ECALTA​ POWDER INJECTION

Indications

• Invasive candidiasis
• Invasive aspergillosis

Dosage

Children: Refer to BNF for Children for specific pediatric dosing information.

Adults: Loading dose 70 mg once daily for 1 day, then maintenance 50 mg once daily.

Mechanism of action

Anidulafungin inhibits glucan synthase, an enzyme found in fungi but not in mammalian cells. This inhibition prevents the formation of 1,3-beta-D-glucan, which is vital for the integrity of the fungal cell wall, leading to osmotic instability and cell death.

Pharmacodynamics

Anidulafungin is active against various Candida species and some Aspergillus species. It is characterized by its ability to prevent the synthesis of 1,3-beta-D-glucan, leading to compromised cell wall integrity. However, it is not effective against Cryptococcus neoformans, Trichosporon, Fusarium, or zygomycetes.

Pharmacokinetics

Anidulafungin has a high protein binding capacity and is metabolized in the liver. Its pharmacokinetics are characterized by a prolonged half-life, allowing for once-daily dosing. It is mainly excreted in the feces, with minimal renal excretion, which is advantageous for patients with renal impairment.

Adverse effects

• Nausea
• Vomiting
• Diarrhea
• Headache
• Elevated liver enzymes
• Hypokalemia
• Hypotension
• Infusion-related reactions

Precautions

• Use caution in patients with hepatic impairment
• Monitor liver function tests during treatment
• Assess for signs of hypersensitivity reactions

Pregnancy

Manufacturer advises to avoid unless potential benefit outweighs risk, as toxicity has been observed in animal studies.

Breast-feeding

Manufacturer advises to avoid unless potential benefit outweighs risk, as present in milk in animal studies.

Storage

Store in a cool, dry place, protected from light. Reconstituted solutions should be used promptly.

Formulations

• Anidulafungin 100 mg powder for concentrate for solution for infusion vials

Mechanism of action

Anidulafungin is a semi-synthetic echinocandin with antifungal activity. Anidulafungin inhibits glucan synthase, an enzyme present in fungal, but not mammalian cells. This results in inhibition of the formation of 1,3-β-D-glucan, an essential component of the fungal cell wall, ultimately leading to osmotic instability and cell death.

Pharmacodynamics

Anidulafungin is a semi-synthetic lipopeptide synthesized from a fermentation product of <i>Aspergillus nidulans</i>. Anidulafungin is an echinocandin, a class of antifungal drugs that inhibits the synthesis of 1,3-&beta;-D-glucan, an essential component of fungal cell walls. Anidulafungin is active in vitro against many <i>Candida</i>, as well as some <i>Aspergillus</i>. Like other echinocandins, anidulafungin is not active against <i>Cryptococcus neoformans</i>, <i>Trichosporon</i>, <i>Fusarium</i>, or zygomycetes.