Who can administer
  
                  May be administered by registered competent doctor or nurse/midwife
      
  
        Important information
  
                  
- Reserve antimicrobial:  Restricted for indications in the antimicrobial prescribing guidelines, or following approval by microbiology/infectious diseases 
 
      
  
        Available preparations
  
                  REZZAYO 200mg vial (Mundipharma pharmaceuticals) 
      
  
        Reconstitution
  
                  Water for injection
9.5 mL per 200mg vial (produces a 20mg per ml solution). 
- Do NOT shake. To avoid foaming it is recommended that diluent should be added carefully, along the walls of the vials gently swirling the vial for up to 5 minutes until the powder is dissolved. The solution should be a clear, colourless to pale yellow colour.
 
- The reconstituted solution should be visually inspected for particulate matter and/or discolouration. If irregularities are found, do not use the vial.  
 
Dilute further prior to administration
      
  
        Infusion fluids
  
                  Sodium chloride 0.9% or Glucose 5%
      
  
        Methods of intravenous administration
  
                  Intermittent intravenous infusion
- Add required dose to 250mL infusion fluid
 
- Administer over 60 minutes using an electronically controlled infusion device
 
- Administer over 180 minutes if the patient experiences an infusion-related reaction (see monitoring section below) 
 
      
  
        Dose in adults
  
                  Invasive candidiasis 
- Give a single 400mg (loading dose) on Day 1, followed by 200mg (maintenance dose) on Day 8 and once weekly thereafter
 
- The duration of treatment should be based upon the patient's clinical and microbiological response. In general, antifungal therapy should continue for at least 14 days after the last positive culture
 
- See Under Further Information below re missed or omitted doses
 
Hepatic impairment
- No dosage adjustment required
 
Renal impairment
- No dosage adjustment required
 
      
  
        Monitoring
  
                  Acute reactions
- Infusion related reactions including flushing, sensation of warmth, nausea, chest tightness, pyrexia, hypotension, skin changes including erythema, rash, phototoxicity, urticaria, wheezing and tremor
 
- If infusion-related reactions occur, stop treatment and restart at a slower rate once symptoms have resolved
 
Note: contains polysorbate 80 as an excipient which may cause hypersensitivity reactions including anaphylaxis.
Monitor
- Hepatic function
 
- Monitor for infusion-related reactions for the duration of the infusion
 
- Advise patients to avoid sun exposure and other sources of UV radiation without adequate protection during treatment and for 7 days after the last dose of rezafungin
 
      
  
        Further information
  
                  
- If a scheduled dose is missed (not given on the assigned day) the missed dose should be administered as soon as possible. 
 
- If the missed dose is administered within 3 days of the assigned day, the next weekly dose may be given on schedule. 
 
- If the missed dose is administered more than 3 days after the assigned day, the dosing schedule should be revised to ensure there are at least 4 days before the next dose. 
 
- If administration is restarted after at least 2 weeks of missed dosing, the dosing should be started again at the 400 mg loading dose.
 
      
  
        Storage
  
                  Store below 250C
      
  
        References
  
                  
REZZAYO (Mundipharma Pharmaceuticals) SPC 01/04/2025
1. Injectable Medicines Guide, Downloaded from Medusa, 03/11/2025
      
  
        Therapeutic classification
  
                  Antifungal agent