Anidulafungin  Eraxis

Antibiotic Class

Echinocandin

Antimicrobial Spectrum

Candida spp. including azole-resistant strains. Activity against molds difficult to quantify but includes Aspergillus spp. Table 1, Table 2

Mechanism of Action

Non-competitive inhibition of the enzyme b-(1,3)-glucan synthase.

Pharmacodynamics

In-vitro studies have demonstrated concentration-dependent fungicidal activity against Candida spp. Echinocandins have more fungicidal effects against Candida species compared to filamentous organisms.

Pharmacokinetics

Elimination half-life: 29h; Volume of distribution: 41.2L; Protein binding: 84%; Clearance: 16mL/min

Table 3

Adverse Effects

Hepatic: Elevated ALT

Respiratory: Dyspnea

Dermatologic: Flushing

Dosage

IV only: 50mg vials

Candidemia/Candidiasis: 200mg IV on day 1, then 100mg q24h thereafter

Esophageal candidiasis: 100mg IV on day 1, then 50mg q24h thereafter

Disease state based dosing

Hepatic failures: No dosing adjustment recommended

Renal failures: No dosing adjustment recommended

Geriatric patients: No dosing adjustment recommended

Contraindications/Warnings/Precautions

None to date

Drug Interactions

No clinically relevant drug interactions found in studies of coadministration of anidulafungin with cyclopsorin, voriconazole, tacrolimus, liposomal amphotericin B, and rifampin. Anidulafungin is not metabolized by the cytochrome P450 system.

Pregnancy

Category C: Risk unknown. Human studies inadequate.

Monitoring Requirements

Routine monitoring of hepatic enzymes is recommended

Brand names/Manufacturer

Eraxis/Pfizer pharmaceuticals