Products
Anidulafungin is commercially available as a powder for the preparation of an infusion solution (Ecalta, generics). It has been approved in many countries since 2009.
Structure and properties
Anidulafungin (C58H73N7O17, Mr = 1140.3 g/mol) is a cyclic lipopeptide. It is a semisynthetic echinocandin obtained from a fermentation product of . It exists as a white powder that is practically insoluble in water.
Effects
Anidulafungin (ATC J02AX06) has fungicidal properties against Candida yeast fungi. It interferes with the formation of the polysaccharide 1,3-β-D-glucan, an important component of the fungal cell wall. The cell walls become defective and brittle and the fungus can no longer continue to grow. The effects are due to inhibition of the enzyme 1,3-β-D-glucan synthase, which is found only in fungi and not in humans.
Indications
For the treatment of candidemia in non-neutropenic adult patients, i.e., a fungal infection caused by Candida species that has spread to the bloodstream. It is also approved in some countries for the treatment of Candida infections of the trachea.
Dosage
According to the product information leaflet.
Contraindications
- Hypersensitivity to the drug and other echinocandins (eg, caspofungin).
- Hereditary fructose intolerance (the preparation contains fructose).
Full precautions can be found in the drug label.
Interactions
Anidulafungin does not appear to interact with CYP450. Interaction with anesthetics was noted in a small study in rats.
Adverse effects
The most common potential adverse effects include diarrhea, nausea, vomiting, flushing, blood clotting disorders, convulsions, headache, pruritus, rash, thrombocytopenia, hypokalemia, hyperkalemia, hypomagnesemia, and disorders of other blood parameters. Unlike amphotericin B, anidulafungin has a lower risk of nephrotoxicity.
