Micafungin Accord-Uk (Micafungin)

Micafungin is an echinocandin antifungal that inhibits fungal cell wall synthesis.

• Invasive candidiasis: effective treatment of bloodstream and deep‑tissue Candida infections.
• Esophageal candidiasis: resolves mucosal infection of the esophagus caused by Candida species.
• Prophylaxis in hematopoietic stem cell transplantation: prevents invasive fungal infections in high‑risk transplant recipients.

• Micafungin binds to the fungal enzyme β‑(1,3)‑D‑glucan synthase, blocking the synthesis of β‑(1,3)‑D‑glucan, an essential component of the fungal cell wall. This inhibition compromises cell wall integrity, leading to osmotic instability and cell death, while having minimal effect on human cells that lack this pathway.

Micafungin may be associated with a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Infusion‑related reactions: flushing, chills, or rigors during administration.
• Fever: transient elevations in body temperature.
• Nausea: mild gastrointestinal discomfort.
• Headache: occasional mild to moderate headache.
• Elevated liver enzymes: transient increases in ALT or AST.
• Rash: mild skin erythema or pruritus.

Serious or Rare Side Effects

• Hypersensitivity reactions: anaphylaxis or severe skin reactions.
• Severe hepatic dysfunction: marked elevation of liver enzymes or hepatitis.
• Renal impairment: acute kidney injury or worsening renal function.
• Severe hypotension: marked drop in blood pressure during infusion.
• Stevens‑Johnson syndrome/toxic epidermal necrolysis: rare severe skin disorders.
• Cardiac arrhythmia: uncommon but serious rhythm disturbances.

Prior to initiating Micafungin therapy, clinicians should consider several precautionary measures.

• Pregnancy: safety category unknown; use only if potential benefit justifies the risk.
• Renal impairment: assess renal function and adjust dosing as needed.
• Hepatic impairment: monitor liver enzymes and consider dose modification.
• Concomitant azole antifungals: potential interaction may increase Micafungin levels; monitor closely.
• Patients with known hypersensitivity to echinocandins: avoid use.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

• Micafungin can interact with other medicines