Brexafemme Side Effects: What You Need to Know

Brexafemme (Ibrexafungerp) is a prescription antifungal medication used to treat vaginal yeast infections and prevent them from coming back. Like all medications, it can cause side effects. The good news is that most side effects are mild and short-lived — after all, the typical treatment is just one day of medication.

This guide covers the common and serious side effects of Brexafemme based on FDA clinical trial data, so you know exactly what to expect and when to seek medical attention.

What Is Brexafemme?

Brexafemme is a triterpenoid antifungal that works by blocking an enzyme called glucan synthase, which fungi need to build their cell walls. It's FDA-approved for treating vulvovaginal candidiasis (VVC) and reducing recurrent VVC in adult and postmenarchal females. For a deeper dive, see our guide on what Brexafemme is and how it's used.

The standard dose is 300 mg (two tablets) taken twice in one day, about 12 hours apart. For recurrent infections, this one-day dose is repeated monthly for 6 months.

Common Side Effects

In clinical trials, the most frequently reported side effects were gastrointestinal (stomach and digestive) symptoms. These usually appeared on the day of treatment and resolved within a day or two.

• Diarrhea — reported in about 16.7% of patients. This was the most common side effect.
• Nausea — reported in about 11.9% of patients.
• Abdominal pain — reported in about 11.4% of patients. This includes stomach cramps and discomfort.
• Dizziness — reported in about 3.3% of patients.
• Vomiting — reported in about 2.0% of patients.

These side effects make sense given that Brexafemme is taken as a relatively high dose in a single day. Your digestive system may react, but the symptoms are generally manageable and go away on their own.

Serious Side Effects

Serious side effects from Brexafemme are rare, but they're important to know about:

Embryo-Fetal Toxicity (Pregnancy Warning)

This is the most critical safety concern. Brexafemme is contraindicated in pregnancy. Animal studies showed it can cause harm to a developing fetus. Your doctor must verify that you are not pregnant before prescribing Brexafemme. If you are of reproductive age, you should use effective contraception during treatment and for 4 days after your last dose.

If you think you might be pregnant or become pregnant after taking Brexafemme, contact your doctor immediately.

Hypersensitivity Reactions

Some patients may experience allergic reactions, including rash. If you develop hives, difficulty breathing, swelling of the face or throat, or a severe skin rash after taking Brexafemme, seek medical attention right away.

Elevated Liver Enzymes

In some cases, Brexafemme may cause elevated transaminases (liver enzymes). This is usually detected through blood tests rather than symptoms. Your doctor may monitor your liver function if you have a history of liver problems.

Other Reported Effects

• Dysmenorrhea (painful periods)
• Vaginal bleeding

If you experience any unusual bleeding or severe menstrual pain after taking Brexafemme, let your doctor know.

Specific Populations

Pregnant Women

Brexafemme must not be taken during pregnancy. If you are pregnant or think you might be, tell your doctor immediately. There are safer alternatives for treating yeast infections during pregnancy, such as topical Clotrimazole or Miconazole (Monistat).

Breastfeeding

It's currently unknown whether Brexafemme passes into breast milk. If you're breastfeeding, talk to your doctor about the risks and benefits before taking this medication.

Adolescents

Brexafemme is approved for use in postmenarchal (have started having periods) pediatric females. It has not been studied in pre-menarchal girls.

People with Liver Problems

Because Brexafemme can affect liver enzymes, patients with existing liver conditions should discuss risks with their doctor before starting treatment.

How to Manage Common Side Effects

If you experience mild side effects from Brexafemme, here are some practical tips:

• For diarrhea: Stay hydrated by drinking plenty of water. Avoid greasy, spicy, or high-fiber foods on the day you take Brexafemme. An over-the-counter remedy like Loperamide (Imodium) can help if symptoms are bothersome.
• For nausea: Take Brexafemme with a small meal or snack. The medication can be taken with or without food, but eating something may ease nausea. Ginger tea or crackers may also help.
• For abdominal pain: Rest and apply a warm compress to your stomach. The discomfort should pass within a day.
• For dizziness: Avoid driving or operating heavy machinery if you feel dizzy. Sit or lie down until the feeling passes.

Remember, the entire treatment is typically just one day. Most side effects resolve within 24–48 hours.

When to Call Your Doctor

Contact your doctor or seek medical attention if you experience:

• Signs of an allergic reaction (rash, hives, swelling, difficulty breathing)
• Severe or persistent diarrhea, nausea, or vomiting
• Unusual vaginal bleeding
• Yellowing of the skin or eyes (possible sign of liver problems)
• You discover you are pregnant after taking Brexafemme

Final Thoughts

Brexafemme is generally well-tolerated, especially considering it's a one-day treatment. The most common side effects — diarrhea, nausea, and stomach pain — are usually mild and go away quickly. The most important safety point is to make sure you're not pregnant before taking it.

If you're considering Brexafemme, talk to your doctor about whether it's right for you. To learn more about how Brexafemme works or how to find it in stock, check out our other guides. Ready to fill your prescription? Search Medfinder to find a pharmacy with Brexafemme near you.