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Echinocandin antifungal

Micafungin

Brand names: Mycamine

Micafungin is an echinocandin antifungal used for invasive candidiasis, oesophageal candidiasis and prophylaxis of Candida infection in certain stem-cell transplant settings.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It non-competitively inhibits beta-(1,3)-D-glucan synthase, blocking synthesis of an essential fungal cell-wall component and causing cell lysis.

Prescribing in practice

  • The MHRA has warned of a possible risk of liver tumours observed in animal studies, so it should be used only when other antifungals are inappropriate and hepatic function monitored.
  • It is given by intravenous infusion only and is not active against Cryptococcus or most moulds such as Aspergillus to the same degree as Candida.
  • Drug interactions are fewer than with azoles, but caution applies with ciclosporin and sirolimus where levels may change.

Monitoring

Monitor liver function tests during treatment and review if transaminases rise or signs of hepatic impairment develop.

Counselling the patient

  • This medicine is given through a drip by trained staff.
  • Report any yellowing of the skin or eyes, dark urine or unusual tiredness.

Evidence & guidelines

Efficacy in invasive and oesophageal candidiasis is supported by randomised controlled trials against other antifungals, and use is detailed in the SPC.

Reference: NICE; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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