Anidulafungin
/api/v1/drug/anidulafunginMechanism of action
Sourced from openFDAAnidulafungin is an anti-fungal drug [see Microbiology (12.4) ].
Indications
Sourced from openFDA- ERAXIS is an echinocandin antifungal indicated for the treatment of the following infections: • Candidemia and other forms of Candida infections (intra-abdominal abscess and peritonitis) in adults and pediatric patients (1 month of age and older) ( 1.1 ) • Esophageal candidiasis in adults ( 1.2 ) Limitations of use • ERAXIS has not been studied in adult and pediatric patients with endocarditis, osteomyelitis, and meningitis due to Candida or in sufficient numbers of neutropenic patients. The dosage of ERAXIS for the treatment of Candida dissemination into the CNS and the eye has not been established.ICD-10: B37.9
Contraindications
Sourced from openFDA- ERAXIS is contraindicated in: • Patients with known hypersensitivity to anidulafungin, any component of ERAXIS, or other echinocandins [see Warnings and Precautions (5.2) ] • Patients with known or suspected Hereditary Fructose Intolerance (HFI) [see Warnings and Precautions (5.4) ] • Known hypersensitivity to anidulafungin, any component of ERAXIS, or other echinocandins ( 4 , 5.2 ) • Known or suspected Hereditary Fructose Intolerance (HFI) ( 4 , 5.4 )contraindicated
Dosage & administration
Sourced from openFDAAdults Pediatric Patients 1 Month of Age and Older Candidemia and other forms of Candida infections 200 mg loading dose on Day 1, followed by 100 mg once daily maintenance dose thereafter for at least 14 days after the last positive culture ( 2.1 ) 3 mg/kg (not to exceed 200 mg) loading dose on Day 1, followed by 1.5 mg/kg (not to exceed 100 mg) once daily maintenance dose thereafter for at least 14 days after the last positive culture ( 2.2 ) Esophageal candidiasis 100 mg loading dose on Day 1, followed by 50 mg once daily maintenance dose thereafter for a minimum of 14 days and for at least 7 days following resolution of symptoms ( 2.1 ) Not Approved Rate of Infusion for Adults and Pediatric Patients The rate of infusion should not exceed 1.1 mg/minute [equivalent to 1.4 mL/minute or 84 mL/hour when reconstituted and diluted per instructions] ( 2.3 , 2.4 ) 2.1 Recommended Dosage in Adults Candidemia and other Candida infections (intra-abdominal abscess and peritonitis) The recommended dose is a single 200 mg loading dose of ERAXIS on Day 1, followed by a 100 mg once daily maintenance dose thereafter. Duration of treatment should be based on the patient's clinical response. In general, antifungal therapy should continue for at least 14 days after the last positive culture. Esophageal Candidiasis The recommended dose is a single 100 mg loading dose of ERAXIS on Day 1, followed by a 50 mg once daily maintenance dose thereafter. Patients should be treated for a minimum of 14 days and for at least 7 days following resolution of symptoms.
Warnings & precautions
Sourced from openFDA• Hepatic Effects : Risk of abnormal liver tests, hepatitis, hepatic failure; monitor hepatic function during therapy. ( 5.1 , 13.2 ) • Hypersensitivity : Anaphylaxis, including shock has been reported. Risk of infusion-related adverse reactions, possibly histamine-mediated, including rash, urticaria, flushing, pruritus, bronchospasm, dyspnea, and hypotension; to reduce occurrence, do not exceed a rate of infusion of 1.1 mg/minute. ( 2.4 , 5.2 ) • Risk of Neonatal Toxicity Associated with Polysorbates : ERAXIS contains polysorbate 80, an inactive ingredient. Thrombocytopenia, renal dysfunction, hepatomegaly, cholestasis, ascites, hypotension and metabolic acidosis haves been reported in low-birth weight infants receiving high doses of polysorbate. ERAXIS is not approved in pediatric patients younger than 1 month of age. ( 5.3 , 8.4 ) • Hereditary Fructose Intolerance (HFI) : ERAXIS contains fructose. Risk of metabolic crisis with life-threatening hypoglycemia, hypophosphatemia, lactic acidosis, and hepatic failure. Obtain history of HFI symptoms in pediatric patients before ERAXIS administration. ( 5.4 , 8.4 ) 5.1 Hepatic Adverse Reactions Laboratory abnormalities in liver tests have been seen in healthy volunteers and pediatric patients treated with ERAXIS. In some patients with serious underlying medical conditions who were receiving multiple concomitant medications along with ERAXIS, clinically significant hepatic abnormalities have occurred.
