Micafungin is an echinocandin

Echinocandin

Echinocandins are antifungal drugs that inhibit the synthesis of glucan in the cell wall, probably via noncompetitive inhibition of the enzyme 1,3-β glucan synthase and are thus called penicillin of antifungals . Beta glucans are polymers which, linked in their tens of thousands, make up cell wall...

 antifungal drug

Antifungal drug

An antifungal medication is a medication used to treat fungal infections such as athlete's foot, ringworm, candidiasis , serious systemic infections such as cryptococcal meningitis, and others...

 developed by Astellas Pharma

Astellas Pharma

is a Japanese pharmaceutical company, formed on 1 April 2005 from the merger of and .Astellas' franchise areas are urology, immunology , dermatology, cardiology, and infectious disease...

. It inhibits the production of beta-1,3-glucan

Beta-glucan

β-Glucans are polysaccharides of D-glucose monomers linked by β-glycosidic bonds. β-glucans are a diverse group of molecules that can vary with respect to molecular mass, solubility, viscosity, and three-dimensional configuration...

, an essential component of fungal cell walls. Micafungin is administered intravenously. It received final approval from the U.S. Food and Drug Administration on March 16, 2005, and gained approval in the European Union

European Union

The European Union is an economic and political union of 27 independent member states which are located primarily in Europe. The EU traces its origins from the European Coal and Steel Community and the European Economic Community , formed by six countries in 1958...

 on April 25, 2008.

Indications

Micafungin is indicated for the treatment of candidemia, acute disseminated candidiasis

Candidiasis

Thrush redirects here. For the hoof infection see Thrush .Candidiasis or thrush is a fungal infection of any of the Candida species , of which Candida albicans is the most common...

, Candida

Candida (genus)

Candida is a genus of yeasts. Many species are harmless commensals or endosymbionts of animal hosts including humans, but other species, or harmless species in the wrong location, can cause disease. Candida albicans can cause infections in humans and other animals, especially in immunocompromised...

 peritonitis

Peritonitis

Peritonitis is an inflammation of the peritoneum, the serous membrane that lines part of the abdominal cavity and viscera. Peritonitis may be localised or generalised, and may result from infection or from a non-infectious process.-Abdominal pain and tenderness:The main manifestations of...

, abscesses and esophageal candidiasis

Esophageal candidiasis

Esophageal candidiasis is an opportunistic infection of the esophagus by Candida albicans. The disease occurs in patients in immunocompromised states, including post-chemotherapy and in AIDS. It is also known as candidal esophagitis or monilial esophagitis.-Clinical presentation:Patients with...

. Since January 23, 2008, micafungin has been approved for the prophylaxis of Candida infections in patients undergoing hematopoietic stem cell transplantation (HSCT).

Micafungin works by way of concentration-dependent inhibition of 1,3-beta-D-glucan synthase resulting in reduced formation of 1,3-beta-D-glucan, which is an essential polysaccharide comprising one-third of the majority of Candida spp. cell walls. This decreased glucan production leads to osmotic instability and thus cellular lysis.

Contraindications

Known hypersensitivity to micafungin or any other ingredient contained in the formulation is a contraindication for its use.

Dosage

For the treatment of candidemia, acute disseminated candidiasis, Candida peritonitis and abscesses, the dosage of micafungin is 100 mg once daily. For the treatment of esophageal candidiasis, the dosage is 150 mg once daily. For prophylaxis of Candida infections in HSCT recipients, the dosage is 50 mg once daily.

The metabolism of micafungin occurs hepatically as the drug molecule is a substrate of CYP3A4; a liver enzyme. Precautions should be taken with regards to dosing, as micafungin also inhibits its own clearance via weak CYP3A4 inhibition.

Dosage forms

Micafungin is a natural antifungal product derived from other fungi

Fungus

A fungus is a member of a large group of eukaryotic organisms that includes microorganisms such as yeasts and molds , as well as the more familiar mushrooms. These organisms are classified as a kingdom, Fungi, which is separate from plants, animals, and bacteria...

 as a defense mechanism for competition of nutrients, etc. More specifically, micafungin is derived from FR901379, and is produced by Coleophoma empetri.

• Mycamine 50mg for intravenous (IV) infusion (manufacturer Astellas)
• Mycamine 100mg for IV infusion (manufacturer Astellas)
• Brand names in countries other than the US may vary.

External links

• Mycamine website, run by Astellas Pharma US
• Mycamine Prescribing Information
• Gregory Eschenauer, Daryl D DePestel, and Peggy L Carver: Comparison of echinocandin antifungals. Ther Clin Risk Manag 2007, 3(1): 71–97.