Micafungina Teva (Micafungin)

Micafungin is indicated for several serious fungal infections caused by Candida species.

• Invasive candidiasis: treatment of bloodstream and deep‑tissue Candida infections in adults.
• Esophageal candidiasis: eradication of Candida lesions in the esophagus.
• Prophylaxis in hematopoietic stem cell transplantation: prevention of Candida infection in transplant recipients.
• Candida peritonitis and intra‑abdominal infections: therapy for intra‑abdominal Candida contamination.

• Micafungin inhibits the enzyme β‑(1,3)‑D‑glucan synthase, which is essential for synthesizing β‑(1,3)‑D‑glucan, a critical component of the fungal cell wall. By disrupting cell‑wall formation, the drug leads to osmotic instability and fungal cell lysis, providing a fungicidal effect against susceptible Candida species.

Micafungin may be associated with a range of adverse reactions, which are categorized by frequency and severity.

Common Side Effects

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

Serious or Rare Side Effects

• Hepatic failure: severe liver injury requiring monitoring.
• Severe hypersensitivity: anaphylaxis or angioedema.
• Renal impairment: acute kidney injury in susceptible patients.
• Neutropenia: marked reduction in neutrophil count.
• Severe hypotension: marked drop in blood pressure during infusion.

Before initiating therapy, clinicians should consider patient‑specific factors and monitor for potential complications.

• Renal impairment: monitor renal function and adjust therapy as needed.
• Hepatic dysfunction: assess liver enzymes before and during treatment.
• Concomitant immunosuppression: watch for additive infection risk.
• Pediatric use: safety and efficacy not established; use only if clearly indicated.
• Pregnancy and lactation: benefits must outweigh potential risks; data are limited.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Micafungin can interact with other medicines, affecting efficacy or safety.

Major Interactions (Avoid)

• Strong CYP3A4 inducers (e.g., rifampin, carbamazepine): may reduce micafungin exposure.
• Cyclosporine: may increase micafungin plasma concentrations.
• Co‑administration with other echinocandins: additive toxicity risk.

Moderate Interactions (Monitor Closely)

• Warfarin: monitor INR for possible anticoagulant effect alteration.
• Statins (e.g., simvastatin): observe for signs of myopathy.
• Immunosuppressants (e.g., tacrolimus): check drug levels regularly.