Generic Name

Candicidin

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Classification

FDA Approved Indications

• Treating fungal infections caused by susceptible organisms, especially systemic Candida infections

Mechanism of Action

Bind to ergosterol in fungal cell membranes, forming pores that increase membrane permeability, leading to leakage of cell contents and cell death.

Dosage and Administration

Adult: Dosage varies based on infection severity and site; typically administered intravenously with dosage adjustments as per clinical guidelines.

Pediatric: Dose determined by weight and severity, under specialist guidance.

Geriatric: Careful dose adjustment may be necessary considering renal and hepatic function.

Renal Impairment: Adjust dose based on severity of impairment.

Hepatic Impairment: Use with caution; monitor hepatic function.

Pharmacokinetics

Absorption: Poor oral absorption; administered IV

Distribution: Widely distributed in tissues, including skin and mucous membranes

Metabolism: Minimal hepatic metabolism, mostly unchanged in urine

Excretion: Excreted primarily via bile and urine

Half Life: Approximately 48 hours

Contraindications

• Known hypersensitivity to candicidin or other polyenes.

Precautions

• Use cautiously in patients with renal or hepatic impairment; monitor renal and hepatic functions regularly.

Adverse Reactions - Common

• Nausea (Common)
• Vomiting (Common)
• Fever (Common)

Adverse Reactions - Serious

• Nephrotoxicity (Rare but serious)
• Electrolyte disturbances (hypokalemia, hypomagnesemia) (Serious if prolonged or severe)
• Hepatotoxicity (Rare)

Drug-Drug Interactions

• Other nephrotoxic drugs (e.g., aminoglycosides, amphotericin B)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Report symptoms of allergic reactions, kidney issues, or electrolyte disturbances.
• Keep all follow-up appointments for lab testing.
• Inform them about signs of adverse reactions such as fever, chills, or unusual bleeding.

Special Considerations

Black Box Warnings:

• Potential for severe renal toxicity; caution advised.

Genetic Factors: Sensitivity may vary depending on genetic factors affecting drug metabolism.

Lab Test Interference: May interfere with certain laboratory tests, including those assessing kidney function.

Overdose Management

Signs/Symptoms: Nausea, vomiting, hypotension, renal failure signs.

Treatment: Supportive care; dialysis if necessary; monitor renal function and electrolytes; no specific antidote.

Storage and Handling

Storage: Store at controlled room temperature, away from moisture and light.

Stability: Stable under recommended storage conditions for the duration of the shelf life.