anidulafungin (Eraxis)

Indications: serious fungal infections 1) fungal infections with candida a) esophageal candidiasis b) candidemia 2) intra-abdominal abscess 3) peritonitis Contraindications: - aspergillosis Pregnancy category: C Dosage: (adults) 1) candidemia, intra-abdominal abscess, peritonitis a) 200 mg IV loading dose by infusion*, then b) 100 mg daily for at least 14 days c) continue for at least 14 days after last positive culture 2) esophageal candidiasis a) loading dose is 100 mg b) daily dose is 50 mg for at least 14 days c) continue for at least 7 days following resolution of symptoms * infusion < 1.1 mg/min lyophilized, preservative-free powder, 50 mg single-use vials. diluent 15 mL of 20% [w/w] ethanol in water dilute with D5W or normal saline to at least 100 mL/50 mg use reconstituted solutions within 24 hours Pharmacokinetics: 1) NOT a clinically relevant inducer or substrate of cyt P450 2) negligible renal clearance Adverse effects: 1) diarrhea (3.1%) 2) hypokalemia (3.1%) 3) elevated ALT (2.3%) 4) headache (1.3%) 5) increased GGT (1.3%) 6) histamine-mediated symptoms (uncommon) rash, urticaria, flushing, pruritus, dyspnea, hypotension) 7) adverse effect less frequent with infusion rate < 1.1 mg/min Drug interactions: - no clinically relevant drug-drug interactions with: cyclosporine, voriconazole, tacrolimus, rifampin, liposomal amphotericin B, rifampin Mechanism of action: 1) echinocandin antifungal 2) inhibits cell wall formation Notes: $60/30 g (projected price 2006)

References

Prescriber's Letter 13(5): 2006 New Drug: Eraxis (Anidulafungin) Detail-Document#: 220612 (subscription needed) http://www.prescribersletter.com