Echinocandine

Products

Echinocandins are commercially available as infusion preparations. Caspofungin was the first representative from this group to be approved in 2001, and in many countries in 2002.

Structure and properties

Echinocandins are semisynthetic agents derived from fermentation products of various fungi. These include , and F-11899 They are synthetic lipopeptides with a complex chemical structure and a high molecular mass. For this reason, they are not bioavailable perorally.

Effects

Echinocandins (ATC J02AX) have antifungal properties. They are fungicidal against yeast fungi (-species) and fungistatic against molds (-species). The effects are based on the disruption of the biosynthesis of the polysaccharide 1,3-β-D-glucan, an important component of the fungal cell wall. The active compounds inhibit the enzyme 1,3-β-D-glucan synthase, which is found only in fungi and not in humans. The inhibition is noncompetitive.

Indications

For the treatment of fungal infections. Indications include:

  • Invasive candidiasis, candidemia
  • Esophageal and oropharyngeal candidiasis, as a second-line agent.
  • Invasive aspergillosis
  • Empirical therapy of fungal infection in patients with fever and neutropenia.

Dosage

According to the professional information. The drugs are administered as an intravenous infusion.

Active ingredients

Contraindications

  • Hypersensitivity

For complete precautions, see the drug label.

Adverse effects

The most common possible adverse effects include:

  • Diarrhea, nausea, vomiting
  • Hypokalemia
  • Phlebitis (inflammation of the veins), fever
  • Changes in liver enzymes