II. Indications
- Conditions
- Candidemia (systemic Candidiasis)
- Esophageal Candidiasis
- Activity
- Candida species (including those resistant to Azole Antifungals)
- Aspergillus species (some activity)
III. Contraindications
- Resistant organisms
- Cryptococcus species
- Trichosporon species
- Dimorphic Fungi (e.g. Coccidioides, Blastomyces, Histoplasma)
IV. Mechanism
-
Echinocandin (Cyclic Lipopeptide)
- Inhibits synthesis of beta-(1,3)-D-Glucan a key cell wall component
- Semi-synthetic derived from the fermentation product of the fungue Aspergillus nidulans
V. Dosing: Adult
- Candidemia (systemic Candidiasis)
- Load: 200 mg IV (infused at <1.1 mg/min) on day 1
- Next 100 mg IV (infused at <1.1 mg/min) daily for at least 14 days after the last positive culture
-
Esophageal Candidiasis
- Load: 100 mg IV (infused at <1.1 mg/min) on day 1
- Next 50 mg IV (infused at <1.1 mg/min) daily for at least 14 days (and at least 7 days after symptoms have resolved)
VI. Dosing: Child (Off-label)
- Candidemia (systemic Candidiasis) for age 1 month and older
- Load: 3 mg/kg IV (infused at <1.1 mg/min) on day 1
- Next 1.5 mg/kg IV (infused at <1.1 mg/min) daily for at least 14 days after the last positive culture
VII. Adverse Effects
- Well tolerated overall
- Similar adverse effects to Caspofungin and Micafungin
- Anaphylaxis has occurred
-
Histamine reactions (Pruritus, Urticaria)
- Occurs with more rapid infusion (avoid infusion rates >1.1 mg/min)
VIII. Safety
IX. Pharmacokinetics
- No renal dose adjustment needed
- Does not require dose adjustment in hepatic failure (unlike Caspofungin and Micafungin)
X. Drug Interactions
- No significant Drug Interactions
XI. Resources
- Anidulafungin (DailyMed)
XII. References
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
- (2012) Med Lett Drugs Ther 10(120): 61-8 [PubMed]
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Related Studies
Definition (NCI) | A cyclic lipopeptide echinocandin derivative with antifungal activity. Anidulafungin inhibits 1,3 beta-D-glucan synthase, an enzyme involved in fungal cell wall synthesis, resulting in cell lysis and death. This agent is active against Candida species and Aspergillus. (NCI04) |
Definition (NCI_NCI-GLOSS) | A drug that is used to treat infections caused by fungi. It belongs to the family of drugs called antifungals. |
Definition (PDQ) | A cyclic lipopeptide echinocandin derivative with antifungal activity. Anidulafungin inhibits 1,3 beta-D-glucan synthase, an enzyme involved in fungal cell wall synthesis, resulting in cell lysis and death. This agent is active against Candida species and Aspergillus. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=328242&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=328242&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C38716" NCI Thesaurus) |
Concepts | Amino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121) |
MSH | C102786 |
SnomedCT | 421904007, 422157006 |
LNC | LP94536-7, MTHU032473 |
English | Anidulafungin, Anidulafungin (product), Anidulafungin (substance), anidulafungin (medication), anidulafungin [Chemical/Ingredient], ANIDULAFUNGIN, V-echinocandin, anidulafungin |
Spanish | anidulafungina, anidulafungina (sustancia), anidulafungina (producto) |