Micafungin
An echinocandin for treating and preventing Candida infections
Micafungin is a semi-synthetic cyclic lipopeptide that blocks the fungal cell-wall enzyme beta-(1,3)-D-glucan synthase. Approved as Mycamine in 2005, it is given by daily intravenous infusion to treat candidaemia and esophageal candidiasis and to prevent Candida infections after stem cell transplants. The brand is discontinued; generics are marketed.
What is it?
Micafungin is one of four echinocandins, cyclic lipopeptides that attack an enzyme fungi need to build their cell walls. Because human cells lack that enzyme, the drugs are selective, and they have become first-line treatments for invasive Candida infections in hospitals. FDA approved micafungin as Mycamine on March 16, 2005.
In a 531-patient trial, micafungin matched liposomal amphotericin B for candidaemia, with treatment success of 89.6% and 89.5% in the per-protocol groups. In 595 patients it performed similarly to caspofungin. It is also approved for prevention: in 882 patients undergoing stem cell transplantation, it prevented fungal infection better than fluconazole (80.0% against 73.5% success).
It is given once daily without a loading dose; steady state is reached after about three doses and the half-life is roughly 13 to 15 hours. The label warns of hypersensitivity, blood, liver and kidney effects, and injection-site reactions.
At a Glance
Every value in this table is printed from the Grey Peptides dataset, the same record the compound explorer and comparison tool read, so the three can never disagree.
Educational information, not medical advice. The doses on this page come from approved labels, published studies and, where no study exists, amounts reported by users. None is a recommendation for you. An unapproved compound has no established safe or effective human dose, and products sold for “research use only” are not made or tested for people. Talk to a doctor before acting on anything on this site, including before you start, stop or change any medicine or dose. Full medical disclaimer.
Half-Life: How Much Remains
The dataset records a half-life of about 13 to 15 hours in patients (13.4 h at steady state with candidaemia) for Micafungin. After each half-life, half of what was in the circulation is gone, so about 3% remains after five. Real clearance varies with the person, the dose, the route and kidney or liver function; this is arithmetic on a published figure, not a dosing tool.
Published Research
The trials behind micafungin, from their PubMed abstracts.
Against liposomal amphotericin B
Among 531 randomised patients with candidaemia or invasive candidiasis, treatment success in the per-protocol analysis was 89.6% on micafungin and 89.5% on liposomal amphotericin B, a difference of 0.7 points, regardless of Candida species, site or neutropenia.
Against caspofungin
In 595 patients, about 85% with candidaemia, treatment success at the end of blinded intravenous therapy was 76.4% on micafungin 100 mg, 71.4% on 150 mg and similar on caspofungin.
Prophylaxis after stem cell transplantation
In 882 adults and children undergoing stem cell transplantation, prophylaxis success was 80.0% on micafungin against 73.5% on fluconazole (difference 6.5 points, P = 0.03).
Esophageal candidiasis dose-response
Endoscopic cure rose with dose, 68.8%, 77.4% and 89.8% on 50, 100 and 150 mg a day; the 100 and 150 mg groups together (83.5%) were comparable to fluconazole 200 mg (86.7%), with similar tolerability.
Side Effects & Contraindications
Reported Side Effects
From the studies above.
Contraindications & Cautions
Warnings from the micafungin label (DailyMed, effective September 29, 2023).
Legal Status
Micafungin is an approved prescription drug in the US.
Frequently Asked Questions
?Is micafungin a peptide?
Yes. Like the other echinocandins it is a cyclic lipopeptide: a ring of amino acids with a fatty side chain, made by modifying a natural fungal product.
?What is micafungin used for?
Treating candidaemia and other invasive Candida infections and esophageal candidiasis, and preventing Candida infections in people undergoing stem cell transplantation.
?Is Mycamine still available?
The Mycamine brand is listed as discontinued in the US, but generic micafungin and a ready-to-use premix are marketed.
References
- [fda] US FDA, Drugs@FDA (openFDA): MYCAMINE, NDA 021506 (March 16, 2005; discontinued); micafungin generics and NDA 216142 (Baxter, September 29, 2023). Read October 3, 2026.
- [fda-pi] FDA. Micafungin in Sodium Chloride Injection US prescribing information (Baxter; DailyMed set a95f901e-0ac4-4ec0-9720-9c6a066cd06c, effective September 29, 2023). Read October 3, 2026.
- [clinical-trial] Kuse ER, et al. "Micafungin versus liposomal amphotericin B for candidaemia and invasive candidosis: a phase III randomised double-blind trial." Lancet, 2007;369(9572):1519-1527. PMID: 17482982.
- [clinical-trial] Pappas PG, et al. "Micafungin versus caspofungin for treatment of candidemia and other forms of invasive candidiasis." Clin Infect Dis, 2007;45(7):883-93. PMID: 17806055.
- [clinical-trial] van Burik JA, et al. "Micafungin versus fluconazole for prophylaxis against invasive fungal infections during neutropenia in patients undergoing hematopoietic stem cell transplantation." Clin Infect Dis, 2004;39(10):1407-16. PMID: 15546073.
- [clinical-trial] de Wet N, et al. "A randomized, double-blind, parallel-group, dose-response study of micafungin compared with fluconazole for the treatment of esophageal candidiasis in HIV-positive patients." Clin Infect Dis, 2004;39(6):842-9. PMID: 15472817.
Sources & Citations
Studies were read from their PubMed records; regulatory sources are listed below, read October 3, 2026.
Medical Disclaimer: This content is for educational and informational purposes only. It is not medical advice, and nothing here is an instruction to obtain or use any compound. Consult a licensed healthcare provider before making health decisions.