Anidulafungin (Eraxis)
Last updated 20/10/19
Definition
- IV echinocandin antifungal used to treat systemic/invasive fungal infections (fungaemia)
Features
- Semisynthetic product of echinocandin B
- No dose adjustment compared to Caspofungin
- Not studied in children yet (as compard to Caspofungin & Micafungin)
- Protein bound in plasma
- Undergoes slow chemical degredation
- Does not undergo hepatic metabolism
- T/2 24hrs
- Breakdown products are biliary excreted
Mechanism
- Inhibits glucan (1,3-beta-D-glucan) synthase in fungal cell wall
- Altered membrane permeability
- Does not effect mammalian cells
Indications
- Systemic/invasive fungal infection (fungaemia)
- Candida: fungicidal
- Likey more efficacious with reduced persistant candidaemia than Fluconazole and improved safety profile compared to Amphotericin B
- May have similar efficacy as Fluconazole for oesophageal infections
- Aspergillus: fungistatic
- Cryptococcus neoformans
- Oesophageal rupture
Dose
- IV only
- Ampule: 100mg white powder for reconstitution
- Dilute in saline 0.9% or Dextrose 5%
- Refridgerate 2-8oC
- Fungaemia
- Adult: 200mg IV day 1 then 100mg PO Daily
- Infuse at 1mg/min (or less)
- Continue for 14 days after last positive culture, not exceeding 1 month
Side Effects/Precautions/Contraindications
- Side Effects
- Precautions
- Children <18yrs: no data
- No adjustment for renal or hepatic impairment nor dialysis
- Lactation: limited data, thought safe due to low GIT absorption
- Pregnancy: B3
- Contraindications
- Previous rections to echinocandins