Eraxis

Quick links to important sections

Eraxis

Selected form

Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Eraxis

Quick Facts

Property Description
Active Ingredient Anidulafungin
Form Lyophilized powder for injection (IV)
Pharmacological Class Echinocandin antifungal
Typical Use Treatment of severe systemic Candida infections
Origin Semisynthetic (derived from Aspergillus nidulans)

What Type of Medicine is Eraxis (Anidulafungin)?

Eraxis is the brand name for the active ingredient anidulafungin, which belongs to the echinocandin class of antifungal medications. It is provided as a sterile, lyophilized powder in single-dose vials, and is exclusively administered through an intravenous (IV) infusion by a healthcare professional. Eraxis is a prescription-only medication manufactured by Pfizer.

Anidulafungin is a semisynthetic lipopeptide compound, with its origin rooted in the natural fermentation product of the fungus Aspergillus nidulans before chemical refinement. A key differentiating feature is that anidulafungin is not metabolized by the liver's P450 enzymes. This pharmacological independence is clinically recognized, as it means no dosage adjustment is required for patients with kidney or liver impairment, making it a highly reliable choice for critically ill patients with complex conditions.

What is the General Therapeutic Purpose of Eraxis?

The primary therapeutic purpose of Eraxis is to effectively treat severe, life-threatening systemic fungal infections, particularly those caused by Candida species that have invaded the bloodstream, a condition known as candidemia. The echinocandin class, which includes anidulafungin, is widely recognized in clinical guidelines as a first-line treatment for candidemia in many critical care settings.

The medicine's unique benefit stems from its high-level function: it specifically targets and inhibits an enzyme essential for building the fungal cell wall, a structure absent in human cells. This focused action helps to clear deep-seated infections, and is supported by pharmacological studies that confirm its activity against fungal strains that may show resistance to older antifungal agents.

Regulatory References

  1. DailyMed Label for Anidulafungin (Eraxis)

What side effects are possible with Eraxis?

Eraxis: Possible Side Effects and Safety Information

Eraxis (anidulafungin) is an intravenous antifungal medication. The safety profile is characterized by common gastrointestinal and systemic reactions, as well as specific risks involving hypersensitivity and liver function. All information is based on governmental regulatory documents.


Documented Adverse Reactions

Classification Common Reactions (ge1% to <10%)
Gastrointestinal Nausea, vomiting, diarrhea, abdominal pain, dyspepsia
Systemic/Constitutional Pyrexia (fever), peripheral edema, headache, insomnia
Metabolic/Blood Hypokalemia, increased liver function tests (ALT/AST), anemia

Serious and Clinically Significant Adverse Reactions

  • Hypersensitivity: Anaphylactic reactions, including shock, have been reported. Eraxis must be immediately discontinued if such reactions occur.
  • Hepatic Effects: Abnormalities in liver function tests have been observed. Patients should be monitored for signs of worsening hepatic function, including isolated cases of hepatitis or hepatic failure.
  • Infusion-Related Reactions: Reactions such as flushing, rash, pruritus, bronchospasm, and hypotension are possible. To minimize the occurrence of these reactions, the rate of infusion must not exceed 1.1 mg/minute.

Safety Restrictions and Population Considerations

Contraindications:

Eraxis is contraindicated in individuals with a known hypersensitivity to anidulafungin, any component of Eraxis, or other medicines in the echinocandin class. It is also contraindicated in patients with Hereditary Fructose Intolerance (HFI), as the formulation contains fructose.

Population-Specific Notes:

  • Pregnancy and Lactation: Based on animal studies, Eraxis is not recommended during pregnancy due to the potential for fetal harm. It is unknown if anidulafungin is excreted in human milk.
  • Hepatic/Renal Impairment: No dose adjustments are required for patients with any degree of renal insufficiency or hepatic impairment (mild, moderate, or severe). Monitoring of liver function remains necessary for all patients who develop laboratory abnormalities.
  • Pediatric Use: The presence of polysorbate 80 in the formulation is noted due to its association with toxicities in low-birth weight infants. Use in neonates (lt 1 month) is not recommended.

