rezafungin acetate: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
rezafungin acetate: clinical details
Prescribing considerations
- Initiation should be overseen by a physician experienced in managing invasive fungal infections.
- Use should reflect microbiology, clinical response and official antifungal stewardship guidance.
- Evidence in neutropenic patients is limited.
- Safety and efficacy have not been established in people under 18 years.
- Advise protection from sunlight and other ultraviolet exposure during therapy and for seven days afterwards.
- The product is under additional monitoring; report suspected adverse reactions through the Yellow Card Scheme.
Contraindications and cautions
- Hypersensitivity to rezafungin or any formulation excipient.
- Hypersensitivity to another echinocandin.
Monitoring
- Observe during infusion for anaphylaxis and infusion-related reactions.
- Review liver tests if hepatic enzyme elevations develop and reassess the treatment benefit-risk balance.
- Monitor clinically relevant electrolytes, haemoglobin and hepatic parameters according to the patient's condition and adverse-effect risk.
- Assess for phototoxic skin or eye reactions.
Clinical pharmacology
Rezafungin selectively inhibits fungal 1,3-β-D-glucan synthase. It is highly protein bound, has low systemic clearance and a long terminal half-life. Renal elimination of unchanged rezafungin is minor, with elimination occurring mainly through the faecal route.
Formulation and product differences
- The selected product is a white to pale-yellow powder for concentrate for intravenous infusion.
- It must be reconstituted with water for injections and then diluted using a supported sodium chloride or glucose infusion solution.
- It should be infused as a single agent and must not be mixed with other medicines where compatibility has not been established.
- The vial is single use and the formulation is essentially sodium-free.
rezafungin acetate preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 200 mg
rezafungin acetate interactions
Clinical studies suggest that rezafungin has a relatively low potential for clinically important pharmacokinetic interactions, but the treating team should still review all medicines.
Tacrolimus, ciclosporin, ibrutinib, mycophenolate mofetil and venetoclax
Clinically meaningful pharmacokinetic interactions were considered unlikely when these medicines were administered with rezafungin.
Medicines handled by common CYP enzymes or transport proteins
Studies found clinically important effects unlikely for substrates of CYP2C8, CYP3A4, CYP1A2, CYP2B6 and several major transport proteins.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.