Anidulafungin

Eraxis / Ecalta

Anidulafungin is an echinocandin antifungal, a cyclic lipopeptide that blocks the enzyme β-(1,3)-D-glucan synthase to prevent fungi from building their cell wall. Like the other echinocandins, it targets a structure unique to fungi and is generally well tolerated. What distinguishes anidulafungin is how the body eliminates it: rather than being metabolized by the liver or excreted by the kidneys, it undergoes slow, spontaneous chemical degradation (biotransformation) in the bloodstream. As a result it needs no dose adjustment for kidney or liver impairment and has very few drug interactions — useful in critically ill patients who often have failing organs and long medication lists. Anidulafungin is given intravenously, typically with a loading dose followed by a once-daily maintenance dose. Its main use is the treatment of candidemia and other forms of invasive candidiasis (including intra-abdominal infections and peritonitis) in adults, and esophageal candidiasis. It is fungicidal against many Candida species. Because echinocandins as a class are recommended first-line for many serious Candida infections, anidulafungin is a common choice, especially when a patient's kidney or liver function or drug interactions make other options less convenient. As with all echinocandins, anidulafungin is a large molecule given only intravenously, penetrates the central nervous system and urine poorly, and is reserved for serious infections rather than superficial ones. It is a prescription hospital medicine used under specialist guidance and is not a topical or oral over-the-counter antifungal.