Overdose and Emergency Response

Overdose and When to Seek Help

The official regulatory guidance for Eraxis (Anidulafungin) is clear that immediate medical attention is required in the event of any suspected or known overdose. As with any injectable medicine administered in a critical care setting, all concerns regarding over-exposure must be reported to a healthcare professional immediately.

Feature Official Regulatory Guidance
Documented Manifestations Clinical experience with acute overdose is limited. The only specific finding documented in studies involving doses exceeding the maintenance level was transient, asymptomatic transaminase elevations related to the hepatic system. No clinical adverse events were reported in a documented case involving a single 400 mg dose.
Antidote Status No specific antidote is known or documented in the official prescribing information.
Required Management Treatment must be strictly symptomatic and supportive, utilizing general supportive measures as necessary to maintain essential functions. Patients must be monitored for the occurrence of any potential adverse reactions.
Procedural Constraint The regulatory text specifies that the drug is not dialyzable, meaning hemodialysis is not documented as an effective method for removing the substance from the circulation during management.

The management structure is therefore defined by the absence of a specific reversal agent, necessitating a focus on utilizing supportive measures and monitoring physiological systems. This approach ensures that emergency action is taken immediately and that management adheres precisely to official regulatory mandates.

Therapeutic Uses of Eraxis

What Eraxis Treats

Eraxis is an antifungal medication belonging to the class of drugs known as echinocandins. It is primarily used to treat serious fungal infections caused by Candida, a type of yeast. These infections can affect various parts of the body and are often classified based on their location and severity.

Main Uses

  • Candidemia: This is a serious infection where Candida enters the bloodstream. It requires prompt medical intervention to prevent the fungus from spreading to internal organs.
  • Invasive Candidiasis: This occurs when the fungal infection spreads beyond the bloodstream to deep tissues or organs, such as the abdomen, heart, or kidneys.
  • Esophageal Candidiasis: This is a fungal infection specifically affecting the lining of the esophagus. It can cause difficulty or pain when swallowing and is often seen in individuals with weakened immune systems.

Benefits and Mechanism

Eraxis works by interfering with the production of glucan, a vital component of the fungal cell wall. By inhibiting the enzyme responsible for creating this structural element, the medication weakens the cell wall of the fungus, leading to its destruction.

The primary benefit of this treatment is its ability to target the infection directly while minimizing the impact on human cells, which do not possess a cell wall structure similar to fungi. This targeted approach helps in managing systemic infections that could otherwise become life-threatening.

Eligibility and Restrictions for Use

Who Can and Cannot Use Eraxis (Anidulafungin)?

Eligibility for Eraxis is formally defined by regulatory authorities based on population characteristics and pre-existing conditions.

Populations Excluded From Use (Contraindications)

Eraxis is absolutely contraindicated and must not be used by individuals with a history of hypersensitivity (allergic reaction) to anidulafungin, any of its inactive ingredients, or to any other medicine belonging to the echinocandin class of antifungals. Use is also contraindicated in patients with rare hereditary problems of Fructose Intolerance (HFI).

Age- and Condition-Based Eligibility

Population Group Eligibility Status Key Restriction
Adults Eligible Approved for use in patients 18 years and older.
Children Eligible (Conditional) Approved for patients 1 month of age and older. Safety and efficacy are not established for infants under 1 month.
Renal Impairment Eligible No dosage adjustment is required for any degree of kidney function impairment, including patients on dialysis.
Hepatic Impairment Eligible No dosage adjustment is required for mild, moderate, or severe liver impairment.

Pregnancy and Lactation Status

Eraxis is generally not recommended during pregnancy unless the potential benefit justifies the risk to the fetus. For women who are breastfeeding, a decision is required to either discontinue nursing or discontinue therapy, considering the potential risk to the child.

What should I know about interactions with other medicines?

Eraxis (anidulafungin) is an antifungal medicine with a low potential for drug interactions. Its metabolism is primarily through slow chemical degradation, which means it is not a substrate, inducer, or inhibitor of the Cytochrome P450 (CYP450) enzyme system in the liver. This non-enzymatic clearance pathway minimizes the likelihood of clinically significant interactions with medicines metabolized by these enzymes.

