Micafungin Rompharm (Micafungin)

Micafungin is an echinocandin antifungal indicated for several serious fungal infections.

• Invasive candidiasis: eradicates bloodstream and deep‑tissue Candida infections.
• Candida esophagitis: resolves esophageal Candida lesions and associated symptoms.
• Candida peritonitis: treats intra‑abdominal Candida infections in peritoneal fluid.
• Febrile neutropenia: provides empirical antifungal coverage in neutropenic patients with fever of unknown origin.

• Micafungin inhibits the enzyme β‑(1,3)‑D‑glucan synthase, blocking synthesis of β‑(1,3)‑D‑glucan, an essential structural component of the fungal cell wall. The resulting deficiency weakens the wall, leading to osmotic instability and fungal cell lysis without affecting human cells.

Micafungin may cause a range of adverse reactions, most of which are mild to moderate.

Common Side Effects

• Fever: transient elevation of body temperature during infusion.
• Nausea: mild gastrointestinal discomfort.
• Headache: occasional mild to moderate headache.
• Elevated liver enzymes: transient increase in ALT or AST.
• Rash: mild skin erythema or pruritus.
• Infusion‑related reactions: flushing, chills, or mild hypotension.

Serious or Rare Side Effects

• Hepatic failure: severe liver injury requiring monitoring.
• Severe hypersensitivity: anaphylaxis or angioedema.
• Stevens‑Johnson syndrome/toxic epidermal necrolysis: rare severe skin reactions.
• Renal impairment: acute kidney injury in susceptible patients.
• Severe hypotension: marked drop in blood pressure during infusion.

Use of Micafungin requires careful clinical monitoring to minimize risks.

• Liver function monitoring: assess ALT/AST before and during therapy.
• Renal function assessment: evaluate creatinine clearance in patients with kidney disease.
• Hypersensitivity screening: avoid in individuals with known allergy to echinocandins.
• Concomitant nephrotoxic drugs: use with caution when combined with other renal‑impacting agents.
• Pediatric use: dosing and safety not established; reserve for specialist guidance.
• Store at 2‑8°C: keep refrigerated, protect from light, do not freeze or shake.

Micafungin can interact with other medicines, altering its efficacy or safety.

Major Interactions (Avoid)

• Rifampin: strong CYP3A4 induction reduces micafungin exposure.
• Carbamazepine: enzyme induction may lower therapeutic levels.
• Phenytoin: may decrease micafungin concentrations.

Moderate Interactions (Monitor Closely)

• Azole antifungals (e.g., fluconazole): may increase micafungin levels.
• Warfarin: potential alteration of anticoagulant effect.
• Immunosuppressants (e.g., cyclosporine, tacrolimus): monitor blood levels for possible increase.