Rezafungin
Echinocandins
Echinocandins
Very long-acting IV echinocandin: one weekly infusion treats candidaemia and invasive candidiasis in adults with few options.
Also called: rezafungin acetate
Quick facts
- Group
- Echinocandins
- Target
- β-1,3-D-glucan synthase (Fks1 catalytic subunit)
- Used for
- Candidaemia and invasive candidiasis
- Key effects
- Diarrhoea · Fever · Tremor
- Monitor
- Liver tests · Follow-up blood cultures
- ATC
- J02AX08
No doses: the clinician sets them by the current guideline.
Mechanism of action
The figure shows caspofungin, another echinocandin, bound to yeast Fks1 glucan synthase; rezafungin acts on the same enzyme.
Like the other echinocandins, rezafungin inhibits the fungal membrane glucan synthase and halts synthesis of β-1,3-D-glucan, the scaffold of the wall. The wall weakens and the yeast dies. Its distinctive feature is a very long half-life, which allows weekly dosing.
- Binds the fungal glucan synthase (Fks1)
- β-1,3-D-glucan synthesis halts
- The Candida wall weakens and breaks
- Its long half-life allows one dose a week
Indications
- Candidaemia and invasive candidiasis in adults when other options have failed or are not available Candidiasis: oral, oesophageal and invasive →
Adverse effects
Common
- Diarrhoea, nausea, vomiting, abdominal pain and constipation
- Fever, tiredness and weakness
- Tremor
Contraindications
- Allergy to rezafungin or other echinocandins (caspofungin, micafungin, anidulafungin)
Key interactions
- Other medicines and herbal products
- All are reviewed before starting; the doctor may adjust or monitor.
What is monitored
- Liver tests, above all with previous liver disease
- Follow-up blood cultures
- Signs of reaction during the infusion
Administration and safety
- IV infusion once a week, at a health facility
- If an appointment is missed it is rescheduled; a delay of more than 3 days means the schedule is revised
- Name looks like the other «-fungins» (caspofungin, micafungin, anidulafungin) given daily: the product and interval are checked
Nursing care
- Ask about liver disease and echinocandin allergy
- Teach sun protection: clothing, sunglasses and sunscreen
- Watch for flushing, itching or chest tightness during the infusion
- Explain to men that it may lower sperm count
Pharmacokinetics
- Absorption
- IV only.
- Half-life
- Very long, allowing one infusion a week.
Test yourself
Think of the answer, then tap the question to see it.
What sets rezafungin apart from caspofungin and micafungin?
Its very long half-life, which allows a weekly infusion instead of a daily one.
Which enzyme do echinocandins such as rezafungin act on?
β-1,3-D-glucan synthase, which makes the glucan of the fungal wall.
What skin advice is given to someone receiving rezafungin?
Sun protection, because it can cause photosensitivity.
Connections
← Back to the class: Echinocandins
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Rezafungin Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); Structure of beta-1,3-glucan synthase in complex with caspofungin, Rho1 and long glucan (RCSB Protein Data Bank, 2026).
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Representative model, for educational purposes only.