Echinocandins

• Introduction 

• Illustrated mechanism of action 

• Examples of Medication Brand Names (with Images)

• Indication

• Side Effects 

• Precautions & Contraindications 

• Monographs

• Reference 

1. Introduction:

Echinocandins are a class of antifungal drugs used primarily to treat serious fungal infections caused by Candida and Aspergillus species.

They are sometimes referred to as the “penicillin of antifungals” due to their targeted action on the fungal cell wall, which is unique among antifungal medications.

4. Indication:

• Invasive Candidiasis (including bloodstream infections)

• Esophageal candidiasis

• Empiric treatment of suspected fungal infections in neutropenic patients

• Invasive Aspergillosis (as salvage therapy when other agents fail or are not tolerated)

5. Side Effects:

• Fever

• Headache

• Injection site reactions

• Elevated liver enzymes (transaminases)

• Hypokalemia or hypomagnesemia

• Allergic reactions (rare)

• Rash or pruritus

6. Precautions & Contraindications:

• Use with caution in patients with hepatic impairment

• Contraindicated in patients with known hypersensitivity to echinocandins

• Liver function tests should be monitored during prolonged therapy

• Use during pregnancy or breastfeeding only if clearly needed and under medical supervision

7. Monographs:

Each drug has a detailed monograph that includes:

• Chemical structure & pharmacokinetics

• Mechanism of action

• Recommended dosages (e.g., Caspofungin: loading dose followed by daily maintenance)

• Drug interactions

• Clinical indications and safety information

• Storage and administration guidelines (all echinocandins are IV only)

8. References:

• Micromedex Drug Monographs

• UpToDate Clinical Database

• WHO Model List of Essential Medicines

• PubMed (NIH)

• Drug prescribing information from manufacturers