Anidulafungin (Ecalta)

Anidulafungin (Ecalta) - is an echinocandin, similar to caspofungin and micafungin. It covers a wide range of Candida species causing invasive candidiasis (including C. krusei and C. glabrata) and is eliminated by nonenzymatic degradation to an inactive metabolite. The key distinguishing features compared to caspofungin are simplicity of dosing regimen, storage at room temperature, narrower clinical indication and fewer drug interactions.

Uses:
Invasive candidiasis in adult non-neutropenic patients

Contraindications:
Hypersensitivity to echinocandin

Administration
• IV: Load with 200 mg on day 1, followed by 100 mg daily thereafter for a minimum of 14 days

Reconstitute each vial with 30 ml solvent provided, allowing up to 5 min for reconstitution. Add the reconstituted solution to a bag of sodium chloride 0.9% or glucose 5%, i.e. 100 mg in 250 ml and 200 mg in 500 ml.Administer at 3 ml/min Available in vials containing 100 mg with solvent containing ethanol anhydrous in WFI

How not to use anidulafungin:
Do not use in children under 18 years as insufficient data

Adverse effects:
Coagulopathy
Convulsion
Headache
Increased creatinine
Hypokalaemia
Elevated LFT
Flushing
Diarrhoea, nausea and vomiting
Rash
Pruritus

Cautions:
Hepatic failure worsening LFTs
The diluent contains the equivalent of 6 g of ethanol/100 mg of anidulafungin. Caution in breast feeding and pregnancy and high-risk groups, e.g. liver disease, epilepsy, alcoholism Fructose intolerance

Organ failure:
Renal: no dose adjustment necessary, as negligible renal clearance
Hepatic: no dose adjustment, as not metabolised in liver

Renal replacement therapy:
Unlikely to be removed by dialysis, therefore no dose adjustment required.