Documented Interactions

Clinical studies have found no need for dosage adjustment when Eraxis is co-administered with several medicines that are often used in patients with serious fungal infections, including:

  • Immunosuppressants: Cyclosporine and Tacrolimus
  • Antifungals: Voriconazole and Liposomal Amphotericin B
  • Antituberculosis Agent: Rifampin

For these specific co-administered agents, the pharmacokinetics of both Eraxis and the other medicine were not significantly altered.

Procedural and Precautionary Notes

To help reduce the risk of infusion-related adverse reactions, the infusion rate of Eraxis must not exceed 1.1 mg per minute.

Eraxis is for intravenous use and its compatibility with other intravenous substances, additives, or medications other than 5% Dextrose or 0.9% Sodium Chloride (normal saline) has not been established. Therefore, Eraxis should not be diluted with other solutions or co-infused with other medications or electrolytes.

Mechanism of Action

Eraxis (anidulafungin) is a member of the echinocandin class of antifungal agents. Its mechanism of action involves the highly specific inhibition of an enzyme critical to the structural integrity of the fungal cell wall.

The primary molecular target is glucan synthase, an enzyme complex present exclusively in fungal cells and absent in mammalian cells.

<<>>

Eraxis acts as a non-competitive inhibitor of this enzyme. By modulating the glucan synthase complex, Eraxis prevents the synthesis of 1,3-beta-D-glucan, which is an essential polysaccharide component providing rigidity and shape to the fungal cell wall. The loss of this critical structural element triggers a mechanistic cascade: the cell wall destabilizes, compromising its integrity.

<<>>

The physiological consequence of this structural compromise is osmotic instability, leading to lysis of the fungal cell and the release of intracellular contents. This targeted, disruption of the cellular structural framework results in the functional inactivation of the fungal organism.

Dosage and Administration Information

Eraxis (anidulafungin) is administered only as a slow intravenous (IV) infusion and must not be given as a rapid bolus injection. Treatment begins with a higher loading dose on Day 1, followed by a lower maintenance dose once daily thereafter.

Official Dosing Regimen

Infection Type Day 1 (Loading Dose) Day 2 and Thereafter (Maintenance Dose)
Candidemia/Invasive Infections (Adults) 200 mg 100 mg once daily
Esophageal Candidiasis (Adults) 100 mg 50 mg once daily
Pediatric Patients (1 month to < 18 years) 3.0 mg/kg (max 200 mg) 1.5 mg/kg (max 100 mg)

Preparation and Administration Rules

Eraxis is supplied as a lyophilized powder and requires a two-step preparation process before administration. The vial must first be reconstituted with sterile Water for Injection, followed by dilution with either 0.9% Sodium Chloride (normal saline) or 5% Dextrose Injection to a final concentration of 0.77 mg/mL.

Infusion Time: The administration rate must not exceed 1.1 mg/minute. Consequently, a 200 mg dose requires a minimum infusion time of 180 minutes (3 hours), and a 100 mg dose requires 90 minutes.

Special Populations: No dose adjustment is required for adult patients with any degree of renal or hepatic impairment. The drug may be administered without regard to the timing of hemodialysis.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Eraxis (Anidulafungin)


Evidence for Use in Candidemia and Invasive Candidiasis

The primary evidence exploring anidulafungin's use for severe, systemic fungal infections, particularly bloodstream infections (known as candidemia), comes from large-scale, short-term Randomized Controlled Trials (RCTs). These studies were designed to observe and measure patient outcomes under controlled research conditions, often including another antifungal agent as a comparator group.

In these studies, researchers monitored various outcomes related to physical discomfort and systemic or functional imbalance. The main measure used was a composite endpoint called Global Response, which tracked the measurement of clinical status (defined as resolution or improvement of signs and symptoms) and microbiological status (defined as the eradication of the Candida species from the blood or other normally sterile sites). Research examined how these outcomes evolved in critically ill patients and individuals diagnosed with confirmed Candida infection.


