label.
    weight 30 kg or less: 3 mg/kg/day IV is the FDA-approved maximum dosage; however, doses up to 4.5 mg/kg/day IV have been used off-label.

    Infants

    4 to 11 months: 3 mg/kg/day IV is the FDA-approved maximum dosage; however, doses up to 4.5 mg/kg/day IV have been used off-label.
    1 to 3 months: 4 mg/kg/day IV is the FDA-approved maximum dosage; however, doses up to 4.5 mg/kg/day IV have been used off-label.

    Neonates

    4 mg/kg/day IV is the FDA-approved maximum dosage; however, doses up to 15 mg/kg/day IV have been used off-label for CNS infections.

    Micafungin sodium

    powder for injection

    • 50mg/vial
    • 100mg/vial