Comprehensive medication guide to Micafungin including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
Covered under Medicare Part B with 20% co-insurance after the annual deductible; commercial insurance covers through the medical benefit with applicable deductible and co-insurance. Specialty tier co-pays may apply if billed through the pharmacy benefit for home infusion.
Estimated Cash Pricing
Generic micafungin 50 mg vials start around $28 to $80 per vial and 100 mg vials around $47 to $150 at specialty pharmacy prices; brand Mycamine is significantly more expensive. Hospital contract pricing is typically lower than retail estimates.
Medfinder Findability Score
72/100
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Micafungin (brand name Mycamine) is an intravenous antifungal medication belonging to the echinocandin drug class. It was first approved by the FDA in 2005 and is manufactured by Astellas Pharma under the Mycamine brand name, with generic versions now available from multiple manufacturers. It is indicated for the treatment and prevention of serious Candida fungal infections in adults and pediatric patients, including neonates less than 4 months old.
Micafungin is administered as an intravenous infusion over approximately one hour, once daily. It is not available in oral form. It is typically given in hospitals, outpatient infusion centers, or through home infusion pharmacy services. FDA-approved indications include candidemia, acute disseminated candidiasis, Candida peritonitis and abscesses, esophageal candidiasis, and prophylaxis of Candida infections in hematopoietic stem cell transplant (HSCT) recipients.
Micafungin is not a controlled substance and has no abuse potential. It is widely used in hospitalized, immunocompromised patients including those with cancer, organ transplants, HIV/AIDS, and those in intensive care with central venous catheters who are at elevated risk for invasive fungal infections.
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Micafungin belongs to the echinocandin class of antifungals and works by blocking the enzyme beta-1,3-D-glucan synthase, which is responsible for building the fungal cell wall. Beta-1,3-D-glucan is a key structural carbohydrate polymer in the cell walls of Candida and other fungi. By inhibiting this enzyme, micafungin prevents fungal cells from constructing and maintaining their protective cell wall, causing them to weaken and ultimately die.
This mechanism is highly selective because human cells do not have cell walls or produce beta-1,3-D-glucan. As a result, micafungin attacks structures unique to fungi, contributing to its relatively favorable tolerability compared to older antifungals like amphotericin B. Micafungin is fungicidal (kills fungi) against most Candida species and fungistatic (stops growth) against Aspergillus species.
Micafungin has linear pharmacokinetics, does not require a loading dose, and achieves approximately 85% of steady-state concentrations after just three daily doses. It is highly protein-bound (over 99%), distributed primarily to the lungs, liver, spleen, and kidneys, and eliminated mainly through biliary (fecal) excretion. It does not require dose adjustment for renal impairment and is not removed by hemodialysis.
50 mg — vial (IV injection)
Used for HSCT prophylaxis (50 mg once daily) and pediatric weight-based dosing
100 mg — vial (IV injection)
Standard adult dose for candidemia and invasive candidiasis (100 mg once daily)
150 mg — reconstituted from 100 mg vial
Adult dose for esophageal candidiasis (150 mg once daily)
4 mg/kg — weight-based IV
Neonatal dose for candidemia in patients under 4 months old
As of 2026, micafungin is not listed on the FDA Drug Shortage Database, and multiple generic manufacturers supply the market, providing reasonable supply stability. However, micafungin's unique characteristics as an IV-only specialty medication mean that access challenges can arise even without a formal shortage. It is not available at retail pharmacies. Access depends on your care setting: hospital pharmacies generally maintain formulary stock, while home infusion pharmacies may have variable availability and lead times of 2 to 5 business days to source the medication.
For patients and caregivers trying to locate micafungin at a specialty pharmacy near them, medfinder contacts pharmacies on your behalf and texts you results showing which ones can fill your prescription, saving significant time compared to calling pharmacies individually.
The overall findability score for micafungin is 72 out of 100, reflecting general availability through hospital and institutional channels with some challenges at the home infusion specialty pharmacy level. Patients being discharged from hospital to home infusion should coordinate pharmacy sourcing at least 48 to 72 hours before discharge to avoid treatment gaps.
