Micafungin Explained

Verifiedfields:changed
Verifiedrevid:462252182
Width:250
Tradename:Mycamine
Dailymedid:Micafungin
Routes Of Administration:Intravenous
Atc Prefix:J02
Atc Suffix:AX05
Legal Us:Rx-only
Legal Status:Rx-only
Protein Bound:99.8%
Metabolism:Via catechol-O-methyltransferase pathway
Elimination Half-Life:11–17 hours
Excretion:40% feces, <15% urine
Cas Number:235114-32-6
Pubchem:477468
Drugbank:DB01141
Chemspiderid:21106351
Unii:R10H71BSWG
Kegg:D02465
Chembl:1201351
Iupac Name:oxidanesulfonic acid
C:56
H:71
N:9
O:23
S:1
Smiles:CCCCCOc1ccc(-c2cc(-c3ccc(C(=O)N[C@H]4C[C@@H](O)[C@@H](O)N=C(O)[C@@H]5[C@@H](O)[C@@H](C)CN5C(=O)[C@H]([C@H](O)CC(=N)O)N=C(O)[C@H]([C@H](O)[C@@H](O)c5ccc(O)c(OS(=O)(=O)O)c5)N=C(O)[C@@H]5C[C@@H](O)CN5C(=O)[C@H]([C@H](C)O)N=C4O)cc3)no2)cc1
Stdinchi:1S/C56H71N9O23S/c1-4-5-6-17-86-32-14-11-28(12-15-32)39-21-33(63-87-39)27-7-9-29(10-8-27)49(75)58-34-20-38(70)52(78)62-54(80)45-46(72)25(2)23-65(45)56(82)43(37(69)22-41(57)71)60-53(79)44(48(74)47(73)30-13-16-36(68)40(18-30)88-89(83,84)85)61-51(77)35-19-31(67)24-64(35)55(81)42(26(3)66)59-50(34)76/h7-16,18,21,25-26,31,34-35,37-38,42-48,52,66-70,72-74,78H,4-6,17,19-20,22-24H2,1-3H3,(H2,57,71)(H,58,75)(H,59,76)(H,60,79)(H,61,77)(H,62,80)(H,83,84,85)/t25-,26-,31+,34-,35-,37+,38+,42-,43-,44-,45-,46-,47-,48-,52+/m0/s1
Stdinchikey:PIEUQSKUWLMALL-NFGJWQNFSA-N

Micafungin, sold under the brand name Mycamine, is an echinocandin antifungal medication used to treat and prevent invasive fungal infections including candidemia, abscesses, and esophageal candidiasis. It inhibits the production of beta-1,3-glucan, an essential component of fungal cell walls that is not found in mammals.

Administered intravenously, Micafungin received final approval from the U.S. Food and Drug Administration (FDA) in March 2005, and gained approval in the European Union in April 2008. It is on the World Health Organization's List of Essential Medicines.[1]

In August 2023, Mycamine was acquired from Astellas Pharma by Sandoz.[2]

Indications

Micafungin is indicated for the treatment of candidemia, acute disseminated candidiasis, Candida peritonitis, abscesses and esophageal candidiasis.

Micafungin works by way of concentration-dependent inhibition of 1,3-beta-D-glucan synthase resulting in reduced formation of 1,3-beta-D-glucan, which is an essential polysaccharide comprising one-third of the majority of Candida spp. cell walls. This decreased glucan production leads to osmotic instability and thus cellular lysis.[3] [4]

Dosage

The metabolism of micafungin occurs hepatically via acryp sulfatase followed by secondary metabolism by a transferase. Precautions should be taken with regards to dosing, as micafungin weakly inhibits CYP3A4.[5] [6]

Dosage forms

Micafungin is a natural antifungal product derived from other fungi as a defense mechanism for competition of nutrients, etc. To be specific, micafungin is derived from FR901379, and is produced by Coleophoma empetri.[7] [8]

Further reading

Notes and References

  1. Book: ((World Health Organization)) . World Health Organization model list of essential medicines: 22nd list (2021) . 2021 . 10665/345533 . World Health Organization . World Health Organization . Geneva . WHO/MHP/HPS/EML/2021.02 . free .
  2. Web site: Dharma RK . 28 August 2023 . Sandoz concludes acquisition of Mycamine antifungal agent . 29 August 2023 . Pharmaceutical Technology . en-US.
  3. Pappas PG, Rotstein CM, Betts RF, Nucci M, Talwar D, De Waele JJ, Vazquez JA, Dupont BF, Horn DL, Ostrosky-Zeichner L, Reboli AC, Suh B, Digumarti R, Wu C, Kovanda LL, Arnold LJ, Buell DN . Micafungin versus caspofungin for treatment of candidemia and other forms of invasive candidiasis . Clinical Infectious Diseases . 45 . 7 . 883–93 . October 2007 . 17806055 . 10.1086/520980 . free .
  4. Pettengell K, Mynhardt J, Kluyts T, Lau W, Facklam D, Buell D . Successful treatment of oesophageal candidiasis by micafungin: a novel systemic antifungal agent . Alimentary Pharmacology & Therapeutics . 20 . 4 . 475–81 . August 2004 . 15298643 . 10.1111/j.1365-2036.2004.02083.x . FK463 South African Study Group . 31500007 . free .
  5. Carver PL . Micafungin . The Annals of Pharmacotherapy . 38 . 10 . 1707–21 . October 2004 . 15340133 . 10.1345/aph.1D301 . 265942428 .
  6. Kohno S, Masaoka T, Yamaguchi H, Mori T, Urabe A, Ito A, Niki Y, Ikemoto H . A multicenter, open-label clinical study of micafungin (FK463) in the treatment of deep-seated mycosis in Japan . Scandinavian Journal of Infectious Diseases . 36 . 5 . 372–9 . 2004 . 15287383 . 10.1080/00365540410020406 . 10873612 .
  7. Hashimoto S . Micafungin: a sulfated echinocandin . The Journal of Antibiotics . 62 . 1 . 27–35 . January 2009 . 19132058 . 10.1038/ja.2008.3 . free .
  8. 10.1351/pac200779040603 . 2007 . Discovery of micafungin (FK463): A novel antifungal drug derived from a natural product lead . Pure and Applied Chemistry . 79 . 4 . 603–614 . Fujie A . free .