Micafungin is a selective inhibitor of 1,3-β-D-glucan synthesis and effectively inhibits the production of the fungal cell wall.

Human cells do not have a cell wall, nor do their cells contain 1,3-β-D-glucan. This explains the good tolerability of echinocandins, even at a high dose.

Micafungin has linear dose proportional PK over a dose range of 0.15–8 mg/kg.

Exposure to micafungin is considerably lower in critically ill patients, including burn patients. These patients could benefit from an augmented dose of micafungin 150–200 mg.

The clearance of micafungin is much higher in neonates and older children and these populations receive a considerably higher weight-corrected dose than adults.

High-dose micafungin is a candidate for less frequent dosing (i.e. 200 mg every 48 h, or 300 mg every 72 h) due to its favorable toxicity profile and a possible post-antifungal effect, as well as practical reasons.