Echinocandin
Candida spp. including azole-resistant strains. Activity against molds difficult to quantify but includes Aspergillus spp. Table 1, Table 2
Non-competitive inhibition of the enzyme b-(1,3)-glucan synthase.
In-vitro studies have demonstrated concentration-dependent fungicidal activity against Candida spp. Echinocandins have more fungicidal effects against Candida species compared to filamentous organisms.
Elimination half-life: 29h; Volume of distribution: 41.2L; Protein binding: 84%; Clearance: 16mL/min
Hepatic: Elevated ALT
Respiratory: Dyspnea
Dermatologic: Flushing
IV only: 50mg vials
Candidemia/Candidiasis: 200mg IV on day 1, then 100mg q24h thereafter
Esophageal candidiasis: 100mg IV on day 1, then 50mg q24h thereafter
Hepatic failures: No dosing adjustment recommended
Renal failures: No dosing adjustment recommended
Geriatric patients: No dosing adjustment recommended
None to date
No clinically relevant drug interactions found in studies of coadministration of anidulafungin with cyclopsorin, voriconazole, tacrolimus, liposomal amphotericin B, and rifampin. Anidulafungin is not metabolized by the cytochrome P450 system.
Category C: Risk unknown. Human studies inadequate.
Routine monitoring of hepatic enzymes is recommended
Eraxis/Pfizer pharmaceuticals