Generic Name

Anidulafungin

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Classification

FDA Approved Indications

• Treatment of candidemia and other forms of invasive candidiasis

Mechanism of Action

Inhibits β-1,3-D-glucan synthase enzyme, leading to impairment of fungal cell wall synthesis and resulting in cell death.

Dosage and Administration

Adult: 200 mg loading dose on day 1, followed by 100 mg once daily; dose adjustments not typically necessary.

Pediatric: Not established; safety and efficacy have not been fully determined.

Geriatric: No specific dose adjustment recommended, but monitor renal and hepatic function.

Renal Impairment: No dose adjustment needed.

Hepatic Impairment: No dose adjustment needed.

Pharmacokinetics

Absorption: Not applicable (administered intravenously).

Distribution: Widely distributed in body tissues and fluids.

Metabolism: Metabolized minimally; primarily excreted unchanged.

Excretion: Primarily via feces, minimal renal excretion.

Half Life: ≈24 hours.

Contraindications

• Hypersensitivity to anidulafungin or other echinocandins.

Precautions

• Use with caution in patients with hepatic impairment. Monitoring liver enzymes is recommended.
• Ensure renal function is monitored, especially if combined with nephrotoxic drugs.

Adverse Reactions - Common

• Headache (Less common)
• Nausea (Less common)
• Vomiting (Less common)
• Histamine-mediated infusion reactions (flushing, rash, hypotension) (Less common)

Adverse Reactions - Serious

• Hepatotoxicity (elevations in liver enzymes) (Rare)
• Anaphylaxis (Rare)

Drug-Drug Interactions

• Potential increased risk of bleeding with anticoagulants.
• Caution with other nephrotoxic or hepatotoxic drugs.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Report any allergic reactions immediately.
• Inform about possible side effects and the importance of adhering to dosing schedule.
• Keep follow-up appointments for lab testing.

Special Considerations

Black Box Warnings:

• No black box warnings for anidulafungin.

Genetic Factors: Limited data on pharmacogenomics.

Lab Test Interference: May cause transient elevations in liver enzymes, monitor liver function tests regularly.

Overdose Management

Signs/Symptoms: Potential for infusion reactions, liver toxicity.

Treatment: Supportive care; no specific antidote. Discontinue drug and provide symptomatic treatment as needed.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable for the duration specified in the package insert, typically stored protected from light.