Alternate Name(s):
Mycamine
Classification:
Antifungal
Original Date:
June 2025
Indications:
- Treatment of patients with Candidemia, Acute Disseminated Candidiasis, Candida Peritonitis and Abscesses infections. Mycamine has not been adequately studied in patients with endocarditis, osteomyelitis and meningitis due to Candida infections.
- Treatment of esophageal candidiasis
- Consultation with ID is recommended
- Prophylaxis of Candida infections in patients undergoing hematopoietic stem cell transplantation
Reconstitution and Stability:
| Vial Size | 0.9% Sodium Chloride Required | Final Concentration |
| 100 mg | 5 mL | 20 mg/mL |
- Store unopened vials at room temperature and protect from light
- Diluted solution is stable for 24 hours at room temperature and protect from light
Compatibility:
- Solutions Compatible: 0.9% Sodium Chloride, 5% Dextrose
- Y-site Compatible: Furosemide, Hydromorphone, Heparin, Lorazepam, Lidocaine, Magnesium sulfate, KCl, Sodium bicarbonate, TPN
- Incompatible: Epinephrine, Insulin, Levofloxacin, Midazolam, Morphine, Octreotide, Ondansetron, Phenytoin
Administration:
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | No |
| IM | No |
| IV Push | No |
| IV Intermittent Infusion |
YES Dose ≤ 50mg: 1 mg/mL syringe Dose > 50mg: Diluted in 0.9% NaCl
Infusion time: 60 minutes |
| IV Continuous Infusion | No |
Dosage:
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
Infants (≥4 months), Children & Adolescents:
- For treatment of Candidemia: 2 mg/kg (Max: 100 mg) IV once daily
- Prophylaxis of candida infections: 1 mg/kg (max: 50 mg) IV once daily OR 9 mg/kg (max: 300 mg) IV twice weekly
Potential hazards of parenteral administration:
- More rapid infusions may result in histamine mediated reactions (rash, pruritus, facial swelling, and vasodilatation). If histamine-like reactions occur, slow the infusion.
- Anaphylactic reactions have been reported, infusions should be discontinued for serious hypersensitivity reactions.
- New onset or worsening hepatic impairment has been reported. Monitor liver function
- Hemolytic anemia
- Injection-site reactions; more frequent with peripheral administration
- Increase urea, creatinine, renal dysfunction, and/or acute renal failure have been reported. Monitor renal function closely.
Notes:
- Flush line with 0.9% NaCl prior to administration
References:
- Lexicomp
- King’s Guide for Compatibility
- Micafungin product monograph. Astellas Pharma. 2014
- Micafungin twice-a-week for prophylaxis of invasive Aspergillus infections in children with acute lymphoblastic leukaemia: A controlled cohort study (https://doi.org/10.1016/j.ijantimicag.2023.107058)