Micafungin Disease Interactions

Laboratory abnormalities in liver function tests have been observed in healthy volunteers and patients treated with echinocandins, and clinical hepatic abnormalities have occurred in some patients with serious underlying conditions who were receiving multiple concomitant medications with echinocandin therapy. Isolated cases of significant hepatic dysfunction, hepatitis, or worsening hepatic failure have also been reported, although a causal relationship has not been established. Therapy with echinocandins should be administered cautiously in patients with preexisting liver disease. Liver function should be monitored regularly during therapy.

Acute, transient, and asymptomatic intravascular hemolysis and hemoglobinuria were reported in a healthy volunteer given an infusion of micafungin 200 mg and oral prednisolone 20 mg. Isolated cases of significant hemolysis and hemolytic anemia have also been reported in patients treated with micafungin. Therapy with micafungin should be administered cautiously in patients with preexisting anemia.

Elevations in BUN and creatinine, as well as isolated cases of significant renal dysfunction or acute renal failure, have been reported in patients treated with micafungin. In controlled clinical trials, the incidence of drug-related renal adverse events was 0.4% for patients receiving micafungin and 0.5% for patients receiving fluconazole. Therapy with micafungin should be administered cautiously in patients with preexisting renal impairment. Renal function should be monitored regularly during therapy.