Evidence in Special Populations

Research examined anidulafungin's use in several special patient populations, using dedicated studies to monitor physiological strain or stress and confirm the drug's behavior.

  • Kidney and Liver Impairment: Studies monitored anidulafungin in adults with pre-existing hepatic impairment (liver dysfunction) and renal insufficiency (kidney impairment). The research examined the drug's concentration and elimination patterns in these groups, with findings describing patterns in the drug's concentration and elimination for these specific contexts.
  • Pediatric Patients: Anidulafungin was evaluated in a broad age range of pediatric patients, including neonates, infants, and older children. Research examined how the drug was processed by the body in these younger populations to help inform the necessary concentration ranges.

What Remains Uncertain: Evidence Gaps and Limitations

While a significant evidence base exists, several areas in the research record are documented as being limited or insufficient: evidence is limited for adult and pediatric patients diagnosed with invasive Candida infections who also have neutropenia (an abnormally low white blood cell count). Research for specific, deep-seated infections such as endocarditis or meningitis has been confined to smaller studies or case reports, meaning certainty remains low for generalized findings.

Frequently Asked Questions (FAQ)

Common questions about Eraxis (FAQ)

Q: Is Eraxis the same kind of medication as fluconazole?

Eraxis belongs to a group of medicines called echinocandins, which is a distinct class of antifungal drug. Official documents state that Eraxis works differently than medications like fluconazole. Clinical studies have sometimes used fluconazole as a comparison drug to evaluate Eraxis.

Q: How long does the treatment with Eraxis usually last?

The official length of treatment depends on the patient’s clinical response and the specific infection being treated. For infections in the bloodstream (candidemia), regulatory documents indicate therapy should continue for at least 14 days after the last positive culture.

Q: Can Eraxis be used to treat skin or nail infections?

According to official product information, Eraxis is indicated for the treatment of specific deep-seated or systemic infections, such as invasive candidiasis. It is not indicated for the treatment of superficial fungal infections, such as those affecting the skin or nails.

Q: Are there any specific foods or drinks to avoid while receiving Eraxis?

Regulatory labeling advises that patients should discuss the use of any medication, including Eraxis, with their healthcare provider in relation to food, alcohol, or tobacco consumption. Following specific instructions from a healthcare provider about any activity or dietary restrictions is part of the treatment protocol.

Q: What happens if I miss a dose of Eraxis?

Official patient guidance provides specific instructions regarding missed doses, including when to skip a dose and when to administer it as soon as possible. The guidance also advises against using extra medication to make up for a missed dose.

Q: Does Eraxis have a warning about heart problems?

While no specific warning about pre-existing heart disease is listed, infusion-related reactions such as low blood pressure (hypotension) are reported as a common event in clinical studies. The infusion rate is carefully controlled to help minimize the risk of such reactions.

Q: How long does Eraxis stay in your system after the final dose?

Pharmacological data indicates that the medicine, anidulafungin, has an elimination half-life of approximately 40 to 50 hours. The half-life refers to the time it takes for the amount of medicine in the body to decrease by half.

Q: What kind of specialist usually prescribes Eraxis?

Official regulatory documents specify that the initiation of treatment with Eraxis is generally reserved for a physician who is experienced in managing severe or invasive fungal infections. This is due to the nature of the serious infections it is designed to treat.

Q: How does Eraxis compare to caspofungin in terms of the kind of infections treated?

Eraxis belongs to the echinocandin class of antifungals, which also includes caspofungin. Official documentation states that patients should not use Eraxis if they have a known hypersensitivity to any medicine in the echinocandin class. The regulatory label does not include direct comparisons between these medications.

Q: Does Eraxis interact with blood thinners like warfarin?

According to clinical study data, using Eraxis alongside blood-thinning medications like warfarin may potentially increase the effect of the warfarin. Official guidance describes that monitoring of blood parameters, such as the International Normalized Ratio (INR), is typically included in the management when these two medications are co-administered.

Q: Is Eraxis effective against mold infections?

