How is anidulafungin given?

It is administered only as an intravenous infusion in a healthcare setting, typically as a loading dose followed by once-daily maintenance doses.

Is anidulafungin well tolerated?

Echinocandins are generally well tolerated; reported effects include infusion-related reactions and transient liver enzyme elevations, and monitoring is done by the treating team.

Does anidulafungin need dose adjustment for kidney or liver problems?

Because it is cleared by non-enzymatic degradation rather than the kidneys or liver, it usually does not require dose adjustment, but this is a clinical decision.

EMA-approvedaka Eraxis, Ecalta

Anidulafungin — Complete Research Guide (2026)

Q: How does anidulafungin work?

It inhibits beta-1,3-glucan synthase, disrupting the fungal cell wall in a way that does not affect human cells.

Last updated 2026-06-30

TL;DR

Anidulafungin (also known as Eraxis) is a peptide catalogued under Cyclic & Antimicrobial (Echinocandin). It is described as: β-1,3-glucan synthase. Documented context: Invasive candidiasis. Neutral reference entry; EU status: EU-approved prescription medicine.

What is Anidulafungin?

Anidulafungin (brand names Eraxis in the US and Ecalta in the EU) is an echinocandin antifungal, a semi-synthetic cyclic lipopeptide administered intravenously.

It is approved by the FDA and EMA for candidaemia and other forms of invasive candidiasis, and for oesophageal candidiasis, on the basis of randomised controlled trials in adults.

Evidence level is high: its use is supported by pivotal human phase 3 RCTs, and echinocandins are first-line agents for invasive candidiasis in major guidelines.

How does Anidulafungin work?

Anidulafungin non-competitively inhibits beta-1,3-glucan synthase, an enzyme absent in mammalian cells, blocking synthesis of beta-1,3-glucan in the fungal cell wall.

The resulting loss of cell-wall integrity is fungicidal against most Candida species and fungistatic against Aspergillus.

What does the research say about Anidulafungin?

In a pivotal phase 3 RCT, anidulafungin was non-inferior and numerically superior to fluconazole for treating invasive candidiasis and candidaemia in adults. ^[1]
It remained effective in a prespecified analysis of severely ill patients with candidaemia and other invasive candidiasis. ^[2]
In a double-blind RCT it was highly effective for endoscopically confirmed oesophageal candidiasis, comparable to oral fluconazole. ^[3]

Clinical research & studies

The references below are the primary sources cited throughout this guide. Each links directly to PubMed or the regulator. Where evidence is preclinical (animal or in-vitro), that is stated rather than implied.

[1] Anidulafungin versus fluconazole for invasive candidiasis — Reboli AC et al., The New England Journal of Medicine 2007. (Randomized controlled trial (phase 3))
[2] Anidulafungin compared with fluconazole in severely ill patients with candidemia and other forms of invasive candidiasis — Kett DH et al., Critical Care 2011. (Randomized controlled trial (subgroup analysis))
[3] A randomized, double-blind trial of anidulafungin versus fluconazole for the treatment of esophageal candidiasis — Krause DS et al., Clinical Infectious Diseases 2004. (Randomized controlled trial)
[4] Population pharmacokinetic analysis of anidulafungin, an echinocandin antifungal — Dowell JA et al., Journal of Clinical Pharmacology 2004. (Population pharmacokinetic analysis)
[5] Therapeutic Drug Monitoring of the Echinocandin Antifungal Agents: Is There a Role in Clinical Practice? — Kim HY et al., Therapeutic Drug Monitoring 2022. (Review / consensus statement)

Dosing context

This is not medical advice or a usage recommendation. Dosing figures are reported research context only, cited from the published literature.

In clinical trials anidulafungin was given intravenously as a single loading dose followed by a lower once-daily maintenance infusion.

This is context only and not a dosing recommendation; actual regimens are determined by the treating physician based on indication and patient factors.

Side effects & safety profile

Echinocandins including anidulafungin are generally well tolerated, with infusion-related (histamine-mediated) reactions and transient elevations in hepatic transaminases among the more commonly reported effects.

It undergoes non-enzymatic degradation rather than hepatic metabolism, so it has few cytochrome P450 drug interactions and typically needs no renal or hepatic dose adjustment.

This is educational information only; anidulafungin is a hospital-administered prescription medicine and any use must be directed and monitored by a clinician.

Stacking & combinations

Anidulafungin is a prescription-only intravenous antifungal and is not a supplement or peptide intended for self-directed combination or stacking.

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Frequently asked questions

It is approved for candidaemia and other forms of invasive candidiasis, and for oesophageal candidiasis, in adults.

References

[1] Anidulafungin versus fluconazole for invasive candidiasis — Reboli AC et al., The New England Journal of Medicine 2007. PMID: 17568028. View sourceStudy: Randomized controlled trial (phase 3)Anidulafungin was non-inferior and numerically superior to fluconazole for invasive candidiasis and candidaemia.
[2] Anidulafungin compared with fluconazole in severely ill patients with candidemia and other forms of invasive candidiasis — Kett DH et al., Critical Care 2011. PMID: 22026929. View sourceStudy: Randomized controlled trial (subgroup analysis)Anidulafungin showed favourable outcomes versus fluconazole in more severely ill patients.
[3] A randomized, double-blind trial of anidulafungin versus fluconazole for the treatment of esophageal candidiasis — Krause DS et al., Clinical Infectious Diseases 2004. PMID: 15472806. View sourceStudy: Randomized controlled trialAnidulafungin achieved high endoscopic cure rates in oesophageal candidiasis, comparable to fluconazole.
[4] Population pharmacokinetic analysis of anidulafungin, an echinocandin antifungal — Dowell JA et al., Journal of Clinical Pharmacology 2004. PMID: 15145966. View sourceStudy: Population pharmacokinetic analysisAnidulafungin pharmacokinetics support a loading-dose plus once-daily regimen with no renal/hepatic adjustment.
[5] Therapeutic Drug Monitoring of the Echinocandin Antifungal Agents: Is There a Role in Clinical Practice? — Kim HY et al., Therapeutic Drug Monitoring 2022. PMID: 34654030. View sourceStudy: Review / consensus statementReviews echinocandin exposure, tolerability and monitoring considerations across the drug class.

This article is for educational and research purposes only. Peptides discussed here are not approved for human consumption by the FDA, EMA, or equivalent regulators outside of specific clinical contexts. Always consult a licensed medical professional before any therapeutic use.