What Is Micafungin? Uses, Dosage, and What You Need to Know in 2026

Micafungin is an antifungal medication used to treat and prevent serious Candida infections. It belongs to a class of drugs called echinocandins and works by attacking the fungal cell wall, causing the fungi to die. Sold under the brand name Mycamine, it is available as a generic medication and is administered intravenously (through the vein). Here is a comprehensive patient-friendly guide to understanding micafungin in 2026.

What Is Micafungin Used For?

Micafungin is FDA-approved for four main uses in adults and most pediatric patients:

Candidemia — Treatment of Candida (yeast/fungal) infections in the bloodstream, also called a Candida bloodstream infection

Acute disseminated candidiasis, Candida peritonitis, and abscesses — Invasive Candida infections that have spread to internal organs, the abdominal cavity, or formed abscesses

Esophageal candidiasis — A Candida infection of the esophagus (the tube connecting your throat to your stomach), commonly seen in people with weakened immune systems

Prophylaxis in HSCT recipients — Prevention of Candida infections in patients who have undergone a hematopoietic stem cell transplant (bone marrow transplant), whose immune systems are severely weakened by the transplant process

Micafungin is also sometimes used for Candida auris infections as initial therapy, as recommended by the CDC for this emerging drug-resistant fungal pathogen.

Who Takes Micafungin?

Micafungin is approved for adults, children, and even newborns less than 4 months old (for specific indications). Patients who most commonly receive it include:

Cancer patients undergoing chemotherapy, whose immune systems are suppressed

Bone marrow and organ transplant recipients

Patients in the intensive care unit (ICU) with central venous catheters

People living with HIV/AIDS

Premature and newborn infants in neonatal intensive care units

How Is Micafungin Given?

Micafungin is only available as an intravenous (IV) medication. It comes as a powder that is dissolved in fluid and infused through a vein over approximately one hour, once per day. There is no pill or oral form available. The medication must not be mixed with or given at the same time as other IV medications through the same line, as it can precipitate (form particles) when mixed with many commonly used drugs.

Micafungin Dosing for Adults

Standard adult dosing depends on the indication:

Candidemia, disseminated candidiasis, peritonitis/abscesses: 100 mg IV once daily

Esophageal candidiasis: 150 mg IV once daily

HSCT prophylaxis: 50 mg IV once daily

No loading dose is required. Approximately 85% of steady-state drug concentrations are achieved after just 3 daily doses. No dose adjustment is needed for kidney disease, and modest hepatic differences (about 22% reduction in drug levels in moderate liver impairment) do not require dose changes.

Micafungin Dosing for Children (4 Months and Older)

Pediatric dosing is based on body weight. Children weighing more than 40 kg generally use adult doses, while those under 40 kg use weight-based dosing (typically 2 to 4 mg/kg/day depending on indication).

Micafungin for Neonates (Under 4 Months)

In 2020, the FDA approved micafungin for the treatment of candidemia in infants younger than 4 months old, making it the first antifungal drug specifically approved for this population in the United States. The approved neonatal dose is 4 mg/kg once daily. This is significant because Candida infections in newborns are associated with approximately 20% mortality.

How Long Is a Course of Micafungin?

Treatment duration depends on your specific infection. For candidemia, treatment should continue for at least 14 days after the last positive blood culture and resolution of symptoms, with an average duration of about 15 days (range 10 to 47 days). For esophageal candidiasis, the average is also around 15 days (range 10 to 30 days). For HSCT prophylaxis, treatment averages 19 days (range 6 to 51 days).

Is Micafungin a Controlled Substance?

No. Micafungin is not a controlled substance and has no DEA scheduling. It does not have abuse or dependence potential.

To understand how micafungin actually kills fungal infections, read our explainer on how micafungin works: mechanism of action explained in plain English.