MICAFUNGIN, 100mg, concentrate, 10ml, vial

• In the WHO list of Essential Medicines 2025 (Complementary List)

Antifungal for systemic use

Echinocandin antifungal, fungicidal with high activity against Candida spp incl. Candida auris.

Invasive candidiasis caused by Candida spp

In severe/critical invasive candidiasis, micafungin is preferred to fluconazole in terms of safety, level of resistance and efficacy, except in UTIs or ocular infections.

Must be given as IV slow infusion (approx. 1 hour).

Reconstitute the powder vial as follows:

• Remove the plastic cap from the vial and disinfect the stopper with alcohol.
• Using a syringe, withdraw 5 ml from a 100 ml bottle of 0.9% NaCl.
• Add this volume to the powder vial of micafungin, directing along the inner wall to minimise foam generation.
• Gently rotate the vial until complete dissolution of the contents. Do not shake!. The solution must be clear and free of visible particles.
• The reconstituted solution contains 20mg/ml micafungin.
• Withdraw the reconstituted micafungin solution and transfer it into the remaining 100 ml bottle of 0.9% NaCl to obtain a diluted solution of 1.0mg/ml micafungin.
• Gently invert the infusion bottle to disperse the solution. Do not agitate, to avoid foaming.
• Do not use the solution if it is cloudy or has precipitated.
• Place the infusion bottle containing the diluted micafungin into a closable opaque bag for protection from light.

Dosage should be determined by susceptibility of the causative organisms, severity and site of infection, and the condition of the patient.

The antibiotic treatment will be started only once culture results are available.

Only to be used in health settings where validated microbiology laboratory is available to confirm detection of Candida spp ("yeasts") in culture.