Eraxis is officially indicated for the treatment of Candida species infections. While laboratory studies suggest activity against certain molds, the drug is not specifically indicated for the treatment of mold infections like aspergillosis.

Q: What does the research say about Eraxis use in elderly patients?

Official product information confirms that no dosing adjustments are required for adult patients based solely on age, including elderly patients. Research has not indicated any geriatric-specific problems that limit the usefulness of the medicine in this population.

Q: Can Eraxis cause changes in mood or confusion?

Regulatory documentation lists insomnia (inability to sleep) as a common side effect, which is related to the central nervous system. However, specific side effects such as mood changes or confusion are not listed among the common or serious adverse reactions in the official product information.

Q: How often do the serious side effects of Eraxis occur?

Official documents classify serious adverse reactions, such as hepatic dysfunction or failure, as uncommon events. This means they are reported to occur in less than 1 out of every 100 patients, but in at least 1 out of every 1,000 patients in clinical trials.

Q: Do studies show Eraxis is effective for common candida infections?

Studies examining the use of Eraxis for invasive candidiasis measured a combined outcome called Global Response, which tracks clinical improvement and fungal eradication. One main study reported that a high proportion of patients achieved this Global Response endpoint at the conclusion of the IV therapy.

Q: What is the risk of having an allergic reaction to Eraxis?

Infusion-related reactions, such as flushing, rash, or bronchospasm, are known to occur. Official information specifies that the intravenous infusion rate is carefully controlled to a certain limit to help reduce the possibility of these reactions.

Q: Does Eraxis require any specific blood tests while you are receiving it?

Regulatory documents state that monitoring for signs of worsening liver function (hepatic function) is part of the required protocol during therapy. This monitoring is carried out through laboratory blood tests.

Q: Is there any research about the long-term effects of Eraxis?

Studies that support the use of Eraxis primarily involved treatment durations of up to 42 days. Official documentation indicates there is insufficient data available to fully support the use of the drug for certain infections that require therapy longer than 35 days.

Q: Does Eraxis contain any ingredients that could cause issues for people with certain allergies?

Official information warns that Eraxis is contraindicated in patients with a known allergy to anidulafungin or any component of the medication, including its excipients. It is also contraindicated for patients allergic to any medicine belonging to the echinocandin class of antifungals.

Q: What is the purpose of the 'loading dose' of Eraxis that is sometimes given?

A higher initial dose, known as a loading dose, is administered on the first day of treatment. The pharmacological purpose of this is to help the drug reach its steady-state concentration in the plasma as quickly as possible.

Q: Is Eraxis considered a 'last resort' drug for fungal infections?

Regulatory and clinical guidelines widely recognize the echinocandin class of medicines, which includes Eraxis, as a first-line treatment for invasive candidiasis in many critical care settings. It is therefore not typically considered a 'last resort' drug.

Q: What are the major themes reported in clinical trials for Eraxis?

Clinical trials for Eraxis focused on a key measure called Global Response. This measure tracked whether the patient's symptoms improved and whether the Candida species was successfully eliminated from the patient’s body.

Q: Do studies investigate the use of Eraxis in cancer patients?

Studies have included a limited number of patients with neutropenia, which is a condition involving a low white blood cell count often seen in patients receiving cancer therapy. Research in this specific patient context has been conducted to examine the drug's effects.

How should Eraxis be stored and disposed of?

Official Storage and Handling

The required storage conditions for Eraxis (anidulafungin) are defined by the product's stage, based on official regulatory labeling.

Product Stage Required Conditions Stability Time Limit
Unreconstituted Vials Refrigerated (2 C to 8 C); Do not freeze. 96 hours permitted up to 25 C
Reconstituted Solution Store at up to 25 C Up to 24 hours
Final Infusion Solution Store at up to 25 C; Do not freeze. Up to 48 hours

All prepared solutions must be visually inspected for particulate matter or discoloration prior to administration; if identified, the solution must be discarded. Disposal of unused Eraxis product, along with associated waste materials such as needles and syringes, must be conducted according to local regulations, and sharps must be kept out of the reach of children.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

Available in countries:

Equivalent of Eraxis found in:

A-Z Index: