title: Pharmacokinetics of micafungin in patients undergoing allogeneic hematopoietic stem cell transplantation.
abstract: OBJECTIVE
  Micafungin (MCFG) is an antifungal agent that is widely used for the treatment of invasive fungal infection. Although the pharmacokinetics of MCFG is considered to depend on the hepatic metabolism, the impact of hepatic function on the pharmacokinetics of MCFG has been inconsistent among previous studies. The object of this study was to evaluate the relationship between plasma MCFG concentration and clinical and laboratory data.
  
  
  METHODS
  We examined the plasma concentration of MCFG in 10 patients who underwent allogeneic hematopoietic stem cell transplantation (HSCT). MCFG at 150 mg/day was administered intravenously a median of 58.5 days after HSCT. Trough and peak concentrations of MCFG (Cmin and Cmax) were measured at a median of 5.5 days after the first administration of MCFG.
  
  
  RESULTS
  The presence of graft-versus-host disease involving the liver at blood sampling was associated with significantly higher Cmin and Cmax of MCFG. Among the laboratory data, Cmin and Cmax were significantly higher in patients with severely impaired hepatic function defined as serum total bilirubin (TBi) level >5 mg/dL and/or serum gamma-glutamyltransferase (γ-GTP) level >500 IU/L, but the presence of mildly impaired hepatic function defined as serum TBi level >2 mg/dL and/or serum γ-GTP level >200 IU/L did not affect Cmin and Cmax. Renal function did not show significant impact on Cmin and Cmax.
  
  
  CONCLUSIONS
  These findings suggest that the pharmacokinetics of MCFG is affected only by severely impaired liver function.
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Oshima
authors.forename: Y
authors.initials: Y
authors.lastname: Kanda
authors.forename: S
authors.initials: S
authors.lastname: Kako
authors.forename: K
authors.initials: K
authors.lastname: Ohno
authors.forename: S
authors.initials: S
authors.lastname: Kishino
authors.forename: M
authors.initials: M
authors.lastname: Kurokawa
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000493:pharmacokinetics*; D054714:Echinocandins / Q000008:administration & dosage / Q000493:pharmacokinetics*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D055666:Lipopeptides / Q000008:administration & dosage / Q000493:pharmacokinetics*; D008099:Liver / Q000378:metabolism; D008111:Liver Function Tests; D008297:Male; D000077551:Micafungin; D008875:Middle Aged; D009181:Mycoses / Q000097:blood / Q000188:drug therapy*; D014184:Transplantation, Homologous / Q000009:adverse effects; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000077551:Micafungin