Echinocandin antifungal
Micafungin
Brand names: Mycamine
Adult dose
Dose: Invasive candidiasis: 100mg IV OD (200mg if >40kg adult and severe). Oesophageal candidiasis: 150mg OD. Prophylaxis (HSCT): 50mg OD
Route: IV
Frequency: OD
Clinical pearls
- Invasive/oesophageal candidiasis; HSCT prophylaxis
- Hepatic monitoring during therapy; report sustained ALT rise
Contraindications
- Hypersensitivity to echinocandins
- Severe hepatic impairment (caution)
Side effects
- Hepatotoxicity (incl. potentially severe — black box; tumour development in animals)
- Histamine-mediated infusion reactions
- Cytopenias
- Renal impairment
Interactions
- Sirolimus (raised levels)
- Nifedipine
- Itraconazole
Monitoring
- LFTs
- FBC
- U&E
Reference: BNF; NICE; SmPC; https://bnf.nice.org.uk/drugs/micafungin/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Eczema Herpeticum · BAD; NICE CKS
- Suspected Bacterial Meningitis (Adult) · NICE NG240 (2024); NICE NG143 (paeds)
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Returning Traveller — Fever · NaTHNaC; PHE; ESCMID 2018
- Malaria — Diagnosis & Management · PHE 2016; WHO 2023