Adverse reactions
Sourced from openFDAThe following most serious adverse reactions are described elsewhere in other labeling sections: • Hepatic Adverse Reactions [see Warnings and Precautions (5.1) ] • Anaphylactic and Hypersensitivity Reactions [see Warnings and Precautions (5.2) ] Adults • Candidemia and other forms of Candida infections: Most common adverse reactions (≥15%) are hypokalemia, nausea, diarrhea, vomiting, pyrexia, insomnia, hypotension. ( 6.1 ) • Esophageal candidiasis: Most common adverse reactions (≥5%) are diarrhea, pyrexia, anemia, headache, vomiting, nausea, dyspepsia, oral candidiasis, and hypokalemia. ( 6.1 ) Pediatric Patients (1 month and older) Candidemia and other forms of Candida infections: Most common adverse reactions (≥ 5%): diarrhea, vomiting, pyrexia, abdominal pain, anemia, thrombocytopenia, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) increased, hypoglycemia, epistaxis, and rash. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Pfizer Inc at 1-800-438-1985 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch . 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. Clinical Trials Experience in Adults The safety of ERAXIS for Injection was assessed in 929 individuals, including 257 healthy subjects and 672 patients in clinical trials of candidemia, other forms of Candida infections, and esophageal candidiasis.
Use in specific populations
Sourced from openFDA• Pregnancy : Based on findings from animal studies, ERAXIS can cause fetal harm when administered to a pregnant woman. Inform pregnant woman of the risk to the fetus. ( 8.1 ) • Pediatric Use : The safety and effectiveness in patients younger than 1 month of age has not been established. ( 8.4 ) 8.1 Pregnancy Risk Summary Based on findings from animal studies, ERAXIS can cause fetal harm when administered to a pregnant woman. There are no available human data on the use of ERAXIS in pregnant women to inform a drug-associated risk of adverse developmental outcomes. In animal reproduction studies fetal toxicity was observed in the presence of maternal toxicity when anidulafungin was administered to pregnant rabbits during organogenesis at 4 times the proposed therapeutic maintenance dose of 100 mg/day on the basis of relative body surface area ( see Data ) . Inform pregnant woman of the risk to the fetus. The estimated background risk of major birth defects and miscarriage for the indicated populations are unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20% respectively.
Pharmacokinetics
Sourced from openFDA- Metabolism
- General Pharmacokinetic Characteristics The pharmacokinetics of anidulafungin following intravenous (IV) administration of ERAXIS have been characterized in healthy subjects, special populations and patients. Systemic exposures of anidulafungin are dose-proportional and have low inter-subject variability (coefficient of variation <25%) as shown in Table 5.
Overdosage
Sourced from openFDADuring clinical trials a single 400 mg dose of ERAXIS was inadvertently administered as a loading dose. No clinical adverse events were reported. In a study of 10 healthy subjects administered a loading dose of 260 mg followed by 130 mg daily; 3 of the 10 subjects experienced transient, asymptomatic transaminase elevations (≤3 × ULN) [see Warnings and Precautions (5.1) ] . Anidulafungin is not dialyzable. The maximum non-lethal dose of anidulafungin in rats was 50 mg/kg, a dose which is equivalent to 10 times the recommended daily dose for esophageal candidiasis (50 mg/day) or equivalent to 5 times the recommended daily dose for candidemia and other Candida infections (100 mg/day), based on relative body surface area comparisons.
