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Am Fam Physician. 2022;106(3):324-325

Author disclosure: No relevant financial relationships.

Ibrexafungerp (Brexafemme) is an antifungal labeled for the treatment of vulvovaginal candidiasis in adult and postmenarchal adolescent female patients.1 Ibrexafungerp inhibits glucan synthase, an enzyme necessary for creation of the fungal cell wall, which is active against most fluconazole (Diflucan)–resistant Candida species.

DrugDosageDose formCost of full course*
Ibrexafungerp (Brexafemme)300 mg taken twice per day 12 hours apart for total of 600 mg150-mg tablet$520


No serious adverse effects were reported in the phase 3 clinical studies of ibrexafungerp. Based on findings from animal studies that resulted in fetal malformations, the medication is contraindicated in pregnant patients. Patients of reproductive age should be tested for pregnancy before initiation of ibrexafungerp. Contraception should be used during treatment and for four days after the last dose. Use of ibrexafungerp should be avoided in premenarchal female patients because safety and effectiveness have not been established in this population.

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