Specimens for fungal culture and other relevant laboratory studies (including histopathology) should be obtained prior to therapy to isolate and identify causative organism(s). Therapy may be instituted before the results of the cultures and other laboratory studies are known. However, once these results become available, antifungal therapy should be adjusted accordingly.
A single 200 mg loading dose should be administered on Day 1, followed by 100 mg daily 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.
Anidulafungin should be reconstituted with water for injection to a concentration of 3.33 mg/mL and subsequently diluted to a concentration of 0.77 mg/mL before use according to the instructions given in Special precautions for disposal and other handling under Cautions for Usage.
It is recommended that anidulafungin is administered at a maximum rate of infusion that does not exceed 1.1 mg/minute (see Precautions, Adverse Reactions and Special precautions for disposal and other handling under Cautions for Usage).
Renal and hepatic impairment: No dosing adjustments are required for patients with mild, moderate, or severe hepatic impairment. No dosing adjustments are required for patients with any degree of renal insufficiency, including those on dialysis. Anidulafungin can be given without regard to the timing of haemodialysis (see Pharmacology: Pharmacokinetics under Actions).
Other special populations: No dosing adjustments are required for adult patients based on patient gender, weight, ethnicity, HIV positivitity, or geriatric status.
Children and adolescents: The experience in children is limited (see Pharmacology: Pharmacokinetics under Actions). Use in patients under 18 years of age is not recommended until further data becomes available, unless the potential benefit justifies the risk.