Approval history
Sourced from openFDA- Feb 17, 2006NDANDA021632Vicuron Holdings
FAERS reports
- 1Drug Ineffective37624%
- 2Multiple Organ Dysfunction Syndrome17211%
- 3Off Label Use17211%
- 4Septic Shock1288.2%
- 5Sepsis1157.4%
- 6Pneumonia946.0%
- 7Candida Infection905.8%
- 8Pyrexia905.8%
- 9Death815.2%
- 10Neutropenia805.1%
- 11Renal Failure684.4%
- 12Respiratory Failure634.1%
- 13Condition Aggravated603.9%
- 14Drug Resistance583.7%
- 15Hypotension573.7%
Literature
Recent PubMed references pinned to Anidulafungin as a MeSH major topic. Citations link to pubmed.ncbi.nlm.nih.gov.
- Rapid detection of anidulafungin and fluconazole susceptibility profiles of clinical Candida strains by MALDI-TOF MS.Acta microbiologica et immunologica Hungarica · 2025 · Toker Onder I, Alp A, Arikan-Akdagli S, et al.PMID 41171318DOI 10.1556/030.2025.02678
- Minimum Inhibitory Concentrations of Anidulafungin as a Potential Predictor of Biocide Susceptibility of Clade 1 Candidozyma (Candida) auris Isolates.MicrobiologyOpen · 2025 · Erganis S, Seyer A, Mustapha MT, et al.PMID 41121674DOI 10.1002/mbo3.70093
- Anidulafungin exposure and population pharmacokinetics in critically ill patients with invasive candidiasis.Infection · 2025 · Elkayal O, Hoffert Y, Mertens B, et al.PMID 39641856DOI 10.1007/s15010-024-02448-x
- Evaluation of clinical outcomes of anidulafungin for the treatment of candidemia in hospitalized critically ill patients with obesity: A multicenter, retrospective cohort study.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2024 · Alsowaida YS, Sulaiman KA, Mahrous AJ, et al.PMID 39241957DOI 10.1016/j.ijid.2024.107234
- Repurposing Anidulafungin for Alzheimer's Disease via Fragment-Based Drug Discovery.ACS chemical neuroscience · 2024 · Xie S, Liang Y, Song Y, et al.PMID 39096284DOI 10.1021/acschemneuro.4c00150
- Anidulafungin Levels in Breast Milk After Cessation of Treatment: A Case Report.Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine · 2024 · Eijsink JFH, Wieringa A, Vries-Koenjer MLM, et al.PMID 38174985DOI 10.1089/bfm.2023.0246
- Antiviral activity and mechanism of the antifungal drug, anidulafungin, suggesting its potential to promote treatment of viral diseases.BMC medicine · 2022 · Shen S, Zhang Y, Yin Z, et al.PMID 36266654DOI 10.1186/s12916-022-02558-z
- Synergistic in-vitro antiviral effects of combination treatment using anidulafungin and T-1105 against Zika virus infection.Antiviral research · 2021 · Lu JW, Chen YC, Huang CK, et al.PMID 34648875DOI 10.1016/j.antiviral.2021.105188
Clinical trials
The 10 most recently updated of 43 ClinicalTrials.gov registrations naming Anidulafungin as an intervention. Registration is not evidence of efficacy or safety — reference crosswalk only.