Micafungin is not a controlled substance, so there are no DEA scheduling restrictions on who can prescribe it. However, because its indications (candidemia, invasive candidiasis, HSCT prophylaxis) require specialist-level diagnosis and management, it is primarily prescribed by hospital-based and specialty physicians. The following providers most commonly prescribe micafungin:
Infectious disease (ID) physicians and ID clinical pharmacists
Transplant hematologists and oncologists
Hospitalists and critical care physicians (intensivists)
Neonatologists (for neonatal candidiasis)
Nurse practitioners and physician assistants in ID or transplant settings
Telehealth prescribing is not applicable for micafungin initiation, as the drug requires intravenous administration and diagnosis requires laboratory-based testing (blood cultures, imaging). Follow-up monitoring visits may sometimes be conducted via telehealth once therapy is established, depending on the health system.
No. Micafungin is not a controlled substance and has no DEA scheduling. It does not carry abuse potential, dependence risk, or diversion concerns. There are no special prescription requirements, quantity limits, or refill restrictions related to controlled substance status.
Although micafungin is not controlled, it does require a physician's prescription, and because it is an intravenous specialty medication, it can only be dispensed through hospital pharmacies, specialty pharmacies with IV preparation capabilities, or licensed home infusion pharmacy services. Retail pharmacies do not dispense micafungin.
Micafungin is generally well-tolerated compared to older antifungal agents. Common side effects include:
Nausea, diarrhea, and vomiting
Fever (pyrexia)
Headache
Elevated liver enzymes (transaminase elevation)
Low platelet count (thrombocytopenia)
Rash, itching (pruritus), and flushing — especially if infused too quickly
Anaphylaxis and anaphylactoid reactions including shock — seek emergency care immediately
Hemolytic anemia and hemoglobinuria (red or brown urine) — report to doctor immediately
Clinically significant liver damage — monitor liver function tests throughout therapy
Kidney damage — monitor renal function during treatment
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Caspofungin (Cancidas)
Echinocandin; daily IV; first-line for candidemia, aspergillosis; loading dose required; dose adjustment needed for moderate hepatic impairment
Anidulafungin (Eraxis)
Echinocandin; daily IV; no hepatic or renal dose adjustment; fewest drug interactions; loading dose required
Rezafungin (Rezzayo)
Newest echinocandin (FDA 2023); once-weekly IV dosing; convenient for outpatient use; approved for candidemia and invasive candidiasis in adults
Fluconazole (Diflucan)
Azole antifungal; oral and IV; step-down therapy for stable patients with fluconazole-susceptible Candida; not appropriate as empiric therapy for candidemia
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Sirolimus (Rapamune)
moderateMicafungin increases sirolimus AUC by approximately 21%. Monitor sirolimus levels and reduce dose if toxicity occurs.
Nifedipine (Procardia, Adalat)
moderateMicafungin increases nifedipine AUC by 18% and Cmax by 42%. Monitor blood pressure and reduce nifedipine dose if hypotension or other toxicity occurs.
Itraconazole (Sporanox)
moderateMicafungin increases itraconazole AUC by 22% and Cmax by 11%. Monitor for itraconazole toxicity.
Saccharomyces boulardii (Florastor)
majorMicafungin decreases the effectiveness of S. boulardii probiotic supplements. Avoid combination during antifungal treatment.
Lonafarnib (Zokinvy)
majorMicafungin may increase lonafarnib levels via weak CYP3A4 inhibition. Avoid combination if possible; reduce lonafarnib dose and monitor QT interval if coadministration is unavoidable.
Micafungin is a cornerstone therapy for serious Candida infections, offering a favorable safety profile, predictable pharmacokinetics, minimal drug interactions, and FDA approval across all age groups including neonates. It is generally available through hospital and specialty pharmacy channels in 2026, with no active FDA shortage as of the time of writing.
Access challenges for micafungin are largely logistical rather than supply-related — primarily due to its IV-only formulation, specialty pharmacy requirements, and insurance prior authorization complexity. Patients transitioning from hospital to home infusion therapy should work closely with their care team to coordinate home pharmacy access well before discharge.
If you or a loved one is having difficulty finding micafungin at a specialty pharmacy near you, medfinder can help by contacting pharmacies on your behalf to identify which ones have the medication in stock, saving you time and reducing the stress of an already difficult situation.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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