Anidulafungin

Indications

Anidulafungin is used for: Oesophageal candidiasis, Invasive candidiasis, Candidaemia, Candida infections (intra-abdominal abscess, pertonitis)

Adult Dose

Intravenous Oesophageal candidiasis Adult: Loading dose of 100 mg on day 1, then 50 mg once daily thereafter. Continue treatment for at least 14 days and for at least 7 days following resolution of symptoms. To be given by IV infusion. Max infusion rate: 1.1 mg/min. Invasive candidiasis, Candidaemia, Candida infections (intra-abdominal abscess, pertonitis) Adult: Loading dose of 200 mg on day 1, then 100 mg once daily thereafter. Continue treatment for at least 14 days after the last positive culture. To be given by IV infusion. Max infusion rate: 1.1 mg/min.

Child Dose

Renal Dose

No dosage adjustment needed.

Administration

IV Preparation Reconstitute each 50 mg vial w/ sterile water for inj 15 mL, or each 100 mg vial w/ sterile water for inj 30 mL to provide a concentration of 3.33 mg/mL. Further dilute the reconstituted solution w/ either dextrose inj 5% or sodium chloride inj 0.9% to obtain a solution containing 0.77 mg/mL.

Contra Indications

Hypersensitivity to anidulafungin or other echinocandins.

Precautions

Patients w/ serious underlying conditions receiving multiple concomitant medications w/ anidulafungin may experience hepatic abnormalities e.g. hepatitis, hepatic dysfunction or worsening hepatic failure. Pregnancy and lactation. Lactation There are no data on presence of drug in human milk, effects on breastfed infant or on milk production; drug was found in milk of lactating rats; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed child from therapy or from underlying maternal condition

Pregnancy-Lactation

Pregnancy Based on findings from animal studies, therapy can cause fetal harm when administered to a pregnant woman; there are no available human data on use in pregnant women to inform a drug-associated risk of adverse developmental outcomes Lactation There are no data on presence of drug in human milk, effects on breastfed infant or on milk production; drug was found in milk of lactating rats; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed child from therapy or from underlying maternal condition

Interactions

Adverse Effects

Side effects of Anidulafungin : 1-10% Candidemia treatment Diarrhea (3%) Hypokalemia (3%) Abnl LFTs (2%) Esophageal Candidiasis treatment Headache (1%) Nausea (1%) Neutropenia (1%) Rash (1%) Frequency Not Defined Possible histamine-mediated symptoms reported including rash, urticaria, flushing, pruritus, bronchospasm, dyspnea, and hypotension; infrequent when infusion rate does not exceed 1.1 mg/minute.

Mechanism of Action

Anidulafungin is a semi-synthetic echinocandin antifungal. It inhibits 1, 3-beta-D-glucan synthesis, an essential component of the fungal cell walls. It has been shown to have in vitro activity against many Aspergillus spp and Candida spp.