- A Phase 3, Randomized, Double-blind Study for Patients With Invasive Candidiasis Treated With IV Echinocandin Followed by Either Oral Ibrexafungerp or Oral FluconazoleTerminated · Phase 3 · Interventional · 68 enrolled · Scynexis, Inc.NCT05178862updated 2025-12-19
- Translational PKPD Modeling of Anti-infective Drugs Used in Pediatric Units.Recruiting · Observational · 150 enrolled · Poznan University of Medical SciencesNCT05426499updated 2025-05-31
- A Study Comparing Short-course Antifungal Therapy (SCAT) 7 Day vs Standard 14 Day Antifungal Therapy for Uncomplicated CandidemiaNot yet recruiting · Observational · 150 enrolled · Augusta UniversityNCT06907992updated 2025-04-04
- Short and Long-term Safety of Micafungin and Other Parenteral Antifungal AgentsCompleted · Observational · 40,110 enrolled · Astellas Pharma Europe B.V.NCT01686607updated 2024-10-21
- Impact of Capillary Leak and Hypoalbuminemia on PK/PD of Anidulafungin and Caspofungin in Critically Ill PatientsRecruiting · Observational · 60 enrolled · Universitaire Ziekenhuizen KU LeuvenNCT04045366updated 2024-07-03
- Azole-echinocandin Combination Therapy for Invasive AspergillosisTerminated · Phase 3 · Interventional · 66 enrolled · Erasmus Medical CenterNCT04876716updated 2024-05-07
- Candida in the Respiratory Tract Secretions of Critically Ill Patients and The Efficacy of Antifungal TreatmentTerminated · Phase 2 · Interventional · 61 enrolled · Daren K. HeylandNCT00934934updated 2021-02-01
- Pharmacokinetics of Anidulafungin (Ecalta ®) Intravenous Given to Patients at High Risk for Developing Invasive Fungal DiseaseCompleted · Phase 2 · Interventional · 26 enrolled · Radboud University Medical CenterNCT01249820updated 2020-12-08
- Anidulafungin Pharmacokinetics Given as a Single Intravenous Dose to Obese Patients (ADOPT)Completed · Phase 4 · Interventional · 8 enrolled · Radboud University Medical CenterNCT02021123updated 2020-12-01
- Negative Beta Glucan in ICU PatientsCompleted · Phase 4 · Interventional · 85 enrolled · Universidade Federal do Rio de JaneiroNCT01734525updated 2019-07-08
Frequently asked questions
- How does Anidulafungin work?
- Anidulafungin is an anti-fungal drug [see Microbiology (12.4) ].
- What is Anidulafungin used for?
- According to FDA labeling, Anidulafungin carries indications including: ERAXIS is an echinocandin antifungal indicated for the treatment of the following infections: • Candidemia and other forms of Candida infections (intra-abdominal abscess and peritonitis) in adults and pediatric patients (1 month of age and older) ( 1.1 ) • Esophageal candidiasis in adults ( 1.2 ) Limitations of use • ERAXIS has not been studied in adult and pediatric patients with endocarditis, osteomyelitis, and meningitis due to Candida or in sufficient numbers of neutropenic patients. The dosage of ERAXIS for the treatment of Candida dissemination into the CNS and the eye has not been established.. This is a reference summary of labeled uses, not medical advice or a treatment recommendation.
- What class of drug is Anidulafungin?
- Anidulafungin is classified as Other antimycotics for systemic use, Echinocandin Antifungal, Glucan Synthase Inhibitors, Decreased Cell Wall Integrity.
- What are the brand names for Anidulafungin?
- Anidulafungin is marketed under brand names including Eraxis.
- What are the contraindications for Anidulafungin?
- Anidulafungin labeling lists contraindications including: ERAXIS is contraindicated in: • Patients with known hypersensitivity to anidulafungin, any component of ERAXIS, or other echinocandins [see Warnings and Precautions (5.2) ] • Patients with known or suspected Hereditary Fructose Intolerance (HFI) [see Warnings and Precautions (5.4) ] • Known hypersensitivity to anidulafungin, any component of ERAXIS, or other echinocandins ( 4 , 5.2 ) • Known or suspected Hereditary Fructose Intolerance (HFI) ( 4 , 5.4 ). Always consult the full prescribing information and a clinician.
anidulafungin is illustrative MVP content compiled from public sources. pharmacopeia is for educational and informational use only and is not a substitute for professional medical advice.